Percutaneous collagen induction therapy: An alternative treatment for burn scars
Percutaneous collagen induction therapy: An alternative treatment for burn scars
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DOI：
10.1016/j.burns.2009.11.014
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发表时间：
2010-09-01
期刊：
影响因子：
2.7
通讯作者：
Vogt, Peter M.
中科院分区：
文献类型：
--
作者：
Aust, Matthias C.;Knobloch, Karsten;Vogt, Peter M.
目的：本研究旨在评估经皮胶原诱导（PCI）在烧伤后疤痕中的作用。背景：烧伤后疤痕患者经常要求帮助改善其残余疤痕畸形的美观。其疤痕通常通过组织转移、W 和 Z 成形术、皮瓣、可的松注射或烧蚀手术来治疗，这些手术会损伤或破坏表皮及其基底膜，随后导致乳头状真皮纤维化。理想的治疗方法是保留表皮并促进真皮中正常胶原蛋白和弹性蛋白的形成。患者：德国共有 16 名连续患者（平均年龄：37 +/- 15.5 岁，平均体重指数 (BMI)：25.7），患有烧伤后疤痕。干预：使用 Medical Roll-CIT（南非开普敦 Vivida）进行 PCI。该装置旨在对皮肤进行多次穿刺，直至真皮疤痕水平，以进行重塑。术前为患者准备外用维生素 A 和 C 美容霜至少 4 周，以最大程度地刺激胶原蛋白。结果测量：干预后 12 个月测量结果评级（视觉模拟量表 (VAS) 和温哥华疤痕量表 (VSS)）、组织学标本。结果：平均而言，患者评价其改善程度比治疗前平均提高 80% (+/- 15.5)。组织学检查显示术后12个月胶原蛋白和弹性蛋白沉积显着增加。术后 1 年，表皮显示棘层和正常网状脊增厚 45%，网状真皮中胶原蛋白/弹性蛋白基质正常化。结论：这项初步研究表明 PCI 似乎是治疗烧伤后疤痕而不破坏表皮的安全方法。该程序可以安全地重复，并且也适用于激光治疗和深层换肤使用有限的地区。然而，有必要启动有效性试验来证明该试点研究的数据。 (C) 2009 Elsevier Ltd 和 ISBI。版权所有。
Objective: This study aims to evaluate percutaneous collagen induction (PCI) in post-burn scarring.Background: Patients with scarring after burn frequently request help in improving the aesthetic appearance of their residual cicatricial deformity. Their scars are generally treated by tissue transfer, W- and Z-plasties, flaps, cortisone injections or ablative procedures that injure or destroy the epidermis and its basement membrane and subsequently lead to fibrosis of the papillary dermis. The ideal treatment would be to preserve the epidermis and promote normal collagen and elastin formation in the dermis.Patients: A total of 16 consecutive patients (average age: 37 +/- 15.5 years, average body mass index (BMI): 25.7) in Germany with post-burn scarring.Intervention: PCI using the Medical Roll-CIT (Vivida, Cape Town, South Africa). This device was designed to multiply-puncture the skin to the level of the dermal scar to institute remodelling. Patients were prepared with topical vitamin A and C cosmetic creams for a minimum of 4 weeks preoperatively to maximise collagen stimulation.Outcome measures: The outcome was measured rating (visual analogue scale (VAS) and Vancouver Scar Scale (VSS)), histological specimen 12 months after intervention.Results: On average, patients rated their improvement as a mean of 80% better (+/- 15.5) than before treatment. Histologic examination revealed considerable increase in collagen and elastin deposition 12 months postoperatively. The epidermis demonstrated 45% thickening of stratum spinosum and normal rete ridges as well as the normalisation of the collagen/elastin matrix in the reticular dermis at 1 year postoperatively.Conclusions: This pilot study shows that PCI appears to be a safe method for treating postburn scarring without destroying the epidermis. The procedure can be repeated safely and is also applicable in regions where laser treatments and deep peels are of limited use. However, it is necessary to initiate an efficacy trial to prove the data of this pilot study. (C) 2009 Elsevier Ltd and ISBI. All rights reserved.