Kelemen Ottó, Kollár Lajos
Magy Seb. 2007 Apr;60(2):63-70. doi: 10.1556/MaSeb.60.2007.2.1.
The aetiology of pathologic scarring is unknown today regarding the keloids. The authors have analyzed the literature and own experience retrospectively according to the evidence based treatments and prevention of the hypertrophic and keloid scars. The corticosteroids have been used intralesionally since the beginning of the 1960-ies. It was followed by the pressure garment therapy in order to treat the widespread burns scars in the early 1970-ies. The silicone gel sheeting is being used since the 1980-ies. The basic treatment of keloids changed, radiotherapy was combined with the above mentioned methods because of its high recurrence rate. Newer methods, cryosurgery as well as lasers were used to treat keloids. The number of effective topical agents was increased. The researchers have been looking for other, intralesionally usable medicine and genetic causes for more than ten years. The clinicians have had the standard protocols of the adjunct and alternative methods too. After having the standard and internationally accepted scar assessment system (Vancouver-scar scale and score), the controlled, randomized trials were practicable. The prospective evaluation of the efficacy of different protocols with adequate follow-up became performable. The comparison of different methods is difficult because of the lack of its standard outcome.
目前,瘢痕疙瘩病理性瘢痕形成的病因尚不清楚。作者根据肥厚性瘢痕和瘢痕疙瘩的循证治疗及预防方法,对文献和自身经验进行了回顾性分析。自20世纪60年代初以来,皮质类固醇一直用于病灶内注射。随后,在20世纪70年代初,为了治疗大面积烧伤瘢痕,采用了压力衣疗法。自20世纪80年代起开始使用硅胶片。由于瘢痕疙瘩的复发率高,其基本治疗方法发生了变化,放射治疗与上述方法联合使用。更新的方法,如冷冻手术和激光,被用于治疗瘢痕疙瘩。有效的外用药物数量增加。十多年来,研究人员一直在寻找其他可用于病灶内注射的药物和遗传病因。临床医生也有辅助和替代方法的标准方案。在有了标准的、国际认可的瘢痕评估系统(温哥华瘢痕量表和评分)之后,进行对照、随机试验变得可行。对不同方案的疗效进行有充分随访的前瞻性评估也变得可行。由于缺乏标准的结果,不同方法之间的比较很困难。