Department for Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Carl-Neubergstr. 1, 30625 Hannover, Germany.
Burns. 2010 Sep;36(6):836-43. doi: 10.1016/j.burns.2009.11.014. Epub 2010 Jan 13.
This study aims to evaluate percutaneous collagen induction (PCI) in post-burn scarring.
Patients with scarring after burn frequently request help in improving the aesthetic appearance of their residual cicatricial deformity. Their scars are generally treated by tissue transfer, W- and Z-plasties, flaps, cortisone injections or ablative procedures that injure or destroy the epidermis and its basement membrane and subsequently lead to fibrosis of the papillary dermis. The ideal treatment would be to preserve the epidermis and promote normal collagen and elastin formation in the dermis.
A total of 16 consecutive patients (average age: 37+/-15.5 years, average body mass index (BMI): 25.7) in Germany with post-burn scarring.
PCI using the Medical Roll-CIT (Vivida, Cape Town, South Africa). This device was designed to multiply-puncture the skin to the level of the dermal scar to institute remodelling. Patients were prepared with topical vitamin A and C cosmetic creams for a minimum of 4 weeks preoperatively to maximise collagen stimulation.
The outcome was measured rating (visual analogue scale (VAS) and Vancouver Scar Scale (VSS)), histological specimen 12 months after intervention.
On average, patients rated their improvement as a mean of 80% better (+/-15.5) than before treatment. Histologic examination revealed considerable increase in collagen and elastin deposition 12 months postoperatively. The epidermis demonstrated 45% thickening of stratum spinosum and normal rete ridges as well as the normalisation of the collagen/elastin matrix in the reticular dermis at 1 year postoperatively.
This pilot study shows that PCI appears to be a safe method for treating post-burn scarring without destroying the epidermis. The procedure can be repeated safely and is also applicable in regions where laser treatments and deep peels are of limited use. However, it is necessary to initiate an efficacy trial to prove the data of this pilot study.
本研究旨在评估经皮胶原诱导（PCI）在烧伤后瘢痕中的作用。
烧伤后出现瘢痕的患者常要求改善其残余瘢痕畸形的美观外观。他们的瘢痕通常通过组织转移、W 成形术和 Z 成形术、皮瓣、皮质激素注射或消融术来治疗，这些方法会损伤或破坏表皮及其基底膜，随后导致乳头真皮纤维化。理想的治疗方法是保留表皮并促进真皮中正常胶原和弹性蛋白的形成。
德国共有 16 例连续烧伤后瘢痕患者（平均年龄：37+/-15.5 岁，平均体重指数（BMI）：25.7）。
使用 Medical Roll-CIT（Vivida，南非开普敦）进行 PCI。该设备旨在对皮肤进行多针穿刺至真皮瘢痕水平，以进行重塑。患者在术前至少 4 周使用局部维生素 A 和 C 美容霜进行预处理，以最大限度地刺激胶原形成。
通过视觉模拟评分（VAS）和温哥华瘢痕量表（VSS）评估治疗后 12 个月的结果，并进行组织学检查。
平均而言，患者对改善的评分平均提高了 80%（+/-15.5），优于治疗前。组织学检查显示术后 12 个月胶原和弹性蛋白沉积明显增加。术后 1 年，表皮棘层厚度增加 45%，正常网织状真皮的 rete 嵴以及胶原/弹性蛋白基质正常化。
这项初步研究表明，PCI 似乎是一种安全的治疗烧伤后瘢痕的方法，不会破坏表皮。该方法可以安全重复使用，并且在激光治疗和深层去皮术有限的地区也适用。然而，有必要开展疗效试验来验证这项初步研究的数据。
