Li-Tsang Cecilia Wai Ping, Zheng Yong Ping, Lau Joy C M
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
J Burn Care Res. 2010 May-Jun;31(3):448-57. doi: 10.1097/BCR.0b013e3181db52a7.
To investigate the effect of pressure therapy (PG), silicone gel sheeting (SGS), and combined therapy on the management of posttraumatic hypertrophic scar (HS) using a randomized controlled clinical trial. A total of 104 subjects with HS mostly resulting from burns and scald injuries (63 men and 41 women; average age: 21.8 +/- 18.7 years) were recruited from Jiangsu People's First Affiliated Hospital in Nanjing, China. The mean scar formation period was 14.9 +/- 30.8 months. All subjects were randomly allocated into four groups, namely the PG, SGS, combined PG and SGS groups, and single-blinded control group for the treatment of 6 months. Standardized scar assessments (pigmentation, vascularity, thickness, pain, and itchiness) were conducted before the intervention, 2, 4, and 6 months of the intervention, and 1 month after completion of the program, respectively, to observe the progress of the treatments. The results showed that the combined therapy seemed to be more effective in improving the thickness of scar after 2 months of intervention (P < .001). After 6 months of intervention, both the combined therapy group and the PG group showed significant improvement in scar thickness. The improvement in scar thickness was most significant in the combined therapy group. SGS was found to be more effective in alleviating the pain and pruritus rather than the scar thickness. This randomized clinical trial has demonstrated the evidence of the effect of combined PG and gel intervention on posttraumatic HS. The PG group showed an improvement in scar thickness too. Further studies are needed to investigate the biomechanical and physiological effect that PG and gel sheeting would exert on the scar tissues.
采用随机对照临床试验，研究压力疗法（PG）、硅胶片（SGS）及联合疗法对创伤后增生性瘢痕（HS）的治疗效果。共招募了104例主要因烧伤和烫伤导致HS的患者（63例男性，41例女性；平均年龄：21.8±18.7岁），来自中国南京的江苏省人民医院第一附属医院。瘢痕形成的平均时间为14.9±30.8个月。所有受试者被随机分为四组，即PG组、SGS组、PG与SGS联合组和单盲对照组，进行为期6个月的治疗。分别在干预前、干预2个月、4个月和6个月以及疗程结束后1个月进行标准化瘢痕评估（色素沉着、血管分布、厚度、疼痛和瘙痒），以观察治疗进展。结果显示，联合疗法在干预2个月后似乎在改善瘢痕厚度方面更有效（P<0.001）。干预6个月后，联合治疗组和PG组的瘢痕厚度均有显著改善。联合治疗组瘢痕厚度改善最为显著。发现SGS在减轻疼痛和瘙痒方面比改善瘢痕厚度更有效。这项随机临床试验证明了PG与凝胶联合干预对创伤后HS疗效的证据。PG组的瘢痕厚度也有所改善。需要进一步研究来探讨PG和凝胶片对瘢痕组织产生的生物力学和生理效应。
