University of Texas Southwestern Medical Center, Dallas, TX 75390 USA.
Dermatol Ther (Heidelb). 2012 Dec;2(1):12. doi: 10.1007/s13555-012-0012-8. Epub 2012 Aug 28.
The standard postsurgical treatment of wounds after dermatologic procedures is currently limited. Topical corticosteroids have been used successfully in postoperative management of ophthalmologic surgeries that involve the skin of the eyelid. In particular, tobramycin 0.3%/dexamethasone 0.1% ophthalmic ointment is considered the "gold standard" of steroid-antibiotic fixed combinations and is marketed worldwide as an agent used to control postsurgical inflammation and prevent postsurgical infection. The purpose of this study is to evaluate both the efficacy and safety of tobramycin-dexamethasone ointment for the postsurgical management of Mohs or dermatologic surgery in comparison to white petrolatum.
The authors employed a half-scar study in which patients who underwent skin cancer removal surgery were given tobramycin-dexamethasone ointment and white petrolatum to apply to each half of their wound for 2 weeks. The study was double blinded, and physicians and the patients independently evaluated the scars for cosmetic appearance at 2 and 6 weeks postoperatively. The evaluation criteria included judging which side of the wound looked better based on color, thickness, and discomfort.
Eighteen patients were enrolled, of which 13 patients completed the three phases of the study. After 6 weeks the wounds did not show a statistically significant difference in color, thickness, or discomfort on either side.
Results obtained to date suggest that the application of tobramycin-dexamethasone ointment to wounds after dermatologic surgery does not promote better wound healing than white petrolatum. These findings indicate that a topical steroid and antibiotic ointment may not be an effective intervention in improving postoperative outcomes in dermatologic surgeries.
目前，皮肤科手术后伤口的标准治疗方法有限。皮质类固醇类药物已成功应用于涉及眼睑皮肤的眼科手术后的术后管理。特别是妥布霉素 0.3%/地塞米松 0.1%眼膏被认为是皮质类固醇-抗生素固定组合的“金标准”，并在全球作为一种用于控制术后炎症和预防术后感染的药物上市。本研究旨在评估妥布霉素-地塞米松眼膏在 Mohs 或皮肤科手术后的疗效和安全性，并与白色凡士林进行比较。
作者采用半瘢痕研究，对接受皮肤癌切除术的患者，在术后 2 周内用妥布霉素-地塞米松眼膏和白色凡士林涂抹伤口的每一半。该研究为双盲研究，医生和患者独立评估术后 2 周和 6 周时的瘢痕美容外观。评估标准包括根据颜色、厚度和不适感判断伤口的哪一侧看起来更好。
共有 18 名患者入组，其中 13 名患者完成了研究的三个阶段。6 周后，两侧伤口的颜色、厚度或不适感均无统计学差异。
迄今为止的结果表明，在皮肤科手术后应用妥布霉素-地塞米松眼膏并不能促进伤口愈合优于白色凡士林。这些发现表明，局部类固醇和抗生素软膏可能不是改善皮肤科手术后结局的有效干预措施。
