Keloid Management: A Retrospective Case Review on a New Approach Using Surgical Excision, Platelet-Rich Plasma, and In-office Superficial Photon X-ray Radiation Therapy.
Keloid Management: A Retrospective Case Review on a New Approach Using Surgical Excision, Platelet-Rich Plasma, and In-office Superficial Photon X-ray Radiation Therapy.
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DOI：
10.1097/01.asw.0000482993.64811.74
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发表时间：
2016-07
影响因子：
2.4
通讯作者：
Ridgway J
中科院分区：
文献类型：
--
作者：
Jones ME;Hardy C;Ridgway J
这项回顾性研究的目的是评价作者的瘢痕疙瘩治疗的联合治疗方案的疗效。回顾展整形外科诊所为基础的门诊设置在纽约市。40例患者的44处瘢痕疙瘩需要手术切除。瘢痕疙瘩的治疗采用手术切除，富血小板血浆，术后在办公室浅表光子X射线放射治疗。4名患者接受了一次病灶内注射曲安西龙，瘢痕评分结果较差。患者随访时间为3至11个月，以评估复发和不良反应的证据。出于本研究的目的，复发定义为切除部位以外的任何异常红斑、硬结和肥大体征。在16个瘢痕疙瘩治疗2个部分，没有复发的证据。用3个部分治疗的25个瘢痕疙瘩中的一个显示出复发的证据。3例瘢痕疙瘩中有1例接受单次部分治疗后出现复发迹象。所有患者均观察到放射后色素沉着。手术切除结合富血小板血浆和术后在办公室浅表放射治疗达到了95.5%的无复发率在1至3个月的随访。该方案似乎是治疗瘢痕疙瘩的安全可行的选择，值得进一步对其比较疗效进行随机对照研究。
The objective of this retrospective study was to evaluate the efficacy of the authors’ combination therapy protocol for keloid treatment. Retrospective. Plastic surgery office-based outpatient setting in New York City. Forty patients with 44 keloid scars requiring surgical excision. Keloid scars were treated using surgical excision, platelet-rich plasma, and postoperative in-office superficial photon X-ray radiation therapy. Intralesional triamcinolone injections were administered once to 4 patients with poor results on scar scale assessment. Patient follow-up visits ranged from 3 to 11 months to assess for evidence of recurrence and adverse effects. For the purpose of this study, recurrence was defined as any sign of extraordinary erythema, induration, and hypertrophy beyond the site of excision. In the 16 keloids treated with 2 fractions, there was no evidence of recurrence. One of 25 keloids treated with 3 fractions demonstrated evidence of recurrence. One of 3 keloids treated with a single fraction displayed signs of recurrence. Postirradiation hyperpigmentation was noted in all patients. Surgical excision combined with platelet-rich plasma and postoperative in-office superficial radiation therapy achieved a 95.5% nonrecurrence rate at 1- to 3-month follow-up. This protocol appears to be a safe and viable option in the management of keloids and merits further randomized controlled study of its comparative efficacy.