【 文献重点摘要 】

With the number of aesthetic soft tissue filler treatments rapidly increasing, we have witnessed an increase in complications associated with such treatments. While rare, abscesses can arise as a result of these treatments, and current detailed guidelines do not exist detailing exactly how to manage them.

OBJECTIVE

Our aim was to develop evidence-based and experience-based guidelines on how to, specifically, manage abscesses secondary to hyaluronic acid dermal fillers.

METHODS

A thorough MEDLINE literature search of keywords, including abscess, abscess management/treatment, hyaluronic acid, dermal fillers, and soft tissue fillers, was completed to collect specific cases of abscesses secondary to soft tissue filler. Inclusion criteria involved papers published from 2010 to 2020 that focused specifically on soft tissue fillers in the face. In addition, we looked at papers that discussed abscesses secondary to soft tissue fillers in general and their management. We also reported three cases of abscesses secondary to hyaluronic acid dermal fillers that have been described by three different practitioners, detailing their history, examination, management, and outcomes. Experience and evidence have been collated to produce management guidelines.

RESULTS and CONCLUSION

It is clear that each case is unique, but there is no current universal consensus on the risk assessment before treatment nor general management of abscesses secondary to soft tissue filler. The majority of the reports and cases discussed in the paper suggested the use of co-amoxiclav along with a macrolide or quinolone for at least two weeks. Incision and drainage are universally accepted as gold standard management. Microbiology, sensitivities, and cultures are also recommended. Hyaluronidase use, while controversial, is encouraged in effectively managing abscesses secondary to hyaluronic acid dermal filler.

KEY WORDS

Hyaluronic acid, abscess, complications, cosmetic complications management, management guidelines, dermal filler complications

随着美容软组织填充物治疗数量的迅速增加，我们目睹了与此类治疗相关的并发症的增加。虽然罕见，但脓肿可能是这些治疗的结果，目前还没有详细的指南来详细说明如何处理它们。

目的

我们的目标是制定基于证据和经验的指南，指导如何治疗继发于透明质酸真皮填充物的脓肿。

方法

全面检索MEDLINE文献，检索脓肿、脓肿处理/治疗、透明质酸、真皮填充物、软组织填充物等关键词，收集继发于软组织填充物的脓肿的具体病例。纳入标准涉及2010年至2020年发表的论文，这些论文专门关注面部软组织填充物。此外，我们还查阅了有关软组织填充物继发脓肿及其处理的论文。我们还报告了三个继发于透明质酸真皮填充物的脓肿病例，这三个病例由三个不同的从业者描述，详细描述了他们的病史、检查、治疗和结果。已对经验和证据进行了整理，以制定管理指南。

结果与结论

很明显，每个病例都是独特的，但目前对于软组织填充物继发脓肿的治疗前的风险评估和一般的处理没有普遍的共识。论文中讨论的大多数报告和病例建议联合使用阿莫昔克拉夫和大环内酯类或喹诺酮类药物至少两周。切开引流是公认的金标准治疗。微生物学、敏感性和培养也被推荐。透明质酸酶的使用虽然有争议，但在有效治疗继发于透明质酸真皮填充物的脓肿方面受到鼓励。

关键词

透明质酸、脓肿、并发症、美容并发症处理、管理指南、真皮填充物并发症