Department of Plastic and Reconstructive Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Department of Plastic and Reconstructive Surgery, VU University Medical Center, Amsterdam, The Netherlands.
J Plast Reconstr Aesthet Surg. 2014 Dec;67(12):1703-10. doi: 10.1016/j.bjps.2014.08.046. Epub 2014 Aug 27.
Intralesional (IL) cryotherapy is a new promising technique for the treatment of keloid scars, in which the scar is frozen from inside. Multiple devices are available, mostly based on a simple liquid nitrogen Dewar system, which have a limited freezing capacity. Argon gas-based systems ensure accurate and highly controlled freezing and have shown to be effective within the field of oncologic surgery. However, this technique has never been used for the treatment of keloid scars.
This prospective study evaluates an argon gas-based system for the treatment of keloids in a patient population including all Fitzpatrick skin types with a 1-year follow-up.
Twenty-five patients with 30 keloid scars were included and treated with a device called Seednet (Galil Medical, Yokneam, Israel). Scar quality and possible scar recurrence were assessed before treatment and post treatment (6 and 12 months) with objective devices determining scar color, scar elasticity, scar volume, and patient's skin type. In addition, scars were evaluated using the Patient and Observer Scar Assessment Scale.
After 12 months, a significant volume reduction of 62% was obtained, p = 0.05. Moreover, complaints of pain and itching were alleviated and scar quality had improved according to the Patient and Observer Scar Assessment Scale. Scar pigmentation recovered in 62% of all keloid scars within 12 months. Five out of 30 (17%) scars recurred within 12 months, three of which had previously been treated with liquid nitrogen-based IL cryotherapy. Both recurrent and persistent hypopigmentation were mainly seen in Afro-American patients.
IL cryotherapy with the use of an argon gas-based system proves to be effective in the treatment of keloid scars, yielding volume reduction and low recurrence rates. Although hypopigmentation recovered in most cases, it is strongly related to non-Caucasian patients. Finally, additional treatment of keloid scars previously unresponsive to IL cryotherapy is predisposed to a high recurrence rate.
NCT02063243.
瘤内（IL）冷冻疗法是一种治疗瘢痕疙瘩的新技术，即从内部冷冻瘢痕。有多种设备可供选择，大多数基于简单的液氮杜瓦系统，其冷冻能力有限。基于氩气的系统可确保准确和高度受控的冷冻，并已在肿瘤外科领域显示出有效性。然而，这种技术从未用于治疗瘢痕疙瘩。
本前瞻性研究评估了一种基于氩气的系统在包括所有 Fitzpatrick 皮肤类型的患者人群中治疗瘢痕疙瘩的效果，随访时间为 1 年。
共纳入 25 名患有 30 处瘢痕疙瘩的患者，并使用名为 Seednet（以色列 Yokneam 的 Galil Medical）的设备进行治疗。在治疗前和治疗后（6 个月和 12 个月）使用客观设备评估瘢痕质量和可能的瘢痕复发情况，这些设备可确定瘢痕颜色、瘢痕弹性、瘢痕体积和患者皮肤类型。此外，还使用患者和观察者瘢痕评估量表对瘢痕进行评估。
12 个月后，获得了 62%的显著体积缩小，p=0.05。此外，疼痛和瘙痒等症状得到缓解，根据患者和观察者瘢痕评估量表，瘢痕质量得到改善。在 12 个月内，所有瘢痕疙瘩中有 62%的色素沉着恢复。在 30 处瘢痕中，有 5 处（17%）在 12 个月内复发，其中 3 处之前曾接受过基于液氮的 IL 冷冻疗法。在 12 个月内，复发和持续的色素减退主要见于非裔美国患者。
使用基于氩气的系统进行 IL 冷冻疗法治疗瘢痕疙瘩有效，可减少体积并降低复发率。尽管大多数情况下色素沉着恢复，但它与非白种人患者密切相关。最后，先前对 IL 冷冻疗法无反应的瘢痕疙瘩的额外治疗易导致高复发率。
NCT02063243。
