Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper

School

Zvart Onanian School of Nursing

Department

Nursing

Date of Original Version

4-23-2023

Abstract

Injectable dermal filler for cosmetic enhancement has become increasingly popular and accessible. As these procedures become more popular, it has become more important for providers to be competent in managing potential complications. Vascular occlusion from inadvertent injection into a vessel is a more serious complication of injectable dermal filler. Skin necrosis and scarring may follow if not properly treated in a timely manner, resulting in permanent tissue damage and unsatisfied patients. Studies have shown the efficacy of multi-modal management of dermal filler occlusions, but not at a high level of research given the ethical concerns barring randomized control trials. Among pharmacological management of dermal filler vascular occlusion is the use of hyaluronidase, an enzyme that breaks down hyaluronic acid, the primary make up of many dermal fillers. This use is off-label and does not come with standardized dosing or administration techniques. The purpose of this systematic review was to examine the current literature to study the efficacy of different methods of hyaluronidase injection for hyaluronic acid dermal filler vascular occlusion. This review was created using both PRISMA and ARRIVE 2.0 guidelines to vet the most recent literature. The author of this systematic review performed a cross-study analysis via data collection from four animal studies. These experiments provide evidence for dosage, frequency, timing, and technique of hyaluronidase administration. Providers may use this data to prepare for and manage vascular occlusions in their dermal filler patients, however, more data and higher-level studies in humans is necessary for future research.

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