Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-Dong, Jongno-Gu, Seoul, 110-746, Republic of Korea.
Aesthetic Plast Surg. 2013 Apr;37(2):439-44. doi: 10.1007/s00266-013-0076-6. Epub 2013 Feb 2.
To prevent the recurrence of earlobe keloids after surgical removal, a reliable and safe postoperative treatment method is critical. To the authors' knowledge, no studies have elucidated the most effective postoperative dressing method for preventing the recurrence of earlobe keloids. This study aimed to compare keloid recurrence rates in patients whose keloids were dressed using conventional methods (plain gauze or a polyvinyl alcohol sponge) with those of a matched cohort of patients whose keloids were dressed using magnets combined with hydrocolloid materials.
This observational case-control study compared a retrospective cohort of patients whose keloids were dressed using conventional methods with a matched prospective cohort of patients whose keloids were dressed using magnets combined with hydrocolloid materials. The study included patients with pathologically confirmed earlobe keloids that were surgically excised with primary closure. Patients 8 years of age or older underwent adjuvant pressure therapy with magnets at the study hospital. Patients were excluded from the study if they were unavailable for follow-up evaluation, if they had received additional adjuvant therapy during treatment, or if histologic confirmation of a keloid was not obtained. Matched-pair analysis was performed using the McNemar test. Treatment outcome was evaluated as recurrence or nonrecurrence.
Overall, 9 (11.2%) of the 80 study patients experienced recurrence. The recurrence rate was significantly lower in the matched case group (2 of 40, 5%) than in the matched control group (7 of 40, 17.5%) during the follow-up period of 18 months (p=0.0253).
The authors' novel dressing of magnets and hydrocolloid materials appears to be effective in reducing earlobe keloid recurrence.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
为了防止耳垂瘢痕疙瘩切除术后复发，需要一种可靠且安全的术后治疗方法。据作者所知，目前还没有研究阐明预防耳垂瘢痕疙瘩复发的最有效术后包扎方法。本研究旨在比较使用常规方法（普通纱布或聚乙烯醇海绵）和使用磁铁联合水胶体材料包扎的患者的瘢痕疙瘩复发率。
本观察性病例对照研究比较了一组使用常规方法包扎的患者的回顾性队列和一组使用磁铁联合水胶体材料包扎的患者的匹配前瞻性队列。该研究纳入了接受过手术切除并一期缝合的病理证实的耳垂瘢痕疙瘩患者。年龄在 8 岁及以上的患者在研究医院接受辅助压力治疗，使用磁铁。如果患者无法进行随访评估、治疗过程中接受了其他辅助治疗或未获得瘢痕疙瘩的组织学确认，则将患者排除在研究之外。使用 McNemar 检验进行配对分析。治疗结果评估为复发或未复发。
共有 80 例研究患者中有 9 例（11.2%）出现复发。在 18 个月的随访期间，匹配病例组（40 例中有 2 例，5%）的复发率明显低于匹配对照组（40 例中有 7 例，17.5%）（p=0.0253）。
作者提出的磁铁和水胶体材料的新型包扎方法似乎可以有效降低耳垂瘢痕疙瘩的复发率。
证据水平 III：本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
