Mahdavian Delavary Babak, van der Veer Willem M, Ferreira José A, Niessen Frank B
Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands.
J Plast Surg Hand Surg. 2012 Apr;46(2):95-101. doi: 10.3109/2000656X.2012.669184.
Formation of hypertrophic scars is a common complication of wound healing, and at present little is known about the incidence and risk factors. Our aim was to analyse the incidence, progression, and regression of postoperative hypertrophic scars over time and to identify risk factors of hypertrophic scars. Patients who had had bilateral reduction mammoplasty or median sternotomy incision were included in the study. All patients were examined at 3 and 12 months postoperatively. We recorded: height, weight, allergy status, smoking status, skin type, tanning, and shape of the scar 3 and 12 months postoperatively. Of the 204 patients who were included, 122 (60%) developed a hypertrophic scar within 12 months of operation. Of these patients, 117 (96%) developed a hypertrophic scar within 3 months of operation. Twelve months postoperatively, 66/204 patients (32%) had a hypertrophic scar. In 31 of the 66 of the patients with a hypertrophic scar 3 months postoperatively (47%), the hypertrophic scar(s) regressed after 3 and 12 months. Smoking and age were associated with formation of hypertrophic scars. In conclusion, 60% of patients developed hypertrophic scars postoperatively, typically during the first three months. Most hypertrophic scars that are present after three months are still hypertrophic after 12 months. Young, non-smoking patients are more susceptible to formation of hypertrophic scars.
增生性瘢痕的形成是伤口愈合常见的并发症，目前对其发病率及危险因素知之甚少。我们的目的是分析术后增生性瘢痕随时间的发病率、进展及消退情况，并确定增生性瘢痕的危险因素。本研究纳入了接受双侧乳房缩小成形术或胸骨正中切开术的患者。所有患者均在术后3个月和12个月接受检查。我们记录了术后3个月和12个月时患者的身高、体重、过敏状态、吸烟状况、皮肤类型、晒黑情况及瘢痕形状。在纳入的204例患者中，122例（60%）在术后12个月内出现增生性瘢痕。其中，117例（96%）在术后3个月内出现增生性瘢痕。术后12个月时，204例患者中有66例（32%）有增生性瘢痕。在术后3个月有增生性瘢痕的66例患者中，31例（47%）的增生性瘢痕在3个月至12个月后消退。吸烟和年龄与增生性瘢痕的形成有关。总之，60%的患者术后出现增生性瘢痕，通常在术后前三个月。三个月后仍存在的大多数增生性瘢痕在12个月后仍为增生性。年轻、不吸烟的患者更容易形成增生性瘢痕。
