Tan Stephen R, Tope Whitney D
Cutaneous Surgery and Laser Center, Department of Dermatology, University of Minnesota, USA.
Dermatol Surg. 2004 Apr;30(4 Pt 2):667-73. doi: 10.1111/j.1524-4725.2004.00154.x.
Systemic retinoids possess significant benefits in cutaneous malignancy chemoprevention; however, retinoids have been associated with excessive granulation tissue and hypertrophic scarring.
The objective of this study was to assess wound healing outcomes in organ transplant recipients, both with and without the concomitant use of systemic acitretin chemoprophylaxis.
Twenty-nine immunosuppressed organ transplant recipients underwent treatment of basal cell or squamous cell carcinoma by Mohs or excisional surgery, with a total of 85 wounds. Wounds were evaluated postoperatively at early (average 12.9 days) and late (average 75.8 days) time points. Endpoints for all wounds included infection, hypertrophic granulation tissue, and hypertrophic scarring. Reconstructed wounds were also evaluated for dehiscence.
Eleven patients taking oral acitretin had 41 wounds, of which 33 were reconstructed and 8 healed by second intention. The 18 patients not taking acitretin (control group) had a total of 44 wounds, of which 33 were reconstructed and 11 healed by second intention. There were no statistically significant differences between the acitretin group and the control group in the incidences of infection, dehiscence, hypertrophic granulation tissue, or hypertrophic scarring at early or late evaluation points.
Systemic acitretin chemoprophylaxis does not appear to increase the risk of wound healing complications in organ transplant recipients.
全身性维甲酸在皮肤恶性肿瘤化学预防方面具有显著益处；然而，维甲酸与过度肉芽组织形成和肥厚性瘢痕有关。
本研究的目的是评估器官移植受者在使用和不使用全身性阿维A化学预防的情况下的伤口愈合结果。
29名免疫抑制的器官移植受者通过莫氏手术或切除手术治疗基底细胞癌或鳞状细胞癌，共有85处伤口。在术后早期（平均12.9天）和晚期（平均75.8天）时间点对伤口进行评估。所有伤口的终点包括感染、肥厚性肉芽组织和肥厚性瘢痕。还对重建的伤口进行裂开评估。
11名口服阿维A的患者有41处伤口，其中33处进行了重建，8处二期愈合。18名未服用阿维A的患者（对照组）共有44处伤口，其中33处进行了重建，11处二期愈合。在早期或晚期评估点，阿维A组和对照组在感染、裂开、肥厚性肉芽组织或肥厚性瘢痕的发生率方面没有统计学上的显著差异。
全身性阿维A化学预防似乎不会增加器官移植受者伤口愈合并发症的风险。
