Evidence-based therapy in hypertrophic scars: An update of a systematic review.
Evidence-based therapy in hypertrophic scars: An update of a systematic review.
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DOI：
10.1111/wrr.12839
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Kamolz LP
中科院分区：
文献类型：
--
作者：
Nischwitz SP;Rauch K;Luze H;Hofmann E;Draschl A;Kotzbeck P;Kamolz LP
肥厚性疤痕仍然是许多患者的主要负担，尤其是烧伤后。有多种治疗方案可供选择；然而，目前还没有基于证据的治疗方案，其中的建议大多来自经验或较低质量的研究。本综述旨在讨论当前可用的文献。我们进行了系统评价，并在 PubMed 和 Web of Science 数据库中搜索了合适的出版物。仅分析了涉及活人增生性疤痕治疗的英文原创文章。此外，证据水平低于美国整形外科医生协会定义的 1 级的研究也被排除在外。经过重复排除后，筛选了 1638 项研究。定性评估产生了 163 篇符合证据分级条件的文章。最终纳入了九项研究。其中 4 名使用病灶内注射，4 名使用局部治疗，1 名评估 CO2 激光的疗效。病灶内注射曲安西龙+氟尿嘧啶以及局部压力和/或硅胶治疗显示疤痕高度、柔韧性和色素沉着方面有显着改善。这项系统综述表明，评估增生性疤痕的治疗方法及其机制的高质量研究仍然很少。其中，大多数人评估了采用相同治疗方案病灶内注射曲安西龙的疗效。病灶内注射似乎是治疗增生性疤痕的最佳选择。未来的研究应侧重于浸润疗法的可能优化、一致的终点评估、足够的随访期以及可能的个体化治疗。
Hypertrophic scars are still a major burden for numerous patients, especially after burns. Many treatment options are available; however, no evidence‐based treatment protocol is available with recommendations mostly emerging from experience or lower quality studies. This review serves to discuss the currently available literature. A systematic review was performed and the databases PubMed and Web of Science were searched for suitable publications. Only original articles in English that dealt with the treatment of hypertrophic scars in living humans were analyzed. Further, studies with a level of evidence lower than 1 as defined by the American Society of Plastic Surgeons were excluded. After duplicate exclusion, 1638 studies were screened. A qualitative assessment yielded 163 articles eligible for evidence grading. Finally nine studies were included. Four of them used intralesional injections, four topical therapeutics and one assessed the efficacy of CO2‐laser. Intralesional triamcinolone + fluorouracil injections, and topical pressure and/or silicone therapy revealed significant improvements in terms of scar height, pliability, and pigmentation. This systematic review showed that still few high‐quality studies exist to evaluate therapeutic means and their mechanisms for hypertrophic scars. Among these, most of them assessed the efficacy of intralesional triamcinolone injections with the same treatment protocol. Intralesional injection appears to be the best option for hypertrophic scar treatment. Future studies should focus on a possible optimization of infiltrative therapies, consistent end‐point evaluations, adequate follow‐up periods, and possibly intraindividual treatments.
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影响因子：
1.4
作者：
Blome-Eberwein, Sigrid;Gogal, Christina;Pagella, Patrick
通讯作者：
Pagella, Patrick
影响因子：
2.3
作者：
Izquierdo, Maria Cecilia;Lillo, Cristian R.;Montanari, Jorge
通讯作者：
Montanari, Jorge
DOI：
10.1016/j.bjps.2013.06.004
发表时间：
2013-09-01
影响因子：
2.7
作者：
Huang, Lin;Cai, Yi J.;Burd, Andrew
通讯作者：
Burd, Andrew
影响因子：
10.3
作者：
Huang, L.;Wong, Y. P.;Burd, A.
通讯作者：
Burd, A.
影响因子：
2.7
作者：
Bergquist, Maria;Hastbacka, Johanna;Lipcsey, Miklos
通讯作者：
Lipcsey, Miklos