Shin J U, Park J H, Oh S H, Jeong J J, Kang S, Nam K, Chung W Y, Lee J H
Department of Dermatology and Cutaneous Biology Research Institute.
J Wound Care. 2015 Apr;24(4):163-4, 166-8, 170-1. doi: 10.12968/jowc.2015.24.4.163.
Although hypertrophic scars are cosmetically problematic for patients following thyroidectomy, the associated risk factors are not well defined. Our objective was to determine the factors associated with hypertrophic scar development following thyroidectomy.
A retrospective chart review was performed collecting data on sex, age, body mass index (BMI), operation site, skin characteristics (pigmentation, erythema, elasticity, and hydration), and clinical scar characteristics (itching, tightening, induration, adhesion, and oedema). It was also noted if the patient had early scar intervention with intralesional steroid injection or non-ablative fractional laser irradiation, and preventive topical treatment agents. The effects of these factors were analysed using univariate and multivariate analyses.
Data from 1141 patients showed the incidence of hypertrophic scars was 13.9%. Significant variables in univariate analysis were combined for multivariate analysis. Young age, high BMI, itching, tightening, induration, and adhesion were associated with hypertrophic scar formation. Early scar intervention, as well as the use of preventive topical agents, were associated with decreased hypertrophic scar formation.
Based on our results, we suggest that dermatologists consider using non-ablative fractional laser, intralesional steroid injection, and topical preventive agents to lower the incidence of hypertrophic scars, especially in young patients or those with high BMI and/or clinical symptoms such as itching, tightening, induration, and adhesion.
尽管甲状腺切除术后增生性瘢痕对患者的外貌有不良影响,但其相关危险因素尚不明确。我们的目的是确定甲状腺切除术后增生性瘢痕形成的相关因素。
进行一项回顾性病历审查,收集有关性别、年龄、体重指数(BMI)、手术部位、皮肤特征(色素沉着、红斑、弹性和水合作用)以及临床瘢痕特征(瘙痒、紧绷、硬结、粘连和水肿)的数据。还记录了患者是否接受了早期瘢痕干预,如病灶内注射类固醇或非剥脱性分次激光照射,以及预防性外用治疗药物。使用单因素和多因素分析来分析这些因素的影响。
1141例患者的数据显示增生性瘢痕的发生率为13.9%。单因素分析中的显著变量被合并用于多因素分析。年轻、高BMI、瘙痒、紧绷、硬结和粘连与增生性瘢痕形成相关。早期瘢痕干预以及预防性外用药物的使用与增生性瘢痕形成减少相关。
根据我们的结果,我们建议皮肤科医生考虑使用非剥脱性分次激光、病灶内注射类固醇和外用预防性药物来降低增生性瘢痕的发生率,尤其是在年轻患者或BMI高和/或有瘙痒、紧绷、硬结和粘连等临床症状的患者中。