Zakine G, Le Louarn C
Centre des brûlés, CHRU de Tours, France.
Ann Chir Plast Esthet. 2010 Oct;55(5):421-8. doi: 10.1016/j.anplas.2010.07.011. Epub 2010 Sep 24.
A new medical device based on a concept of the reconstruction of the extracellular matrix by a molecule belonging to the family of the ReGeneraTing Agents (RGTA(®)) has just been available to treat skin lesions. RGTA(®) are biodegradable polymers engineered to mimic heparan-sulfate in the extracellular matrix of damaged tissue. RGTA(®) improves tissue healing in several animal models, by stabilizing and protecting heparin-binding growth factors (HBGFs) and matrix proteins. We have evaluated the effects of this device containing RGTA(®) on cutaneous cicatrisation in a group of patients treated by reduction mammoplasty and in a group operated by a centrofacial lifting.
Seventeen patients who underwent mammoplasty for breast hypertrophy received cutaneous application of the device at D1, D4, D8 and D11 on one breast. Quality, color, inflammation of the scar and eventual complications have been evaluated by photography and at the third postoperative month by the Vancouver Scar Scale. Another group of 50 patients that underwent a centrofacial lifting received a bilateral deposition of drops of RGTA(®) in the operating plane at the end of the surgical procedure. Discomfort, oedema, ecchymosis and inflammation of the scars have been evaluated at 1-month postoperative and compared with an identical group of 50 other patients, operated by the same surgeon without RGTA(®).
In the group of mammoplasties, inflammation, prurit and hypertrophic scars were less frequent for the breast treated by RGTA(®). The mean Vancouver Scar Scale has been lower in the treated group than in the control group. In some patients the pain, related probably to the local inflammation, has been less important for the treated breast. In the sequence of centrofacial lift at 1-month postoperative, scar inflammation, oedema and bruises were much less frequent in the treated group (10 %) than in the non-treated group (90 %).
Topical application of RGTA(®) seems to improve cutaneous healing in a group of patients operated for breast reduction and to reduce discomfort, ecchymosis and oedema in the group of centrofacial lifting. These results are concordant to the experimental results obtained and pilot studies results.
一种基于再生剂（RGTA(®)）家族分子重建细胞外基质概念的新型医疗器械刚刚可用于治疗皮肤损伤。RGTA(®)是经过工程改造的可生物降解聚合物，旨在模仿受损组织细胞外基质中的硫酸乙酰肝素。RGTA(®)通过稳定和保护肝素结合生长因子（HBGFs）和基质蛋白，在多种动物模型中改善组织愈合。我们评估了这种含有RGTA(®)的器械对一组接受缩乳术治疗的患者以及一组接受面部中央提升手术的患者皮肤瘢痕形成的影响。
17例因乳房肥大接受乳房成形术的患者在术后第1天、第4天、第8天和第11天在一侧乳房上皮肤应用该器械。通过摄影以及在术后第三个月使用温哥华瘢痕量表评估瘢痕的质量、颜色、炎症情况及最终并发症。另一组50例接受面部中央提升手术的患者在手术结束时在手术平面双侧滴注RGTA(®)。在术后1个月评估瘢痕的不适、水肿、瘀斑和炎症情况，并与由同一位外科医生进行手术但未使用RGTA(®)的另一组50例相同患者进行比较。
在乳房成形术组中，使用RGTA(®)治疗的乳房炎症、瘙痒和增生性瘢痕的发生率较低。治疗组的温哥华瘢痕量表平均分低于对照组。在一些患者中，可能与局部炎症相关的疼痛，治疗侧乳房的疼痛程度较轻。在面部中央提升术后1个月时，治疗组（10%）的瘢痕炎症、水肿和瘀斑比未治疗组（90%）少得多。
局部应用RGTA(®)似乎可改善一组接受缩乳术患者的皮肤愈合，并减少面部中央提升术组的不适、瘀斑和水肿。这些结果与获得的实验结果和前期研究结果一致。
