Shridharani Sachin M, Magarakis Michael, Manson Paul N, Singh Navin K, Basdag Basak, Rosson Gedge D
Division of Plastic, Reconstructive and Maxillofacial Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Ann Plast Surg. 2010 Mar;64(3):355-61. doi: 10.1097/SAP.0b013e3181afaab0.
The management of keloids and hypertrophic scars continues to challenge health-care providers. Though both forms of pathologic scarring are distinct entities at the macro and microscopic level, their etiologies and treatment are often similar. Potential treatment approaches are progressing, and combinations of treatment options have been proposed in the literature with promising outcomes. The treatment evolution has reached a level where molecular therapeutic modalities are being investigated. Currently, no gold standard treatment exists. Overall success rates and patient satisfaction seem to be slowly climbing, but additional investigational studies must continue to be performed. Several studies have investigated antineoplastic agents, and there seems to be a marked improvement in rates of recurrence, patient satisfaction, and overall quality of scar when these agents are used. Intralesional injection and/or wound irrigation with interferon-a2b, interferon-g, mitomycin-C, bleomycin, or 5-fluorouracil seems to have a positive effect on the reduction of pathologic scars. There is mounting evidence that these drugs used alone or in combination therapy, have the potential to be an integral part of the treatment paradigm for hypertrophic scars and keloids.
瘢痕疙瘩和增生性瘢痕的治疗一直是医疗服务提供者面临的挑战。尽管这两种病理性瘢痕在宏观和微观层面都是不同的实体，但它们的病因和治疗方法通常相似。潜在的治疗方法在不断发展，文献中已经提出了多种治疗方案的组合，取得了令人鼓舞的结果。治疗的发展已经达到了正在研究分子治疗方式的阶段。目前，尚无金标准治疗方法。总体成功率和患者满意度似乎在缓慢上升，但仍需继续开展更多的研究。多项研究对抗肿瘤药物进行了调查，使用这些药物时，复发率、患者满意度和瘢痕的整体质量似乎都有显著改善。病灶内注射和/或用干扰素-α2b、干扰素-γ、丝裂霉素-C、博来霉素或5-氟尿嘧啶进行伤口冲洗，似乎对减少病理性瘢痕有积极作用。越来越多的证据表明，这些药物单独使用或联合治疗，有可能成为增生性瘢痕和瘢痕疙瘩治疗模式的一个组成部分。
