Longitudinal burn scar quantification
Longitudinal burn scar quantification
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DOI：
10.1016/j.burns.2014.03.002
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发表时间：
2014-12-01
期刊：
影响因子：
2.7
通讯作者：
Perrault, Isabelle
中科院分区：
文献类型：
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作者：
Nedelec, Bernadette;Correa, Jose A.;Perrault, Isabelle
目前缺乏对烧伤疤痕临床恢复的定量研究。以前的报告验证了高频超声测量厚度、Cutometer（R）测量柔韧性和Mexameter（R）测量瘢痕红斑和色素沉着的客观、精确的诊断能力。因此，我们使用这些仪器前瞻性量化了患者匹配的烧伤后增生性瘢痕（HSc）、供皮区瘢痕（D）和正常皮肤（N）的临床特征。一名研究者在烧伤后3、6和12个月测量了46名烧伤幸存者的3个部位（HSc、D、N）。使用混合模型回归分析（调整检验多重性的p值）比较研究中心和时间点之间的平均值。参与者年龄为41.2 ± 13.5岁，87%为男性，主要是白人，平均体表面积烧伤19.5%。HSc厚度在3和6个月、6和12个月以及3和12个月之间显著降低（所有p < 0.0001），但仍比D和N皮肤厚（所有p < 0.0001）。在所有时间点，HSc、D和N部位之间的柔韧性差异显著（所有p < 0.0001），HSc和D在3至12个月之间增加（p < 0.05），但未达到正常。HSc和D部位在3个月和6个月时比正常皮肤明显更粗糙（p < 0.05），但D部位在12个月时接近正常。色素沉着显著不同的唯一时间点是6个月时的HSc和D部位。N皮肤的厚度、柔韧性、红斑和色素沉着在12个月内保持相似。我们发现，烧伤后HSc的厚度，柔韧性和红斑显着不同D和N皮肤在3，6，12个月，并没有恢复到正常的12个月后受伤，但是，显着改善，可以预期的正常。在3个月和6个月时，供体部位比正常皮肤更红，但预计到12个月时会恢复正常。虽然HSc和D部位的颜色随时间显著变化，但这些颜色变化主要是由于部位发红的变化，而不是主要是高加索人群中的黑色素。(C)2014 Elsevier Ltd和ISBI。All rights reserved.
Quantitative studies of the clinical recovery of burn scars are currently lacking. Previous reports validate the objective, precise, diagnostic capabilities of high-frequency ultrasound to measure thickness, the Cutometer (R) to measure pliability and the Mexameter (R) to measure erythema and pigmentation of scars. Thus, we prospectively quantified clinical characteristics of patient-matched, after burn hypertrophic scar (HSc), donor site scar (D) and normal skin (N) using these instruments. One investigator measured 3 sites (HSc, D, N) in 46 burn survivors at 3, 6, and 12 months after-burn. A mixed model regression analysis, adjusting p-values for multiplicity of testing, was used to compare means among sites and time points. Participants were 41.2 +/- 13.5 years old, 87% males, predominantly Caucasian, with an average of 19.5% body surface area burned. HSc thickness decreased significantly between 3 and 6, 6 and 12, and 3 and 12 months (all p < 0.0001), but remained thicker than D and N skin (all p < 0.0001). Pliability differed significantly between HSc, D and N sites at all time points (all p < 0.0001), with HSc and D increasing between 3 and 12 months (p < 0.05) but not reaching normal. HSc and D sites were significantly more erythematous than normal skin (p < 0.05) at 3 and 6 months but D sites approached normal by 12 months. The only time points at which pigmentation significantly differed were the HSc and D sites at 6 months. Thickness, pliability, erythema and pigmentation of N skin remained similar over the 12 months. We found that post-burn HSc thickness, pliability and erythema differed significantly from D and N skin at 3, 6, and 12 months and does not return to normal by 12 months after-injury; however, significant improvements towards normal can be expected. Donor sites are redder than normal skin at 3 and 6 months but can be expected to return to normal by 12 months. Although the color of HSc and D sites change markedly with time these color changes are primarily due to changes in redness of the site, not melanin in this primarily Caucasian population. (C) 2014 Elsevier Ltd and ISBI. All rights reserved.