醋酸离子导入治疗术后手部顽固性瘢痕。
Acetic acid iontophoresis for recalcitrant scarring in post-operative hand patients.
机构信息
Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Department of Orthopaedic Surgery, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Department of Orthopaedic Surgery, Boston, MA, USA; Harvard College, Cambridge, MA, USA.
出版信息
J Hand Ther. 2014 Jan-Mar;27(1):44-8. doi: 10.1016/j.jht.2013.10.008. Epub 2013 Nov 6.
STUDY DESIGN
Retrospective cohort comparison.
INTRODUCTION
Using acetic acid iontophoresis (AAI) as a treatment modality significantly improved the functionality of hand in patients with recalcitrant scarring.
METHODS
Open trigger finger release patients followed up exclusively at a hand clinic between 2009 and 2011 were analyzed. Group I recovered optimal total active range of motion (TAM) after 14 standard of care (SOC) therapy sessions but Group II (10 digits) could only reach optimal recovery after 7 additional AAI sessions.
RESULTS
After SOC therapy, Group I's TAM recovery plateaued at 245 and Group II's at 219 (p < 0.01). After undergoing AAI, the TAM of Group II increased from 219 to 239 (p < 0.01).
DISCUSSION
Clinical studies suggest that AAI can modify collagen structure in scars. AAI could be a novel non-surgical treatment for restoring functionality to areas affected by difficult, recalcitrant scars.
CONCLUSION
AAI significantly improved the TAM of hand surgical patients who could not recover optimally with SOC therapy alone.
LEVEL OF EVIDENCE
Level 3.
研究设计
回顾性队列比较。
引言
使用醋酸离子电渗疗法（AAI）作为治疗方式可显著改善顽固性瘢痕患者手部的功能。
方法
分析了 2009 年至 2011 年间仅在手部诊所接受开放性扳机指松解术的患者。第 I 组在接受 14 次标准护理（SOC）治疗后恢复了最佳总主动活动度（TAM），但第 II 组（10 个手指）在接受 7 次额外的 AAI 治疗后才能达到最佳恢复。
结果
SOC 治疗后，第 I 组的 TAM 恢复到 245，第 II 组的 TAM 恢复到 219（p<0.01）。接受 AAI 治疗后，第 II 组的 TAM 从 219 增加到 239（p<0.01）。
讨论
临床研究表明，AAI 可以改变瘢痕中的胶原结构。AAI 可能是一种恢复受难愈性瘢痕影响区域功能的新型非手术治疗方法。
结论
AAI 显著改善了仅接受 SOC 治疗无法达到最佳恢复的手部手术患者的 TAM。
证据水平
3 级。
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