Brown Richard J, Lee Michael J, Sisco Mark, Kim John Y S, Roy Nakshatra, Mustoe Thomas A
Chicago, Ill. From the Wound Healing Research Laboratory, Division of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University.
Plast Reconstr Surg. 2008 Apr;121(4):1165-1172. doi: 10.1097/01.prs.0000302512.17904.2a.
The effects of ultraviolet light exposure on scar pigmentation are well documented. There is a commonly held belief among physicians that sun exposure may also worsen the appearance of fresh scars and result in excess collagen deposition. However, few studies have documented a relationship between ultraviolet light exposure and hypertrophic scarring. This study sought to evaluate the effect of ultraviolet light exposure on scar hypertrophy in an established rabbit model of cutaneous scarring.
Four 7-mm ulcers were created on the ventral ears of eight rabbits. Starting on postoperative day 15, half of the wounds were exposed to ultraviolet-B radiation daily for either 7 or 14 days. Ultraviolet-B-exposed (n = 16) and control (n = 16) scars were harvested on postoperative day 32 for histologic and reverse-transcriptase polymerase chain reaction analysis.
Exposure to ultraviolet-B radiation for 7 or 14 days was associated with a 52 percent (p < 0.01) or 74 percent (p < 0.05) reduction in scar volume, respectively, compared with controls. In wounds subjected to ultraviolet-B radiation for 14 days, collagen type I-alpha2 mRNA expression was 29 percent lower than in controls (p < 0.05). There was no difference in the mRNA expression of transforming growth factor-beta1.
: These short-term observations demonstrate that ultraviolet-B radiation exposure reduces scar hypertrophy in this clinically relevant animal model. A reduction in collagen production or increase in collagen breakdown may account for this result. However, sunscreen should still be used as primary protection when skin is exposed to direct sunlight.
紫外线照射对瘢痕色素沉着的影响已有充分记载。医生们普遍认为,阳光照射也可能使新鲜瘢痕外观恶化,并导致胶原蛋白过度沉积。然而,很少有研究记录紫外线照射与肥厚性瘢痕之间的关系。本研究旨在评估紫外线照射对已建立的兔皮肤瘢痕模型中瘢痕增生的影响。
在8只兔子的腹侧耳部制造4个7毫米的溃疡。从术后第15天开始,一半的伤口每天接受7天或14天的紫外线B照射。在术后第32天采集接受紫外线B照射的瘢痕(n = 16)和对照瘢痕(n = 16),进行组织学和逆转录酶聚合酶链反应分析。
与对照组相比,接受7天或14天紫外线B照射的瘢痕体积分别减少了52%(p < 0.01)或74%(p < 0.05)。在接受14天紫外线B照射的伤口中,I型α2胶原蛋白mRNA表达比对照组低29%(p < 0.05)。转化生长因子β1的mRNA表达没有差异。
这些短期观察结果表明,在这个具有临床相关性的动物模型中,紫外线B照射可减少瘢痕增生。胶原蛋白生成减少或分解增加可能是导致这一结果的原因。然而,当皮肤暴露在直射阳光下时,仍应使用防晒霜作为主要防护措施。