Comparison of Intra-arterial and Subcutaneous Testicular Hyaluronidase Injection Treatments and the Vascular Complications of Hyaluronic Acid Filler.

Wang M, Li W, Zhang Y, Tian W, Wang H. Dermatol Surg. February 2017; 43 (2): 246-254. doi: 10.1097/DSS.00000000000000955.PMID: 27930375

Abstract: Hyaluronidase is a key treatment against vascular complications of hyaluronic acid (HA) filler injection, but the degradation profile of HA in hyaluronidase is such and the comparison between an intra-arterial and subcutaneous part of hyaluronid is not studied.

Objective: To evaluate the degradation of HA in hyaluronidase and compare different intermediate methods in intra-arterial and subcutaneous testicular hyaluronidase injections.

Materials and methods: The authors observed the degradation of HA by hyaluronidase in vitro through microscopic particle analysis. Rabbit ears were used for the in vivo study. There were 2 control groups with arterial HA body emboli and 2 groups treated with hyaluronidase in different regions. Laser Doppler blood perfusion monitoring measurements were made at the time point of the society and biopsy on day 2.

Results: Almost all HAs were degraded in vitro at the 1-hour time point. Subcutaneous treatment with hyaluronidase showed better recovery of blood perfusion. Histology showed severe in the group of embolism and impact in their groups.

Conclusion: A complete degradation of the enzyme and complement with HA by hyaluronidase requires a certain time and subcutaneous treatment with hyaluronidase may be the best option.