Saini Ritu, Shupack Jerome L
Ronald O. Perelman Department of Dermatology, Dermatopharmacology Unit, New York University School of Medicine, New York, New York 10016, USA.
Dermatol Surg. 2003 Jul;29(7):735-40. doi: 10.1046/j.1524-4725.2003.29188.x.
A common problem facing patients suffering from psoriasis is the need for surgery that requires incision through active psoriatic skin. Many patients have been denied surgery because of the fear of an increased risk of infection, decreased wound healing ability, and worsening of the psoriatic lesions.
To assess the practices and beliefs of dermatologists and surgeons (orthopedic and plastic surgeons) faced with the decision of whether to operate through active psoriatic skin.
Dermatologists, orthopedic surgeons, and plastic surgeons selected from various professional membership lists from five representative cities were sent a survey to ascertain their opinions on operating on active psoriatic skin. Psoriatic patients were also given forms asking about the severity of their psoriasis and whether they had ever been denied surgery.
Dermatologists are more likely to condone surgery in active psoriatic skin and to believe that there is not a risk of increased infection or decreased wound healing than are orthopedic surgeons and plastic surgeons. These findings are statistically significant (P<0.05).
With proper preoperative measures and dermatologic treatment, surgery can be performed on active psoriatic skin in most cases with minimal reservations, although a controlled, prospective study is necessary to arrive at a definitive conclusion.
银屑病患者面临的一个常见问题是需要进行手术，而手术需要切开处于活动期的银屑病皮肤。许多患者因担心感染风险增加、伤口愈合能力下降以及银屑病皮损恶化而被拒绝手术。
评估皮肤科医生和外科医生（骨科和整形外科医生）在面对是否通过处于活动期的银屑病皮肤进行手术这一决策时的做法和观点。
从五个代表性城市的各种专业会员名单中选出皮肤科医生、骨科医生和整形外科医生，向他们发送一份调查问卷，以确定他们对通过处于活动期的银屑病皮肤进行手术的看法。还向银屑病患者发放表格，询问他们银屑病的严重程度以及是否曾被拒绝手术。
与骨科医生和整形外科医生相比，皮肤科医生更倾向于容忍对处于活动期的银屑病皮肤进行手术，并且认为不存在感染风险增加或伤口愈合能力下降的情况。这些发现具有统计学意义（P<0.05）。
通过适当的术前措施和皮肤科治疗，在大多数情况下，可以对处于活动期的银屑病皮肤进行手术，且顾虑最小，不过需要进行一项对照性前瞻性研究才能得出明确结论。
