Skip to main content
Erschienen in: Aesthetic Plastic Surgery 3/2016

26.04.2016 | Original Article

An Islanded Rabbit Auricular Skin Flap Model of Hyaluronic Acid Injection-Induced Embolism

verfasst von: Yan Zhuang, Mingyong Yang, Chunjun Liu

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Background

Hyaluronic acid (HA) injection-induced embolism is a rare but severe complication. This article is aimed to introduce an islanded rabbit auricular skin flap model of HA injection-induced embolism and to study its pathophysiological progress.

Methods

An islanded skin flap was elevated based on the proximal central auricular artery/vein. Eighteen rabbits were randomized into three groups. Ten, twenty, and forty microliters of HA were injected into the central auricular artery in each group, respectively. Flap fluorescence angiography was performed. One-way ANOVA was used to compare fluorescence area at different time points and between dose groups. Two rabbits in each group were randomly chosen for histology examination. In addition to regular HE staining, Alcian Blue staining was performed to better show the existence of HA in the vessel lumen.

Results

The mean calculated fluorescence area was 64.41 % on POD 1, 79.77 % on POD 3, 88.20 % on POD 5, and 92.03 % on POD 7 in 10 μl group; 60.51 % on POD 1, 58.84 % on POD 3, 71.20 % on POD 5, and 76.54 % on POD 7 in 20 μl group; 21.60 % on POD 1, 3.08 % on POD 3, 2.91 % on POD 5, and 7.52 % on POD 7 in 40 μl group. In all three groups, infiltration of eosinophilic granulocytes was observed in the muscular layer of both artery and vein.

Conclusion

Our study successfully created a rabbit auricular skin necrosis model of HA embolism, which provided a valuable animal model for further investigation of the pathophysiological progress and the efficacy of potential treatments.

No Level Assigned

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literatur
2.
Zurück zum Zitat Ozturk CN, Li Y, Tung R, Parker L, Piliang MP, Zins JE (2013) Complications following injection of soft-tissue fillers. Aesthetic Surg J 33(6):862–877CrossRef Ozturk CN, Li Y, Tung R, Parker L, Piliang MP, Zins JE (2013) Complications following injection of soft-tissue fillers. Aesthetic Surg J 33(6):862–877CrossRef
3.
Zurück zum Zitat DeLorenzi C (2014) Complications of injectable fillers, part 2: vascular complications. Aesthetic Surg J 34(4):584–600CrossRef DeLorenzi C (2014) Complications of injectable fillers, part 2: vascular complications. Aesthetic Surg J 34(4):584–600CrossRef
4.
Zurück zum Zitat Funt D, Pavicic T (2015) Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Plast Surg Nurs 35(1):13–32CrossRefPubMed Funt D, Pavicic T (2015) Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Plast Surg Nurs 35(1):13–32CrossRefPubMed
5.
Zurück zum Zitat Chang SH, Yousefi S, Qin J et al (2015) External compression versus intravascular injection: a mechanistic animal model of filler-induced tissue ischemia. Ophthal Plast Reconstr Surg. doi:10.1097/IOP.0000000000000484 Chang SH, Yousefi S, Qin J et al (2015) External compression versus intravascular injection: a mechanistic animal model of filler-induced tissue ischemia. Ophthal Plast Reconstr Surg. doi:10.​1097/​IOP.​0000000000000484​
6.
Zurück zum Zitat Nonomura S, Oshitari T, Miura G, Chiba A, Yamamoto S (2014) A case of ophthalmic artery occlusion following injection of hyaluronic acid into the glabellar area. Nippon Ganka Gakkai Zasshi. 118(9):783–787PubMed Nonomura S, Oshitari T, Miura G, Chiba A, Yamamoto S (2014) A case of ophthalmic artery occlusion following injection of hyaluronic acid into the glabellar area. Nippon Ganka Gakkai Zasshi. 118(9):783–787PubMed
7.
Zurück zum Zitat Sung HM, Suh IS, Lee HB, Tak KS, Moon KM, Jung MS (2012) Case reports of adipose-derived stem cell therapy for nasal skin necrosis after filler injection. Arch Plast Surg 39(1):51–54CrossRefPubMedPubMedCentral Sung HM, Suh IS, Lee HB, Tak KS, Moon KM, Jung MS (2012) Case reports of adipose-derived stem cell therapy for nasal skin necrosis after filler injection. Arch Plast Surg 39(1):51–54CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Kwon SG, Hong JW, Roh TS, Kim YS, Rah DK, Kim SS (2013) Ischemic oculomotor nerve palsy and skin necrosis caused by vascular embolization after hyaluronic acid filler injection: a case report. Ann Plast Surg 71(4):333–334CrossRefPubMed Kwon SG, Hong JW, Roh TS, Kim YS, Rah DK, Kim SS (2013) Ischemic oculomotor nerve palsy and skin necrosis caused by vascular embolization after hyaluronic acid filler injection: a case report. Ann Plast Surg 71(4):333–334CrossRefPubMed
9.
Zurück zum Zitat Kim YJ, Kim SS, Song WK, Lee SY, Yoon JS (2011) Ocular ischemia with hypotony after injection of hyaluronic acid gel. Ophthalmic Plast Reconstr Surg 27(6):e152–e155CrossRef Kim YJ, Kim SS, Song WK, Lee SY, Yoon JS (2011) Ocular ischemia with hypotony after injection of hyaluronic acid gel. Ophthalmic Plast Reconstr Surg 27(6):e152–e155CrossRef
10.
Zurück zum Zitat Grunebaum LD, Allemann IB, Dayan S, Mandy S, Baumann L (2009) The risk of alar necrosis associated with dermal filler injection. Dermatol Surg 35(Suppl 2):1635–1640CrossRefPubMed Grunebaum LD, Allemann IB, Dayan S, Mandy S, Baumann L (2009) The risk of alar necrosis associated with dermal filler injection. Dermatol Surg 35(Suppl 2):1635–1640CrossRefPubMed
11.
Zurück zum Zitat Kim EG, Eom TK, Kang SJ (2014) Severe visual loss and cerebral infarction after injection of hyaluronic acid gel. J Craniofac Surg 25(2):684–686CrossRefPubMed Kim EG, Eom TK, Kang SJ (2014) Severe visual loss and cerebral infarction after injection of hyaluronic acid gel. J Craniofac Surg 25(2):684–686CrossRefPubMed
12.
Zurück zum Zitat Kim DW, Yoon ES, Ji YH, Park SH, Lee BI, Dhong ES (2011) Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management. J Plast Reconstr Aesthetic Surg 64(12):1590–1595CrossRef Kim DW, Yoon ES, Ji YH, Park SH, Lee BI, Dhong ES (2011) Vascular complications of hyaluronic acid fillers and the role of hyaluronidase in management. J Plast Reconstr Aesthetic Surg 64(12):1590–1595CrossRef
13.
Zurück zum Zitat Kassir R, Kolluru A, Kassir M (2011) Extensive necrosis after injection of hyaluronic acid filler: case report and review of the literature. J Cosmet Dermatol 10(3):224–231CrossRefPubMed Kassir R, Kolluru A, Kassir M (2011) Extensive necrosis after injection of hyaluronic acid filler: case report and review of the literature. J Cosmet Dermatol 10(3):224–231CrossRefPubMed
14.
Zurück zum Zitat Hirsch RJ, Lupo M, Cohen JL, Duffy D (2007) Delayed presentation of impending necrosis following soft tissue augmentation with hyaluronic acid and successful management with hyaluronidase. J Drugs Dermatol 6(3):325–328PubMed Hirsch RJ, Lupo M, Cohen JL, Duffy D (2007) Delayed presentation of impending necrosis following soft tissue augmentation with hyaluronic acid and successful management with hyaluronidase. J Drugs Dermatol 6(3):325–328PubMed
15.
Zurück zum Zitat Dayan SH, Arkins JP, Mathison CC (2011) Management of impending necrosis associated with soft tissue filler injections. J Drugs Dermatol 10(9):1007–1012PubMed Dayan SH, Arkins JP, Mathison CC (2011) Management of impending necrosis associated with soft tissue filler injections. J Drugs Dermatol 10(9):1007–1012PubMed
16.
Zurück zum Zitat Hirsch RJ, Cohen JL, Carruthers JD (2007) Successful management of an unusual presentation of impending necrosis following a hyaluronic acid injection embolus and a proposed algorithm for management with hyaluronidase. Dermatol Surg 33(3):357–360PubMed Hirsch RJ, Cohen JL, Carruthers JD (2007) Successful management of an unusual presentation of impending necrosis following a hyaluronic acid injection embolus and a proposed algorithm for management with hyaluronidase. Dermatol Surg 33(3):357–360PubMed
17.
Zurück zum Zitat Cohen JL, Biesman BS, Dayan SH et al (2015) Treatment of hyaluronic acid filler-induced impending necrosis with hyaluronidase: consensus recommendations. Aesthetic Surg J 35(7):844–849CrossRef Cohen JL, Biesman BS, Dayan SH et al (2015) Treatment of hyaluronic acid filler-induced impending necrosis with hyaluronidase: consensus recommendations. Aesthetic Surg J 35(7):844–849CrossRef
18.
Zurück zum Zitat Flynn TC, Sarazin D, Bezzola A, Terrani C, Micheels P (2011) Comparative histology of intradermal implantation of mono and biphasic hyaluronic acid fillers. Dermatol Surg 37(5):637–643CrossRefPubMed Flynn TC, Sarazin D, Bezzola A, Terrani C, Micheels P (2011) Comparative histology of intradermal implantation of mono and biphasic hyaluronic acid fillers. Dermatol Surg 37(5):637–643CrossRefPubMed
19.
Zurück zum Zitat DeLorenzi C (2014) Transarterial degradation of hyaluronic acid filler by hyaluronidase. Dermatol Surg 40(8):832–841CrossRefPubMed DeLorenzi C (2014) Transarterial degradation of hyaluronic acid filler by hyaluronidase. Dermatol Surg 40(8):832–841CrossRefPubMed
Metadaten
Titel
An Islanded Rabbit Auricular Skin Flap Model of Hyaluronic Acid Injection-Induced Embolism
verfasst von
Yan Zhuang
Mingyong Yang
Chunjun Liu
Publikationsdatum
26.04.2016
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 3/2016
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-016-0630-0

Weitere Artikel der Ausgabe 3/2016

Aesthetic Plastic Surgery 3/2016 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.