Lim Young, Wulkan Adam, Avram Mathew
Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Department of Dermatology, Lahey Clinic, Burlington, Massachusetts, USA.
Lasers Surg Med. 2023 Jan;55(1):146-151. doi: 10.1002/lsm.23592. Epub 2022 Aug 2.
Noninvasive cosmetic procedures have continued to gain popularity, owing to their short, in-office treatments combined with little to no downtime. These procedures are also highly accessible, even offered at medical spas by nonphysician operators. The coronavirus disease 2019 (COVID-19) pandemic also saw heightened interest in all cosmetic procedures, presumably as social distancing and stay-at-home orders allotted time and space for postop recovery. As the market for these procedures expand, a thorough understanding of potential adverse events is critical for providers to better counsel their patients on risks and expectations when obtaining informed consent.
We employed the Food and Drug Administration (FDA's) Manufacturer and User Facility Device Experience (MAUDE) database (http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/search.cfm), which compiles medical device reports (MDRs) for suspected injuries from device use or malfunction, submitted by manufactures and operators. We focused our query on three main categories: noninvasive body contouring, cellulite treatments, and muscle stimulation therapies that utilize electromagnetic energy. The query was performed in February 2022 using a comprehensive list of product names and manufacturers.
The initial search yielded 827 MDRs, which were individually reviewed for duplicate reports or insufficient data. Ultimately, 723 MDRs were analyzed (660 for noninvasive body contouring, 55 for cellulite treatment, and 8 for muscle stimulation). Paradoxical hyperplasia accounted for the majority of MDRs for noninvasive body contouring, while burns and scars were most common for muscle stimulation and cellulite treatments, respectively. Of the 7-year span we surveyed, 2021 accounted for 515 of the 723 total assessed MDRs (71.2%), the majority of which were from cryolipolysis procedures.
The MAUDE database remains an essential tool to monitor potential adverse events of medical devices, including those utilized for noninvasive, cosmetic procedures. Insight from the MAUDE database can be clinically translated when discussing treatment options with patients, helping to optimize patient safety and satisfaction.
非侵入性美容手术因治疗时间短、可在诊所内进行且几乎无需停工而持续受到欢迎。这些手术也极易获得,甚至非医生操作人员也可在医疗美容中心提供此类服务。2019年冠状病毒病(COVID-19)大流行期间,人们对所有美容手术的兴趣也有所增加,这可能是因为社交距离和居家令为术后恢复留出了时间和空间。随着这些手术市场的扩大,全面了解潜在不良事件对于医疗服务提供者在获取知情同意时更好地向患者提供风险和预期建议至关重要。
我们使用了美国食品药品监督管理局(FDA)的制造商和用户设施设备经验(MAUDE)数据库(http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/search.cfm),该数据库汇编了制造商和操作人员提交的关于因使用设备或设备故障导致的疑似伤害的医疗器械报告(MDR)。我们将查询重点放在三个主要类别上:非侵入性身体塑形、脂肪团治疗以及利用电磁能量的肌肉刺激疗法。该查询于2022年2月使用产品名称和制造商的综合列表进行。
初步搜索产生了827份MDR,我们对其进行了逐一审查,以查找重复报告或数据不足的情况。最终,分析了723份MDR(非侵入性身体塑形660份、脂肪团治疗55份、肌肉刺激8份)。矛盾性增生在非侵入性身体塑形的MDR中占大多数,而烧伤和疤痕分别是肌肉刺激和脂肪团治疗中最常见的情况。在我们调查的7年时间跨度内,2021年占723份评估MDR总数的515份(71.2%),其中大多数来自冷冻溶脂手术。
MAUDE数据库仍然是监测医疗器械潜在不良事件的重要工具,包括用于非侵入性美容手术的器械。在与患者讨论治疗方案时,MAUDE数据库的见解可转化为临床应用,有助于优化患者安全性和满意度。