Hyaluronic Acid Embolism Treated with Subcutaneous High and Low Hyaluronidase Doses: Efficacy and Surrounding Tissue Effect
| Autor: | Santos Guzmán-López, Rodrigo Enrique Elizondo-Omaña, Yenitzeh Ana Karen Hernández-Garate, Yolanda Salinas-Alvarez, Alejandro Quiroga-Garza, Esperanza C Welsh, Adolfo Soto-Domínguez, Oscar de-la-Garza-Castro |
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| Rok vydání: | 2021 |
| Předmět: |
Pathology
medicine.medical_specialty Post hoc Injections Subcutaneous Embolism Hyaluronoglucosaminidase Femoral artery Vascular occlusion chemistry.chemical_compound Hyaluronidase medicine.artery Dermal Fillers Hyaluronic acid medicine Animals Humans Hyaluronic Acid Dose-Response Relationship Drug business.industry Skeletal muscle medicine.disease Thrombosis Disease Models Animal medicine.anatomical_structure chemistry Injections Intra-Arterial Surgery Rabbits medicine.symptom business medicine.drug |
| Zdroj: | Plastic and reconstructive surgery. 148(6) |
| ISSN: | 1529-4242 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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