Transcutaneous Oxygen Tension-Guided Hyperbaric Oxygen Therapy For Preventing Skin Necrosis After Hyaluronic Acid Filler Injections

Transcutaneous oxygen tension-guided hyperbaric oxygen therapy for preventing skin necrosis after hyaluronic acid filler injections

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Transcutaneous oxygen tension-guided hyperbaric oxygen therapy for preventing skin necrosis after hyaluronic acid filler injections

Qiqiong Yang, MDa,c, Zhiyuan Shi, PhD, MDb, Shuyi Pan, PhD, MDa, Hang Li, PhD, MDa,*

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**Case 1:** A 24-year-old man experienced severe swelling and imminent skin necrosis after HA injections; TcPO2 levels indicated hypoxia, leading to 14 HBOT sessions.

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**Case 2:** A 28-year-old woman showed no severe hypoxia (TcPO2 58 mmHg) and was treated without HBOT; her condition improved by Day 7.

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**Case 3:** A 30-year-old woman had a TcPO2 of 31 mmHg post-injection; she received five HBOT sessions, resulting in significant improvement.

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**Case 4:** A 36-year-old woman had a TcPO2 of 51 mmHg; HBOT was not pursued, and her condition healed without scarring.

This document discusses the use of transcutaneous oxygen tension-guided hyperbaric oxygen therapy for preventing skin necrosis after hyaluronic acid filler injections.

Introduction

Hyaluronic acid (HA) fillers are popular for cosmetic enhancements but can cause vascular complications like skin necrosis.
Hyperbaric oxygen therapy (HBOT) is effective for enhancing tissue oxygenation in various conditions, including skin necrosis from HA fillers.
Current HBOT applications lack standardized indicators, often relying on clinical experience rather than objective measurements.

Methodology

This case series involved four patients with HA-induced skin necrosis treated between November 2022 and December 2023.
Transcutaneous oxygen pressure (TcPO2) measurements were used to guide HBOT decisions and monitor treatment effectiveness.
Ethical standards were followed, and informed consent was obtained from all patients.

Cases Presentation Discussion

HA injections can lead to serious complications, including skin necrosis due to vascular interruption.
HBOT can correct hypoxia, and TcPO2 measurements can guide treatment decisions and duration.
Delayed treatment may lead to irreversible tissue loss, emphasizing the need for prompt intervention.

Conclusion

The study suggests TcPO2 can effectively guide HBOT for skin necrosis following HA injections, warranting further research for validation.

Case 1: A 24-year-old man experienced severe swelling and imminent skin necrosis after HA injections; TcPO2 levels indicated hypoxia, leading to 14 HBOT sessions.
Case 2: A 28-year-old woman showed no severe hypoxia (TcPO2 58 mmHg) and was treated without HBOT; her condition improved by Day 7.
Case 3: A 30-year-old woman had a TcPO2 of 31 mmHg post-injection; she received five HBOT sessions, resulting in significant improvement.
Case 4: A 36-year-old woman had a TcPO2 of 51 mmHg; HBOT was not pursued, and her condition healed without scarring.

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Transcutaneous oxygen tension-guided hyperbaric oxygen therapy for preventing skin necrosis after hyaluronic acid filler injections

Transcutaneous oxygen tension-guided hyperbaric oxygen therapy for preventing skin necrosis after hyaluronic acid filler injections