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【临床并发症文献】软组织填充物并发症的治疗:专家共识

Treatment of Soft Tissue Filler Complications

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【 文献重点摘要 】
 

Background: Dermal fillers have been increasingly used in minimally invasive facial esthetic procedures. This wide-spread use has led to a rise in reports of associated complications. The aim of this expert consensus report is to describe potential adverse events associated with dermal fillers and to provide guidance on their treatment and avoidance.

 

Methods: A multidisciplinary group of experts in esthetic treatments convened to discuss the management of the complications associated with dermal fillers use. A search was performed for English, French, and Spanish language articles in MEDLINE, the Cochrane Database, and Google Scholar using the search terms ‘‘complications’’ OR ‘‘soft filler complications’’ OR ‘‘injectable complications’’ AND ‘‘dermal fillers’’ AND ‘‘Therapy’’. An initial document was drafted by the Coordinating Committee, and it was reviewed and modified by the experts, until a final text was agreed upon and validated.

 

Results: The panel addressed consensus recommendations about the classification of filler complications according to the time of onset and about the clinical management of different complications including bruising, swelling, edema, infections, lumps and bumps, skin discoloration, and biofilm formation. Special attention was paid to vascular compromise and retinal artery occlusion.

 

Conclusions: Clinicians should be fully aware of the signs and symptoms related to complications and be prepared to confidently treat them. Establishing action protocols for emergencies, with agents readily available in the office, would reduce the severity of adverse outcomes associated with injection of hyaluronic acid fillers in the cosmetic setting. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for clinicians who are starting to use dermal fillers. Additionally, this document provides a better understanding about the diagnoses and management of complications if they do occur.

 

Keywords: Esthetic procedures, Dermal fillers, Complications, Treatment

 

背景:真皮填充物已越来越多地用于微创面部美容手术。这种广泛的使用导致了相关并发症报告的增加。这份专家共识报告的目的是描述与真皮填充物相关的潜在不良事件,并就其治疗和避免提供指导。

 

方法:由美容治疗专家组成的多学科小组召开会议,讨论真皮填充物使用相关并发症的处理。检索MEDLINE、Cochrane数据库和Google Scholar中的英文、法文和西班牙文文章,检索词为“Complex”、“Soft Fill Complex”、“or”、“Injectable Complex”和“Healthofers”和“Treatment”,检索词为“Complex”或“Soft Fill Complex”或“Injectable Componers”和“Treatment”。协调委员会起草了一份初步文件,专家们对其进行了审查和修改,直到商定并确认了最后案文。

 

结果:专家小组就填充物并发症根据发病时间的分类以及不同并发症(包括瘀伤、肿胀、水肿、感染、肿块和肿块、皮肤变色和生物膜形成)的临床处理提出了一致的建议。特别注意血管损害和视网膜动脉阻塞。

 

结论:临床医师应充分认识与并发症相关的体征和症状,并做好自信的治疗准备。制定紧急情况下的行动方案,并在办公室随时提供代理,将降低与化妆品环境中注射透明质酸填充物相关的不良后果的严重程度。本文旨在提出一系列建议,并找出可能有用的关键问题适用于开始使用真皮填充物的临床医生。此外,本文档还提供了对并发症(如果确实发生)的诊断和管理的更好的理解。

 

关键词:美容手术;真皮填充物;并发症;治疗

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