Hyaluronidase Protocol in Management of Hyaluronic Acid Filler-Related Vascular Complications: A Systematic Review and Meta-Analysis.
Abstract
[BACKGROUND] Hyaluronic acid (HA) fillers are widely used in aesthetic procedures but can lead to serious vascular complications, including skin necrosis and visual impairment. The timely administration of hyaluronidase (HYAL) is critical for mitigating these adverse effects. This systematic review and meta-analysis aim to evaluate the efficacy and propose a management protocol of HYAL in managing HA-related vascular complications.
[METHODS] A comprehensive literature search was conducted across MEDLINE, PubMed, Cochrane, and Web of Science for studies published from 2000 to February 2025. Eligible studies included randomized controlled trials, cohort studies, and case series involving HYAL treatment for HA-related complications. Data extraction focused on treatment protocols, patient demographics, outcomes, and resolution rates.
[RESULTS] Twenty-one studies involving 231 patients were included. The mean age was 30.1 years, with a predominance of female patients (90.9%). Skin necrosis occurred in 60.6% of cases and visual impairment in 52.8%. The overall resolution rates for skin necrosis and visual impairment were 78.4% and 45.2%, respectively. Early intervention (within 6 hours) significantly improved outcomes, with higher doses of HYAL correlating with better resolution rates in skin necrosis.
[CONCLUSION] This study underscores the effectiveness of hyaluronidase in treating HA-related vascular complications, particularly when administered promptly. The findings support the establishment of standardized treatment protocols to enhance patient safety and outcomes in aesthetic practices. Future research should focus on optimizing dosing strategies and further elucidating the role of adjunctive therapies.
[LEVEL OF EVIDENCE IV] 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 .
[METHODS] A comprehensive literature search was conducted across MEDLINE, PubMed, Cochrane, and Web of Science for studies published from 2000 to February 2025. Eligible studies included randomized controlled trials, cohort studies, and case series involving HYAL treatment for HA-related complications. Data extraction focused on treatment protocols, patient demographics, outcomes, and resolution rates.
[RESULTS] Twenty-one studies involving 231 patients were included. The mean age was 30.1 years, with a predominance of female patients (90.9%). Skin necrosis occurred in 60.6% of cases and visual impairment in 52.8%. The overall resolution rates for skin necrosis and visual impairment were 78.4% and 45.2%, respectively. Early intervention (within 6 hours) significantly improved outcomes, with higher doses of HYAL correlating with better resolution rates in skin necrosis.
[CONCLUSION] This study underscores the effectiveness of hyaluronidase in treating HA-related vascular complications, particularly when administered promptly. The findings support the establishment of standardized treatment protocols to enhance patient safety and outcomes in aesthetic practices. Future research should focus on optimizing dosing strategies and further elucidating the role of adjunctive therapies.
[LEVEL OF EVIDENCE IV] 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 .
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 합병증 | skin necrosis
|
괴사 | dict | 4 | |
| 재료 | ha
|
히알루론산 | dict | 4 | |
| 재료 | hyaluronic acid
|
히알루론산 | dict | 2 | |
| 시술 | hyaluronic acid filler
|
필러 주입술 | dict | 1 |
MeSH Terms
Humans; Hyaluronoglucosaminidase; Hyaluronic Acid; Dermal Fillers; Cosmetic Techniques; Necrosis; Skin; Treatment Outcome; Female; Skin Aging; Adult
📑 인용 관계
이 논문이 참조한 문헌 30
- How Should We Use Hyaluronidase for Dissolving Hyaluronic Acid Fillers?
- Hyaluronic acid filler-induced vascular occlusion-Three case reports and overview of prevention and …
- Early ultrasound for diagnosis and treatment of vascular adverse events with hyaluronic acid fillers…
- Case series of tongue necrosis from vascular complications after chin augmentation with hyaluronic a…
- Efficacy of Percutaneous Intraarterial Facial/Supratrochlear Arterial Hyaluronidase Injection for Tr…
- Efficacy of intra-arterial thrombolytic therapy for vision loss resulting from hyaluronic acid fille…
- Guideline for the Management of Hyaluronic Acid Filler-induced Vascular Occlusion.
- Treatment of skin soft tissue embolism after hyaluronic acid injection for injection rhinoplasty in …
- Management of Delayed Skin Necrosis Following Hyaluronic Acid Filler Injection Using Pulsed Hyaluron…
- Intravenous Hyaluronidase for Visual Loss Secondary to Filler Injection: A Novel Therapeutic Approac…
- The Risk of Skin Necrosis Following Hyaluronic Acid Filler Injection in Patients With a History of C…
- The Role of Anastomotic Vessels in Controlling Tissue Viability and Defining Tissue Necrosis with Sp…
- Efficacy of Retrobulbar Hyaluronidase Injection for Vision Loss Resulting from Hyaluronic Acid Fille…
- New High Dose Pulsed Hyaluronidase Protocol for Hyaluronic Acid Filler Vascular Adverse Events.
- Clinical Outcomes of Impending Nasal Skin Necrosis Related to Nose and Nasolabial Fold Augmentation …
- Transarterial degradation of hyaluronic acid filler by hyaluronidase.
🔗 함께 등장하는 도메인
이 논문이 속한 카테고리와 같은 논문에서 자주 함께 다뤄지는 카테고리들
관련 논문
- Penetrating globe injury following periocular hyaluronic acid filler injection: A case report.
- Choroidal ischemia after self-injection of hyaluronic acid filler.
- Intra-articular therapies for synovial joint dysfunction: a comprehensive integrative review.
- Clinical safety of a low-modification hyaluronic acid filler (MoD 2%) for facial rejuvenation.
- Case report of a rare soft tissue tuberculosis in a patient undergoing lipoabdominoplasty.