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CPR of complications

02 February 2022
Volume 11 · Issue 1


In this article, Dr Harry Singh will look at both capillary refill (C) and patch testing (P) and review (R) their role in complications.

When completing training in facial aesthetics over 20 years ago, the author recalls that there was no mention of complications, let alone how to manage them. Now, avoiding and managing complications should be at the forefront of education in this sector. There has been a rise in the number of complications (Adatia and Boscarino, 2021) due to:

While complications are rising, it is safer to avoid them, rather than simply manage them. The author recommends following the five Ps to reduce the chances of a complication occurring:

In regard to managing complications, there are an array of articles, protocols and templates available within the medical aesthetics sector. However, there is no standardised agreement. In this article, the author will focus on two aspects of managing complications: capillary refill time (CRT) and patch testing. CRT is the time taken for a distal capillary bed to regain its colour after pressure has been applied to cause blanching. It was first introduced by Beecher et al (1947), using the categories of normal, definite slowing and very sluggish (Pickard et al, 2011). In a suspected vascular occlusion or vascular compromise, slow capillary refill is one of the signs and symptoms. However, this alone should not be used to diagnose; the practitioner would need to consider the other possible immediate signs and symptoms, such as pain, blanching and/or discolouration of the skin and a livedo pattern.

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