Zouboulis C C, Orfanos C E
Universitäts-Hautklinik und Poliklinik, Klinikum Steglitz, Freien Universität Berlin.
Hautarzt. 1990 Dec;41(12):683-8.
The treatment of hypertrophic scars and keloids is a problem that has not yet been satisfactorily solved. We report here the results obtained with cryosurgery by the contact freezing method in 45 patients with 56 evaluated lesions. During the period of the investigation, cryosurgical treatment was completed in 23 patients with 28 lesions: in 53.6% we recorded an excellent result (ER), in 32.1% a good result, and in 14.7% a poor result. None of the lesions was totally resistant. Lesions that had been present for under 1 year (ER = 77.8%) and hypertrophic scars (ER = 72.2%) responded better than older lesions (ER = 41.2%) and keloids (ER = 20.0%), respectively. Optimal results were obtained after 4 +/- 2 sessions. Evaluation of the cryosurgical treatment in all patients revealed that the flattening of the lesions was increased after each session. Hypertrophic scars and lesions less than 4 cm2 in area responded more quickly than keloids and larger lesions, respectively. Pretreatment had a negative influence on the results of cryosurgery. No relapses were observed. The treatment was generally well tolerated, slight pain during freezing (52.1%) and hypo-/hyperpigmentation (22.9%) being the most frequent side-effects. Cryosurgery is simple to learn, and the technique is recommended for the treatment of hypertrophic scars and keloids.
增生性瘢痕和瘢痕疙瘩的治疗是一个尚未得到满意解决的问题。我们在此报告采用接触冷冻法对45例患者的56处瘢痕进行冷冻手术的结果。在研究期间,23例患者的28处瘢痕完成了冷冻手术治疗:53.6%的患者效果极佳(ER),32.1%的患者效果良好,14.7%的患者效果较差。没有瘢痕完全抵抗治疗。病程不到1年的瘢痕(ER = 77.8%)和增生性瘢痕(ER = 72.2%)的反应分别优于病程较长的瘢痕(ER = 41.2%)和瘢痕疙瘩(ER = 20.0%)。在4±2次治疗后获得了最佳效果。对所有患者冷冻手术治疗的评估显示,每次治疗后瘢痕的扁平度均有所增加。增生性瘢痕和面积小于4 cm²的瘢痕分别比瘢痕疙瘩和较大面积的瘢痕反应更快。术前治疗对冷冻手术的结果有负面影响。未观察到复发情况。该治疗通常耐受性良好,冷冻时轻微疼痛(52.1%)和色素减退/沉着(22.9%)是最常见的副作用。冷冻手术易于学习,该技术推荐用于增生性瘢痕和瘢痕疙瘩的治疗。