Medical College of Wisconsin in Milwaukee, USA.
Aesthet Surg J. 2012 Nov;32(8):989-98. doi: 10.1177/1090820X12462383.
Within the plastic surgery community, it is widely believed that waiting a minimum of 6 to 12 months after patient cessation of systemic retinoid therapy is necessary before proceeding with elective surgery.
The authors investigate partial- and full-thickness wound healing after treatment with systemic isotretinoin in a porcine model.
Following institutional approval, 2 Hanford miniature pigs were obtained. One pig received isotretinoin at a dose of 2 mg/kg/d, administered orally along with pig feed over a 60-day period; the other (control) pig received only pig feed over the same time period. After the treatment period ended, a total of 24 full-thickness wounds and 24 partial-thickness wounds were made on each pig. The wounds were evaluated by photographic and histological analysis at 7, 14, and 28 days.
The average full-thickness wound size in the control animal was 0.4346 cm(2) at 14 days and 0.0689 cm(2) at 28 days. The average full-thickness wound size in the isotretinoin-treated animal was 0.4685 cm(2) at 14 days and 0.0363 cm(2) at 28 days. The differences were not statistically significant between the 2 animals at either time point. On histological analysis, the healing characteristics of partial- and full-thickness wounds were similar at 7, 14, and 28 days for both animals.
Invasive surgery might be safely performed even in the presence of recent isotretinoin therapy. This finding challenges the current practice of waiting longer than 6 months after completion of therapy to perform surgery.
在整形外科学界，人们普遍认为，在接受全身维甲酸治疗的患者停止治疗后，至少等待 6 至 12 个月，然后再进行择期手术是必要的。
作者在猪模型中研究了全身用异维 A 酸治疗后的部分和全层伤口愈合情况。
在机构批准后，获得了 2 头汉福德微型猪。一头猪接受了 2mg/kg/d 的异维 A 酸治疗，通过口服与猪饲料一起在 60 天内给予；另一只（对照）猪仅在相同时间内给予猪饲料。治疗期结束后，每只猪共制作了 24 个全层伤口和 24 个部分层伤口。通过在第 7、14 和 28 天的摄影和组织学分析评估伤口。
对照动物的平均全层伤口大小在第 14 天为 0.4346cm(2)，在第 28 天为 0.0689cm(2)。接受异维 A 酸治疗的动物的平均全层伤口大小在第 14 天为 0.4685cm(2)，在第 28 天为 0.0363cm(2)。在这两个时间点，这两种动物之间的差异均无统计学意义。在组织学分析中，两种动物的部分和全层伤口的愈合特征在第 7、14 和 28 天相似。
即使在最近接受异维 A 酸治疗的情况下，也可以安全进行侵入性手术。这一发现挑战了目前在治疗结束后等待超过 6 个月才能进行手术的做法。
