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Cross-linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios.
Dermatol Ther. 2020 Feb 14 [Online ahead of print]DT

Abstract

Skin necrosis is the most severe complication arising from hyaluronic acid (HA) injection. To avoid skin necrosis, hyaluronidase should be injected along the course of the involved artery, to allow blood flow restoration. We evaluated the ability of hyaluronidase to degrade a HA filler in two simulated clinical situations-a compression case and an embolization case-to identify differences in the hyaluronidase injection. In the compression case, a bolus of HA filler was directly soaked in hyaluronidase solution; in the embolization case, a vein harvested from a living patient was filled with the same HA filler and then soaked in hyaluronidase. We then evaluated the quantity of HA remaining after 2 hr. While we found hydrolysis of HA in both cases, in the compression case, we detected almost complete hydrolysis, whereas in the embolization case we observed a reduction of the 60%. Our results support the hypothesis that vessel compression can be resolved with only one injection of hyaluronidase, while in the case of vascular embolization, repeated perivascular injections should be performed owing to the reduction of hyaluronidase activity.

Authors+Show Affiliations

Maxillo-Facial Complex Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Dermatology, University of Insubria, Varese, Italy.Pathological Anatomy Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.Maxillo-Facial Surgery, University Federico II, Naples, Italy.Pathological Anatomy Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.Maxillo-Facial Surgery Complex Unit, University of Parma, Parma, Italy.Maxillo-Facial Complex Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.Maxillo-Facial Complex Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32061001

Citation

Rauso, Raffaele, et al. "Cross-linked Hyaluronic Acid Filler Hydrolysis With Hyaluronidase: Different Settings to Reproduce Different Clinical Scenarios." Dermatologic Therapy, 2020, pp. e13269.
Rauso R, Zerbinati N, Franco R, et al. Cross-linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios. Dermatol Ther. 2020.
Rauso, R., Zerbinati, N., Franco, R., Chirico, F., Ronchi, A., Sesenna, E., Colella, G., & Tartaro, G. (2020). Cross-linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios. Dermatologic Therapy, e13269. https://doi.org/10.1111/dth.13269
Rauso R, et al. Cross-linked Hyaluronic Acid Filler Hydrolysis With Hyaluronidase: Different Settings to Reproduce Different Clinical Scenarios. Dermatol Ther. 2020 Feb 14;e13269. PubMed PMID: 32061001.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cross-linked hyaluronic acid filler hydrolysis with hyaluronidase: Different settings to reproduce different clinical scenarios. AU - Rauso,Raffaele, AU - Zerbinati,Nicola, AU - Franco,Renato, AU - Chirico,Fabrizio, AU - Ronchi,Andrea, AU - Sesenna,Enrico, AU - Colella,Giuseppe, AU - Tartaro,Gianpaolo, Y1 - 2020/02/14/ PY - 2019/11/10/received PY - 2020/01/21/revised PY - 2020/02/11/accepted PY - 2020/2/16/pubmed PY - 2020/2/16/medline PY - 2020/2/16/entrez KW - embolism KW - hyaluronic acid KW - hyaluronidase KW - impending necrosis KW - vessel compression SP - e13269 EP - e13269 JF - Dermatologic therapy JO - Dermatol Ther N2 - Skin necrosis is the most severe complication arising from hyaluronic acid (HA) injection. To avoid skin necrosis, hyaluronidase should be injected along the course of the involved artery, to allow blood flow restoration. We evaluated the ability of hyaluronidase to degrade a HA filler in two simulated clinical situations-a compression case and an embolization case-to identify differences in the hyaluronidase injection. In the compression case, a bolus of HA filler was directly soaked in hyaluronidase solution; in the embolization case, a vein harvested from a living patient was filled with the same HA filler and then soaked in hyaluronidase. We then evaluated the quantity of HA remaining after 2 hr. While we found hydrolysis of HA in both cases, in the compression case, we detected almost complete hydrolysis, whereas in the embolization case we observed a reduction of the 60%. Our results support the hypothesis that vessel compression can be resolved with only one injection of hyaluronidase, while in the case of vascular embolization, repeated perivascular injections should be performed owing to the reduction of hyaluronidase activity. SN - 1529-8019 UR - https://www.unboundmedicine.com/medline/citation/32061001/Cross-linked_hyaluronic_acid_filler_hydrolysis_with_hyaluronidase:_different_settings_to_reproduce_different_clinical_scenarios L2 - https://doi.org/10.1111/dth.13269 DB - PRIME DP - Unbound Medicine ER -
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