Madero-Pérez Javier, Gil-Martinez Marta, Muñoz-Gonzalez Cristina, Martin-Marfil Paula, Fakih-Gomez Nabil
Jaume I University, Castellón de la Plana, Spain.
Critical Care Unit, Consorcio Hospitalario Provincial de Castellón, Castellón de la Plana, Spain.
Aesthetic Plast Surg. 2025 Jul;49(14):4043-4056. doi: 10.1007/s00266-025-04808-w. Epub 2025 Mar 31.
The rise in clinical procedures utilizing dermal fillers necessitates preparedness for potential emergencies. Effective management of complications arising from filler use, including vascular occlusions and allergic reactions, hinges on the availability of the appropriate pharmacological supplies.
A two-tiered search in PubMed and Google Scholar was conducted to identify essential drugs for dermal filler emergencies. An initial 10-year review used keywords "Dermal Fillers," "vascular occlusion," and "hyaluronidase," followed by a targeted search on "Resuscitation guidelines," "anaphylaxis management," "allergy fillers," and "lidocaine." This article outlines the critical drug inventory for emergency kits to manage filler-related complications effectively.
An ORA classification system (Obligatory, Recommended, Advisable) is introduced to categorize essential drugs according to urgency and clinical necessity. The required drugs are grouped based on their application in cases of vascular occlusion without ocular involvement, vascular occlusion with ocular involvement, anaphylactic reactions, cardiopulmonary resuscitation and hemodynamic disorders, delayed reactions, and aseptic, oxygen, and topical treatments. Additionally, the importance of meticulous drug inventory management-including tracking of stock entry, exit, and expiration dates-is emphasized to reduce the risk of shortages.
Ensuring that filler emergency kit is well stocked with vital pharmacological supplies is imperative for effective emergency management during filler procedures. Adopting systematic inventory practices and utilizing the ORA classification can enhance preparedness and patient safety.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
使用真皮填充剂的临床手术数量不断增加，这就需要为潜在的紧急情况做好准备。有效管理填充剂使用引起的并发症，包括血管阻塞和过敏反应，取决于是否有合适的药物供应。
在PubMed和谷歌学术上进行了两级搜索，以确定用于真皮填充剂紧急情况的基本药物。最初的10年回顾使用了关键词“真皮填充剂”、“血管阻塞”和“透明质酸酶”，随后对“复苏指南”、“过敏反应管理”、“填充剂过敏”和“利多卡因”进行了针对性搜索。本文概述了应急包中有效管理与填充剂相关并发症所需的关键药物清单。
引入了ORA分类系统（强制性、推荐性、建议性），根据紧迫性和临床必要性对基本药物进行分类。所需药物根据其在无眼部受累的血管阻塞、有眼部受累的血管阻塞、过敏反应、心肺复苏和血流动力学障碍、延迟反应以及无菌、氧气和局部治疗中的应用进行分组。此外，强调了细致的药物库存管理的重要性，包括跟踪库存的出入库和过期日期，以降低短缺风险。
确保填充剂应急包中备有重要的药物供应对于填充剂手术期间的有效应急管理至关重要。采用系统的库存管理方法并使用ORA分类可以提高准备程度和患者安全性。
证据水平V：本杂志要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
