【临床并发症文献】了解避免和管理皮肤填充剂并发症
Understanding Avoiding and Managing Complications
【 文献重点摘要 】
Background: Dermal fillers are increasingly being utilized for multiple cosmetic dermatology indications. The appeal of these products can be partly attributed to their strong safety profiles. Nevertheless, complications can sometimes occur.
Objective: To summarize the complications associated with each available dermal filling agent, strategies to avoid them, and management options if they do arise.
Methods and Materials: Complications with dermal fillers reported in peer-reviewed publications, prescribing information, and recent presentations at professional meetings were reviewed. Recommendations for avoiding and managing complications are provided, based on the literature review and the author’s experience.
Results: Inappropriate placement or superficial placement is one of the most frequent reasons for patient dissatisfaction. Due to the reversibility of hyaluronic acid, complications from these fillers can be easily corrected. Sensitivity to any of the currently approved FDA products is quite rare and can usually be managed with anti-inflammatory agents. Infection is quite uncommon as well and can usually be managed with either antibiotics or antivirals depending on the clinical features. The most concerning complication is cutaneous necrosis, and a protocol to treat the full spectrum of this process is reviewed.
Conclusions: Complications with dermal fillers are infrequent, and strategies to minimize their incidence and impact are easily deployed. Familiarity with each family of soft-tissue augmentation products, potential complications, and their management will optimize the use of these agents.
背景:真皮填充物越来越多地被用于多种美容皮肤病适应症。这些产品的吸引力在一定程度上可以归因于它们强大的安全性。然而,有时也会出现并发症。
目的:总结与各种可用皮肤填充剂相关的并发症,避免这些并发症的策略,以及出现这些并发症时的处理方案。
方法和材料:对同行评议的出版物、处方信息和最近在专业会议上发表的关于真皮填充物并发症的报道进行综述。在文献回顾和作者经验的基础上,提出了避免和处理并发症的建议。
结果:放置不当或放置肤浅是导致患者不满意的最常见原因之一。由于透明质酸的可逆性,这些填充物的并发症可以很容易地纠正。对目前批准的任何FDA产品的敏感性都是相当罕见的,通常可以用抗炎药来控制。感染也相当罕见,通常可以根据临床特征使用抗生素或抗病毒药物进行治疗。最令人关注的并发症是皮肤坏死,并回顾了治疗这一过程的全过程的方案。
结论:真皮填充物的并发症很少见,并且很容易采取策略将其发生率和影响降至最低。熟悉每一系列软组织增强产品、潜在的并发症及其管理将优化这些药物的使用。