Baisch A, Riedel F
Universitäts-Hals-Nasen-Ohren-Klinik Mannheim, Klinikum, Theodor-Kutzer-Ufer, 68135, Mannheim.
HNO. 2006 Dec;54(12):981-92; quiz 993-4. doi: 10.1007/s00106-006-1463-y.
Aberrant wound healing results in unsightly scarring, hypertrophic scarring, and keloid formation, causing functional and cosmetic deformities, discomfort, psychological stress, and patient dissatisfaction. Scar management, both surgical and non-surgical, continue to be important issues for the facial plastic surgeon. Many techniques for the management of hypertrophic scars and keloids have been proven through extensive use, but few are supported by prospective studies with adequate control groups. Several new therapies showed good results in small-scale trials, but these have not been repeated in larger trials with long-term follow-up. This article presents an overview of the available therapies and provides recommendations for the treatment of abnormal scarring. The recommendations focus on the management of hypertrophic scars and keloids. Strategies for the management of keloids and hypertrophic scars are of continuing interest and studies are necessary to understand the basic mechanisms causing aberrant wound healing. In addition, an overview of new developments in molecular wound management and gene therapy, as they relate to facial plastic surgery, is provided.
异常伤口愈合会导致难看的瘢痕形成、增生性瘢痕和瘢痕疙瘩，造成功能和外观畸形、不适、心理压力以及患者不满。对于面部整形外科医生而言，手术和非手术的瘢痕管理仍然是重要问题。许多用于管理增生性瘢痕和瘢痕疙瘩的技术已通过广泛应用得到验证，但很少有前瞻性研究及适当对照组的支持。几种新疗法在小规模试验中显示出良好效果，但在长期随访的更大规模试验中尚未得到重复验证。本文概述了现有的治疗方法，并为异常瘢痕的治疗提供建议。这些建议主要针对增生性瘢痕和瘢痕疙瘩的管理。瘢痕疙瘩和增生性瘢痕的管理策略一直备受关注，有必要开展研究以了解导致异常伤口愈合的基本机制。此外，还提供了与面部整形手术相关的分子伤口管理和基因治疗新进展的概述。
