Effect of Mederma on hypertrophic scarring in the rabbit ear model
Effect of Mederma on hypertrophic scarring in the rabbit ear model
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DOI：
10.1097/00006534-200207000-00029
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发表时间：
2002-07-01
影响因子：
3.6
通讯作者：
Mustoe, TA
中科院分区：
文献类型：
--
作者：
Saulis, AS;Mogford, JH;Mustoe, TA
目前接受的增生性瘢痕的保守治疗仅限于类固醇注射、放射治疗和硅胶封闭治疗。然而，Mederma用于这些有问题的病变在临床环境中已变得相当普遍。几乎没有科学证据支持本产品在减少增生性瘢痕方面的疗效。本研究的目的是研究Mederma对兔增生性瘢痕模型中增生性瘢痕的影响，从而对瘢痕隆起、真皮胶原组织、血管分布和炎症进行组织学定量，并对瘢痕红斑进行大体检查。在4只新西兰白色家兔中，每只耳朵4个全层伤口，共32个疤痕。初次受伤后28天，拍摄增生性瘢痕，并开始用Mederma每天三次治疗每只耳朵上一半的瘢痕，共4周。未处理的疤痕作为对照疤痕，并暴露于空气中。治疗4周后，再次拍摄疤痕。然后处死家兔，并对瘢痕进行组织学分析。治疗前和治疗后的照片进行了比较，通过使用计算机定量的洋红色，黄色和青色的疤痕内的表达。组织学分析表明，瘢痕增生或瘢痕升高指数没有显著降低。然而，在比较Mederma治疗的瘢痕与未治疗的对照瘢痕时，注意到真皮胶原组织的显著改善（P < 0.05）。真皮血管分布或炎症无显著差异。瘢痕照片的计算机分析表明，Mederma治疗后瘢痕红斑没有显著减少。Mederma中的活性产物洋葱（allium cepa）具有作为其衍生物的槲皮素，槲皮素是一种生物活性物质，以其对正常和恶性细胞的抗增殖作用以及其抗组胺释放作用而闻名。理论上，这些特性可以证明有利于逆转增生性瘢痕中的炎症和增殖反应。尽管作者无法证明瘢痕肥大的减少，但在Mederma治疗的瘢痕中观察到的胶原组织的改善表明其可能对增生性瘢痕形成的病理生理学产生影响。
Currently accepted conservative treatments of hypertrophic scars are limited to steroid injections, radiation therapy, and silicone occlusive therapy. However, the use of Mederma for these problematic lesions has become quite prevalent in the clinical setting. Little scientific evidence exists to support the efficacy of this product in reducing hypertrophic scars. The aim of this study was to study the effects of Mederma on hypertrophic scars in the rabbit hypertrophic scar model, allowing the histologic quantification of scar elevation, dermal collagen organization, vascularity, and inflammation and the gross examination of scar erythema. Full-thickness Wounds clown to cartilage, four per ear, were created in four New Zealand White rabbits, for a total of 32 scars. Twenty-eight days after the initial wounding, the hypertrophic scars were photographed, and treatment of half of the scars on each ear was begun with Mederma three times per day for a total of 4 weeks. The untreated scars served as control scars and were left exposed to air. After 4 weeks of treatment, the scars were once again photographed. The rabbits were then killed, and the scars were analyzed histologically. The pretreatment and posttreatment photographs were compared by using computer quantification of magenta, yellow, and cyan expression within the scars. Histologic analysis demonstrated no significant reduction in scar hypertrophy or scar elevation index. However, a significant improvement in dermal collagen organization was noted on comparing Mederma-treated scars with untreated control scars (P < 0.05). No significant difference in dermal vascularity or inflammation was noted. Computer analysis of the scar photographs demonstrated no significant reduction in scar erythema with Mederma treatment. The active product in Mederma, allium cepa, has as its derivative quercetin, a bioflavonoid noted for its antiproliferative effects on both normal and malignant cells, and its antihistamine release effects. These properties could theoretically prove beneficial in reversing the inflammatory and proliferative responses noted in hypertrophic scars. Despite the authors' inability to demonstrate a reduction in scar hypertrophy, the improvement in collagen organization noted in the Mederma-treated scars suggests it may have an effect on the pathophysiology of hypertrophic scar formation.