medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2022-8-100-103medalphabet-2615Research ArticleЭСТЕТИЧЕСКАЯ МЕДИЦИНАПринципы терапии сосудистой окклюзии в области лица, спровоцированной введением гидроксиапатита кальцияPrinciples of therapy of vascular occlusion in facial area provoked by introduction of calcium hydroxyapatitehttps://orcid.org/0000-0002-8813-9132ИконниковаЕ. В.IkonnikovaE. V.

 Иконникова Евгения Владимировна, доцент кафедры дерматовенерологии и косметологии 

 Ikonnikova Evgenia V., associate professor at Dept of Dermatology and Cosmetology 

evikonnikova@bk.ruhttps://orcid.org/0000-0003-4281-1947МантуроваН. Е.ManturovaN. E.

 Мантурова Наталья Евгеньевна, д.м.н., проф., зав. кафедрой пластической и реконструктивной хирургии, косметологии и клеточных технологий

 Manturova Natalya E., DM Sci (habil.), professor, head of Dept of Plastic and Reconstructive Surgery, Cosmetology and Cellular Technologies 

https://orcid.org/0000-0002-1770-0439ГолановаО. А.GolanovaO. A.

 Голанова Ольга Александровна, врач-косметолог-

 Golanova Olga A., cosmetologist 

ФГБУ ДПО «Центральная государственная медицинская академия» Управления делами Президента Российской ФедерацииРоссияCentral State Medical Academy of the Administrative Department of the President of RussiaRussian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава РоссииРоссияRussian National Research Medical University n.a. N.I. PirogovRussian FederationООО «Делайт – Ланцетъ» (клиника «Ланцетъ – Центр»)РоссияLancet – Centre’ ClinicRussian Federation20221805202208Дерматология (1)100103Copyright © Иконникова Е.В., Мантурова Н.Е., Голанова О.А., 20222022Иконникова Е.В., Мантурова Н.Е., Голанова О.А.Ikonnikova E.V., Manturova N.E., Golanova O.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/2615

Применение дермальных наполнителей на основе гидроксиапатита кальция получило широкое распространение среди врачей-косметологов. Данные препараты считаются высокоэффективными в борьбе с возрастными изменениями кожи, обладают высоким профилем безопасности и не склонны вызывать аутоиммунный ответ организма. Благодаря специфике препарата гидроксиапатит кальция обеспечивает как восстановление потери объема мягких тканей, так и стимуляцию неоколлагенеза. Имея длительный опыт применения, препарат прочно занял свое место в эстетической медицине и с успехом применяется многими врачами по всему миру. Однако с увеличением использования инъекционных препаратов возрастает и число побочных эффектов. В настоящее время нет четких рекомендаций по лечению осложнений на введение гидроксиапатита кальция, в отличие от наполнителей на основе гиалуроновой кислоты. Несмотря на низкий риск развития серьезных осложнений в результате непреднамеренной сосудистой окклюзии, ряд врачей опасаются применять препараты гидроксиапатита кальция в связи с недостаточностью знаний по ее устранению. Данная статья описывает основные принципы терапии окклюзионного синдрома и может помочь врачам эффективно и своевременно предпринять терапевтические меры по его коррекции.

The use of dermal fllers based on calcium hydroxyapatite has become widespread among cosmetologists. These fllers are considered highly effective in the fght against age-related skin changes, have a high safety profle and are not prone to cause an autoimmune response of the body. Due to specifcs of the fller, calcium hydroxyapatite provides both restoration of soft tissue volume loss and stimulation of neocollagenesis. Having a long experience of use, the fller has frmly taken its place in aesthetic medicine and is successfully used by many doctors around the world. However, with the increase in the use of fllers, the number of side effects also increases. Currently, there are no clear guidelines for the treatment of complications of injection by calcium hydroxyapatite, unlike fllers based on hyaluronic acid. Despite the low risk of developing serious complications as a result of unintentional vascular occlusion, a number of doctors are afraid to use calcium hydroxyapatite preparations due to lack of knowledge on its elimination. This article describes the basic principles of therapy for occlusive syndrome and can help doctors to take effective and timely therapeutic measures to correct it.

гидроксиапатит кальциясосудистая окклюзиясосудистые осложнениянекрозфиллерcalcium hydroxyapatitevascular occlusionvascular complicationsnecrosisfller.ReferencesLoghem J.V., Yutskovskaya Y.A., Werschler P.W. Calcium hydroxyapatite: over a decade of clinical experience. The Journal of clinical and aesthetic dermatology. 2015; 8 (1): 38–49.Loghem J.V., Yutskovskaya Y.A., Werschler P.W. Calcium hydroxyapatite: over a decade of clinical experience. The Journal of clinical and aesthetic dermatology. 2015; 8 (1): 38–49.Cho K.H., Uthaman S., Park I.K., Cho C.S. Injectable Biomaterials in Plastic and Reconstructive Surgery: A Review of the Current Status. Tissue engineering and regenerative medicine. 2018; 15 (5), 559–574. https://doi.org/10.1007/s13770–018–0158–2Cho K.H., Uthaman S., Park I.K., Cho C.S. Injectable Biomaterials in Plastic and Reconstructive Surgery: A Review of the Current Status. Tissue engineering and regenerative medicine. 2018; 15 (5), 559–574. https://doi.org/10.1007/s13770–018–0158–2Szczerkowska-Dobosz A., Olszewska B., Lemańska M., Purzycka-Bohdan D., Nowicki R. Acquired facial lipoatrophy: pathogenesis and therapeutic options. Postepy dermatologii i alergologii. 2015; 32 (2), 127–133. https://doi.org/10.5114/pdia.2014.40971Szczerkowska-Dobosz A., Olszewska B., Lemańska M., Purzycka-Bohdan D., Nowicki R. Acquired facial lipoatrophy: pathogenesis and therapeutic options. Postepy dermatologii i alergologii. 2015; 32 (2), 127–133. https://doi.org/10.5114/pdia.2014.40971Zerbinati N., D’Este E., Parodi P.C., Calligaro A. Microscopic and ultrastructural evidences in human skin following calcium hydroxylapatite fller treatment. Archives of dermatological research. 2017; 309 (5): 389–396. https://doi:10.1007/s00403–017–1734–3Zerbinati N., D’Este E., Parodi P.C., Calligaro A. Microscopic and ultrastructural evidences in human skin following calcium hydroxylapatite fller treatment. Archives of dermatological research. 2017; 309 (5): 389–396. https://doi:10.1007/s00403–017–1734–3Bentkover S. H. The Biology of Facial Fillers. Facial Plastic Surgery. 2009; 25: 73–85. Doi: 10.1055/s-0029–1220646.Bentkover S. H. The Biology of Facial Fillers. Facial Plastic Surgery. 2009; 25: 73–85. Doi: 10.1055/s-0029–1220646.Pavicic T. Complete biodegradable nature of calcium hydroxylapatite after injection for malar enhancement: an MRI study. Clinical, cosmetic and investigational dermatology. 2015; 8: 19–25. DOI: 10.2147/CCID.S72878.Pavicic T. Complete biodegradable nature of calcium hydroxylapatite after injection for malar enhancement: an MRI study. Clinical, cosmetic and investigational dermatology. 2015; 8: 19–25. DOI: 10.2147/CCID.S72878.Yutskovskaya Y., Kogan E., Leshunov E. A randomized, split-face, histomorphologic study comparing a volumetric calcium hydroxylapatite and a hyaluronic acid-based dermal fller. Journal of drugs in dermatology. 2014; 13 (9): 1047–52.Yutskovskaya Y., Kogan E., Leshunov E. A randomized, split-face, histomorphologic study comparing a volumetric calcium hydroxylapatite and a hyaluronic acid-based dermal fller. Journal of drugs in dermatology. 2014; 13 (9): 1047–52.Marmur E..S, Phelps R., Goldberg D.J. Clinical, histologic and electron microscopic fndind after injection of a calcium hydroxylapatite fller. Journal of cosmetic and laser therapy: offcial publication of the European Society for Laser Dermatology. 2004; 6 (4): 223–6. DOI: 10.1080/147641704100003048.Marmur E..S, Phelps R., Goldberg D.J. Clinical, histologic and electron microscopic fndind after injection of a calcium hydroxylapatite fller. Journal of cosmetic and laser therapy: offcial publication of the European Society for Laser Dermatology. 2004; 6 (4): 223–6. DOI: 10.1080/147641704100003048.van Loghem J., Funt D., Pavicic T., Goldie K., Yutskovskaya Y., Fabi S., Siebenga P., Thuis J., Hkeik J., Kadouch J., Prager W., Azib N., Casabona G., Dayan S., Bay Aguilera S, Snozzi P., Saeed P. Managing intravascular complications following treatment with calcium hydroxylapatite: An expert consensus. Journal of cosmetic dermatology. 2020; 19 (11), 2845–2858. https://doi.org/10.1111/jocd.13353van Loghem J., Funt D., Pavicic T., Goldie K., Yutskovskaya Y., Fabi S., Siebenga P., Thuis J., Hkeik J., Kadouch J., Prager W., Azib N., Casabona G., Dayan S., Bay Aguilera S, Snozzi P., Saeed P. Managing intravascular complications following treatment with calcium hydroxylapatite: An expert consensus. Journal of cosmetic dermatology. 2020; 19 (11), 2845–2858. https://doi.org/10.1111/jocd.13353King M., Walker L., Convery C., Davies E. Management of a Vascular Occlusion Associated with Cosmetic Injections. The Journal of clinical and aesthetic dermatology. 2020; 13 (1): E53–E58.King M., Walker L., Convery C., Davies E. Management of a Vascular Occlusion Associated with Cosmetic Injections. The Journal of clinical and aesthetic dermatology. 2020; 13 (1): E53–E58.Иконникова Е.В., Стенько А.Г., Чайковская Е.А., Змазова В.Г. Осложнение инъекционной ринопластики. Пластическая хирургия и эстетическая медицина. 2019; 4: 76–81. https://doi.org/10.17116/plast.hirurgia201904176Ikonnikova E. V., Stenko A. G., Chaikovskaya E. A., Zmazova V. G. Complication of injection rhinoplasty. Plastic surgery and aesthetic medicine. 2019; 4: 76–81. https://doi.org/10.17116/plast.hirurgia201904176Hong J.Y., Seok J., Ahn G.R., Jang Y.J., Li K., Kim B.J. Impending skin necrosis after dermal fller injection: A ‘golden time’ for frst-aid intervention. Dermatologic Therapy. 2016; 30 (2), e12440. DOI: 10.1111/dth.12440.Hong J.Y., Seok J., Ahn G.R., Jang Y.J., Li K., Kim B.J. Impending skin necrosis after dermal fller injection: A ‘golden time’ for frst-aid intervention. Dermatologic Therapy. 2016; 30 (2), e12440. DOI: 10.1111/dth.12440.Beer K., Downie J., Beer J.. A treatment protocol for vascular occlusion from particulate soft tissue augmentation. The Journal of clinical and aesthetic dermatology. 2012; 5 (5): 44–47.Beer K., Downie J., Beer J.. A treatment protocol for vascular occlusion from particulate soft tissue augmentation. The Journal of clinical and aesthetic dermatology. 2012; 5 (5): 44–47.Yatzidis H. Successful sodium thiosulphate treatment for recurrent calcium urolithiasis. Clinical Nephrology. 1985; 23: 63–7.Yatzidis H. Successful sodium thiosulphate treatment for recurrent calcium urolithiasis. Clinical Nephrology. 1985; 23: 63–7.Robinson D.M. In Vitro Analysis of the Degradation of Calcium Hydroxylapatite Dermal Filler: A Proof – of – Concept Study. Dermatologic Surgery offcial publication for American Society for Dermatologic Surgery. 2018; 44, S5–S9. DOI: 10.1097/DSS.0000000000001683.Robinson D.M. In Vitro Analysis of the Degradation of Calcium Hydroxylapatite Dermal Filler: A Proof – of – Concept Study. Dermatologic Surgery offcial publication for American Society for Dermatologic Surgery. 2018; 44, S5–S9. DOI: 10.1097/DSS.0000000000001683.Pasch A., Schaffner T., Huynh-Do U., Frey B.M. Sodium thiosulfate prevents vascular calcifcations in uremic rats. Kidney Internation. 2008; 74: 1444–53. DOI: 10.1038/ki.2008.455.Pasch A., Schaffner T., Huynh-Do U., Frey B.M. Sodium thiosulfate prevents vascular calcifcations in uremic rats. Kidney Internation. 2008; 74: 1444–53. DOI: 10.1038/ki.2008.455.Danysz W., Nowag B., Hengl T., Kreymerman P., Furne C., Madeuf E., Höennscheidt C., Mraz Robinson D. Can Sodium Thiosulfate Act as a Reversal Agent for Calcium Hydroxylapatite Filler? Results of a Preclinical Study. Clinical, cosmetic and investigational dermatology. 2020; 13, 1059–1073. https://doi.org/10.2147/CCID.S271760Danysz W., Nowag B., Hengl T., Kreymerman P., Furne C., Madeuf E., Höennscheidt C., Mraz Robinson D. Can Sodium Thiosulfate Act as a Reversal Agent for Calcium Hydroxylapatite Filler? Results of a Preclinical Study. Clinical, cosmetic and investigational dermatology. 2020; 13, 1059–1073. https://doi.org/10.2147/CCID.S271760Henderson R., Reilly D.A.., Cooper JS. Hyperbaric Oxygen for Ischemia due to Injection of Cosmetic Fillers: Case Report and Issues. Plastic and reconstructive surgery. 2018; 11; 6 (1). DOI: 10.1097/GOX.0000000000001618.Henderson R., Reilly D.A.., Cooper JS. Hyperbaric Oxygen for Ischemia due to Injection of Cosmetic Fillers: Case Report and Issues. Plastic and reconstructive surgery. 2018; 11; 6 (1). DOI: 10.1097/GOX.0000000000001618.Thom S.R. Hyperbaric oxygen: its mechanisms and effcacy. Plastic and reconstructive surgery. 2011; 127 Suppl 1 (Suppl 1): 131S-141S. DOI: 10.1097/PRS.0b013e3181fbe2bf.Thom S.R. Hyperbaric oxygen: its mechanisms and effcacy. Plastic and reconstructive surgery. 2011; 127 Suppl 1 (Suppl 1): 131S-141S. DOI: 10.1097/PRS.0b013e3181fbe2bf.Menchisheva Y., Mirzakulova U., Rudolf Y. Use of platelet-rich plasma to facilitate wound healing. Internation Wourd Journal. 2019; 16 (2): 343–353. DOI: 10.1111/iwj.13034.Menchisheva Y., Mirzakulova U., Rudolf Y. Use of platelet-rich plasma to facilitate wound healing. Internation Wourd Journal. 2019; 16 (2): 343–353. DOI: 10.1111/iwj.13034.Kang B.K., Kang I.J., Jeong K.H., Shin M.K. Treatment of glabella skin necrosis following injection of hyaluronic acid fller using platelet-rich plasma. Journal Cosmetic and Laser therapy: offcial publication of the European Society for Laser Dermatology. 2016; 18 (2): 111–112. DOI: 10.3109/14764172.2015.1052512.Kang B.K., Kang I.J., Jeong K.H., Shin M.K. Treatment of glabella skin necrosis following injection of hyaluronic acid fller using platelet-rich plasma. Journal Cosmetic and Laser therapy: offcial publication of the European Society for Laser Dermatology. 2016; 18 (2): 111–112. DOI: 10.3109/14764172.2015.1052512.Аксененко И. П. Сочетанное применение ферментно- и карбокситерапии при осложнениях контурной пластики области кисти в косметлогии. Физиотерапия, бальнеология и реабилитация, 19, № 2, С.: 83–89, 2020. doi: 10. 17816/1681–3456–2020–19–2–3.Aksenenko I.P. Combined use of enzyme and carboxytherapy for complications of contouring of the hand area in cosmetology. Physiotherapy, balneology and rehabilitation, 19, No. 2, Pp.: 83–89, 2020. DOI: 10.17816/1681–3456–2020–19–2–3.Casabona G. Blood aspiration test for cosmetic fllers to prevent accidental intravascular injection in the face. Dermatologic Surgery: for American Society for Dermatologic Surgery. 2015; 41 (7): 841–847. Doi: 10.1097/Dss.0000000000000395.Casabona G. Blood aspiration test for cosmetic fllers to prevent accidental intravascular injection in the face. Dermatologic Surgery: for American Society for Dermatologic Surgery. 2015; 41 (7): 841–847. Doi: 10.1097/Dss.0000000000000395.Robati R.M., Moeineddin F., Almasi-Nasrabadi M. The Risk of Skin Necrosis Following Hyaluronic Acid Filler Injection in Patients with a History of Cosmetic Rhinoplasty. Aesthetic surgery journal. 2018; 38 (8), 883–888. https://doi.org/10.1093/asj/sjy005Robati R.M., Moeineddin F., Almasi-Nasrabadi M. The Risk of Skin Necrosis Following Hyaluronic Acid Filler Injection in Patients with a History of Cosmetic Rhinoplasty. Aesthetic surgery journal. 2018; 38 (8), 883–888. https://doi.org/10.1093/asj/sjy005

The authors declare that there are no conflicts of interest present.