Transcutaneous oxygen tension-guided hyperbaric oxygen therapy for preventing skin necrosis after hyaluronic acid filler injections.

[INTRODUCTION] Hyaluronic acid (HA) fillers, popular for facial cosmetic enhancements, pose risks of vascular complications like skin necrosis due to arterial blockage, necessitating effective treatments such as hyperbaric oxygen therapy (HBOT).

[METHODOLOGY] This study presents a series of cases where measurements of transcutaneous oxygen pressure (TcPO) informed the application of HBOT for skin necrosis induced by HA.

[CLINICAL PRESENTATION AND OUTCOMES] In cases 1 and 3, following the injection of HA, potential skin necrosis was observed. In addition to standard treatment, TcPO revealed values below 40 mmHg, indicating tissue hypoxia. Treatment with HBOT increased TcPO levels to above 200 mmHg, suggesting that HBOT could correct the hypoxia. Monitoring TcPO levels also aided in determining the optimal time to discontinue HBOT. In cases 2 and 4, patients received standard treatment, resulting in TcPO levels above 40 mmHg, indicating adequate tissue oxygenation, and no additional HBOT was administered. All four patients mentioned above showed good clinical recovery.

[CONCLUSION] This study investigates the application of TcPO measurement technology in aiding decisions on whether to utilize HBOT in the treatment of complications arising from HA fillers, as well as in optimizing HBOT protocols.