Hyaluronic Acid Embolism Treated with Subcutaneous High and Low Hyaluronidase Doses: Efficacy and Surrounding Tissue Effect.

Autor:	Salinas-Alvarez Y; From the Human Anatomy and Histology Departments, Universidad Autonoma de Nuevo Leon, School of Medicine; and Department of Dermatology, Universidad Autonoma de Nuevo Leon, University Hospital., Welsh EC; From the Human Anatomy and Histology Departments, Universidad Autonoma de Nuevo Leon, School of Medicine; and Department of Dermatology, Universidad Autonoma de Nuevo Leon, University Hospital., Soto-Dominguez A; From the Human Anatomy and Histology Departments, Universidad Autonoma de Nuevo Leon, School of Medicine; and Department of Dermatology, Universidad Autonoma de Nuevo Leon, University Hospital., Quiroga-Garza A; From the Human Anatomy and Histology Departments, Universidad Autonoma de Nuevo Leon, School of Medicine; and Department of Dermatology, Universidad Autonoma de Nuevo Leon, University Hospital., Hernandez-Garate YAK; From the Human Anatomy and Histology Departments, Universidad Autonoma de Nuevo Leon, School of Medicine; and Department of Dermatology, Universidad Autonoma de Nuevo Leon, University Hospital., De-La-Garza-Castro O; From the Human Anatomy and Histology Departments, Universidad Autonoma de Nuevo Leon, School of Medicine; and Department of Dermatology, Universidad Autonoma de Nuevo Leon, University Hospital., Elizondo-Omaña RE; From the Human Anatomy and Histology Departments, Universidad Autonoma de Nuevo Leon, School of Medicine; and Department of Dermatology, Universidad Autonoma de Nuevo Leon, University Hospital., Guzman-Lopez S; From the Human Anatomy and Histology Departments, Universidad Autonoma de Nuevo Leon, School of Medicine; and Department of Dermatology, Universidad Autonoma de Nuevo Leon, University Hospital.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2021 Dec 01; Vol. 148 (6), pp. 1281-1288.
DOI:	10.1097/PRS.0000000000008523
Abstrakt:	Background: The use of hyaluronidase in hyaluronic acid vascular occlusion has been evaluated; however, the models used do not accurately assimilate the facial morphologic characteristics or study the effects on adjacent tissues. The purpose of this study was to determine an effective concentration of subcutaneous hyaluronidase to dissolve a hyaluronic acid embolism and its effect on surrounding tissue. Methods: Fifteen rabbits were divided into six groups. An inguinal incision was performed on the femoral artery to create a hyaluronic acid embolism in the control and treatment groups (low-, medium-, and high-hyaluronidase groups). Hyaluronidase was injected subcutaneously. Photographic follow-up, histologic analysis, and quantification of hyaluronic acid were performed. Kruskal-Wallis test and post hoc with Bonferroni correction (p < 0.05) was used to compare the presence of hyaluronic acid in the arterial lumen between groups. Results: Despite the persistence of intravascular hyaluronic acid, macroscopic and microscopic differences were found between the embolism control group and embolism hyaluronidase high-dose group. Histologic analysis demonstrated thrombosis throughout groups. Skeletal muscle was least affected in the embolism hyaluronidase 500 IU group with less lysis and inflammatory infiltrate. Conclusions: A 500 IU hyaluronidase dose partially prevents the damage caused by the embolism, and does not affect the surrounding tissue. The use of thrombolytic therapy combined with higher doses of hyaluronidase subcutaneously in this model is proposed. Competing Interests: Disclosure:The authors have no financial interests and no conflicts of interest to declare. The study was not supported by any funding source. (Copyright © 2021 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu