采用前瞻性纵向瘢痕评估量表评估外科切除术后瘢痕疙瘩的复发情况。

Evaluating keloid recurrence after surgical excision with prospective longitudinal scar assessment scales.

机构信息

Postgraduate Program in Plastic Surgery, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

J Plast Reconstr Aesthet Surg. 2012 Jul;65(7):e175-81. doi: 10.1016/j.bjps.2012.02.005. Epub 2012 Mar 3.

DOI:10.1016/j.bjps.2012.02.005

PMID:22386498

Abstract

INTRODUCTION

Evaluation tools are used to quantify scar evolution and determine treatment effectiveness. In clinical practice, scar assessment scales are less costly, tend to cover a greater number of aspects related to scar characteristics and can incorporate a patient's opinion in the assessment. However, the scales have not yet been used as an evaluation method for the postoperative recurrence of keloids.

OBJECTIVE

The study aims to evaluate the effectiveness of scar rating scales for keloid recurrence after surgical excision.

METHODS

Patients (n = 25) with keloids on the trunk were treated by surgical resection and postoperative beta radiation therapy. On the 3rd, 6th, 9th and 12th postoperative months, two specialists classified the lesions qualitatively in recurrent and non-recurrent cases. Furthermore, in the objective evaluation, the items on the Seattle Scar Scale (SSS) and the Stony Brook Scar Evaluation Scale (SBSES) were assessed by specialists, and the patients assessed items on the Patient Scar Assessment Scale (PSAS) for the pre- and postoperative periods. The scars were classified qualitatively as "good" or "poor."

RESULTS

Recurrence was observed in 18 patients (72%), according to the specialists' qualitative assessments. The best scores on the SSS and SBSES were given to the non-recurrent (p < 0.001) scars. The highest PSAS values were for the scars classified as "poor" (p < 0.001). There were no differences in the PSAS values for the preoperative period and outcomes for the recurrent scars (p = 0.519). The outcomes showed that the non-recurrent scars had lower values on the PSAS compared to the recurrent scars (p = 0.001) and compared to the preoperative period (p = 0.004).

CONCLUSIONS

The PSAS, SSS and SBSES scales were effective methods in distinguishing keloid postoperative recurrence. It is necessary to establish the recurrence cut-off scores for each of the scales according to the treatment used.

摘要

简介

评估工具用于量化疤痕的演变并确定治疗效果。在临床实践中，疤痕评估量表成本较低，往往涵盖与疤痕特征相关的更多方面，并可以在评估中纳入患者的意见。然而，这些量表尚未被用作评估瘢痕疙瘩术后复发的方法。

目的

本研究旨在评估瘢痕评分量表在外科切除术后瘢痕疙瘩复发中的有效性。

方法

对躯干上有瘢痕疙瘩的 25 名患者进行手术切除和术后β射线治疗。在术后第 3、6、9 和 12 个月，两名专家对复发和非复发病例进行定性分类。此外，在客观评估中，由专家评估西雅图瘢痕量表（SSS）和史东布鲁克瘢痕评估量表（SBSES）的项目，患者评估术前和术后患者瘢痕评估量表（PSAS）的项目。疤痕被定性分类为“好”或“差”。

结果

根据专家的定性评估，18 名患者（72%）出现复发。SSS 和 SBSES 的最佳评分是给予非复发（p<0.001）疤痕。PSAS 值最高的是分类为“差”的疤痕（p<0.001）。复发疤痕的 PSAS 值在术前和结果之间没有差异（p=0.519）。结果表明，与复发疤痕相比（p=0.001）和与术前相比（p=0.004），非复发疤痕的 PSAS 值较低。