Trisliana Perdanasari Aurelia, Lazzeri Davide, Su Weijie, Xi Wenjing, Zheng Zhang, Ke Li, Min Peiru, Feng Shaoqing, Zhang Yi Xin, Persichetti Paolo
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Plastic and Reconstructive Surgery Unit, Campus Bio-Medico University, Rome, Italy.
Arch Plast Surg. 2014 Nov;41(6):620-9. doi: 10.5999/aps.2014.41.6.620. Epub 2014 Nov 3.
Keloid scars are often considered aesthetically unattractive and frustrating problems that occur following injuries. They cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and possibly affect joint movement. The combination of these factors ultimately results in a compromised quality of life and diminished functional performance. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches. However, it has proven to be a challenge to identify a universal treatment that can deliver optimal results for all types of scars. Through a PubMed search, we explored most of the literature that is available about the intralesional injection treatment of hypertrophic scars and keloids and highlights both current (corticosteroid, 5-fluorouracil, bleomycin, interferon, cryotherapy and verapamil) and future treatments (interleukin-10 and botulinum toxin type A). The reference lists of retrieved articles were also analysed. Information was gathered about the mechanism of each injection treatment, its benefits and associated adverse reactions, and possible strategies to address adverse reactions to provide reliable guidelines for determining the optimal treatment for particular types of keloid scars. This article will benefit practitioners by outlining evidence-based treatment strategies using intralesional injections for patients with hypertrophic scars and keloids.
瘢痕疙瘩通常被认为是受伤后出现的在美学上缺乏吸引力且令人困扰的问题。它们会导致功能和外观畸形、不适、瘙痒、疼痛以及心理压力,还可能影响关节活动。这些因素综合起来最终会导致生活质量下降和功能表现受损。已经采用了各种方法,通过手术和非手术途径来改善瘢痕疙瘩。然而,事实证明,找到一种能对所有类型瘢痕都产生最佳效果的通用治疗方法是一项挑战。通过在PubMed上进行检索,我们探究了关于瘢痕疙瘩和增生性瘢痕病灶内注射治疗的大部分现有文献,并重点介绍了当前的治疗方法(皮质类固醇、5-氟尿嘧啶、博来霉素、干扰素、冷冻疗法和维拉帕米)以及未来的治疗方法(白细胞介素-10和A型肉毒毒素)。我们还分析了所检索文章的参考文献列表。收集了有关每种注射治疗的机制、其益处和相关不良反应的信息,以及应对不良反应的可能策略,以便为确定针对特定类型瘢痕疙瘩的最佳治疗方法提供可靠的指导方针。本文将通过概述针对增生性瘢痕和瘢痕疙瘩患者使用病灶内注射的循证治疗策略,使从业者受益。