Whether to bleed or lyse hyaluronic acid embolism generally refers to whether to bleed or inject hyaluronidase first. Usually, when a hyaluronic acid embolism is found, the injection should be stopped immediately and a high dose of hyaluronidase should be injected immediately before considering bleeding.
Clinically, the first step in the treatment of hyaluronic acid embolism is to stop injections and to inject hyaluronidase immediately if an embolism is found or suspected. Hyaluronidase can penetrate blood vessels, so large doses of this drug can be used to dissolve hyaluronic acid in blood vessels; a small amount of lidocaine is injected into the area of blood supply to release vascular spasm, improve local blood supply and accelerate metabolism. Secondly, in cases of severe local stasis, local decompression and decompression can be considered, and the area of hyaluronic acid injection can be incised, i.e., bled, in order to improve local blood flow and exclude a small amount of injected material. Sometimes needle aspiration of the injected drug may also be used.
At the same time, intravenous administration of drugs such as, antibiotics and low molecular dextrose, as well as local application of nitroglycerin ointment, and hyperbaric chamber treatment can be applied where available to increase the oxygen content in the blood to correct local tissue hypoxia and help restore blood flow.
