Department of Dermatology, Gangnam Severance Hospital, Cutaneous Biology Research Institute, College of Medicine, Yonsei University, Seoul, Korea.
Dermatol Surg. 2013 Dec;39(12):1822-6. doi: 10.1111/dsu.12361. Epub 2013 Nov 10.
Postoperative adhesive symptoms (swallowing difficulty or pulling sensation during neck extension) are one of the major complications of thyroidectomy. Moreover, adhesive scars are often visible and cause cosmetic concerns.
To evaluate the efficacy and safety of combined treatment with surgical subcision and intralesional corticosteroid injection for postoperative adhesive thyroidectomy scars.
A retrospective analysis was performed of 16 Korean patients with postoperative adhesive thyroidectomy scars treated with three sessions of surgical subcision and intralesional corticosteroid injection.
The Vancouver Scar Scale score decreased significantly after treatment (P < .001). Follow-up revealed that six of the 16 patients (37.5%) had clinical improvement of 51% to 75%, six (37.5%) had moderate clinical improvement of 26% to 50%, and three (18.8%) had improvement of 76% to 100%; one patient (6.3%) demonstrated minimal to no improvement. After three sessions of treatment, the mean clinical improvement grade was 2.68, which means moderate to marked improvement compared to before treatment. Post-treatment erythema was observed in most patients, and notable bruising after treatment observed in five patients resolved spontaneously within 7 days.
Combined treatment with surgical subcision and intralesional corticosteroid injection is a cost-effective and minimally invasive treatment for postoperative adhesive thyroidectomy scars.
术后粘连症状（颈部伸展时吞咽困难或牵拉感）是甲状腺切除术的主要并发症之一。此外，粘连疤痕常常可见，引起美容问题。
评估手术切开术联合皮损内皮质类固醇注射治疗甲状腺切除术后粘连性疤痕的疗效和安全性。
对 16 例接受三次手术切开术联合皮损内皮质类固醇注射治疗的甲状腺切除术后粘连性疤痕的韩国患者进行回顾性分析。
治疗后温哥华疤痕量表评分显著降低（P<0.001）。随访发现，16 例患者中有 6 例（37.5%）临床改善 51%至 75%，6 例（37.5%）中度临床改善 26%至 50%，3 例（18.8%）改善 76%至 100%；1 例（6.3%）改善最小或无改善。经过三次治疗后，平均临床改善等级为 2.68，与治疗前相比为中等到明显改善。大多数患者治疗后出现红斑，5 例患者治疗后出现明显瘀斑，均在 7 天内自发消退。
手术切开术联合皮损内皮质类固醇注射是治疗甲状腺切除术后粘连性疤痕的一种具有成本效益且微创的方法。
