Busch K H, Bender R, Walezko N, Aziz H, Altintas M A, Aust M C
Department for Plastic and Reconstructive Surgery, Johanniter Hospital, Bonn, Germany.
Department for Plastic and Reconstructive Surgery, Bergmannsheil und Kinderklinik Buer, Gelsenkirchen, Germany.
Burns. 2016 Nov;42(7):1556-1566. doi: 10.1016/j.burns.2016.04.009. Epub 2016 May 4.
Burn scars remain a serious physical and psychological problem for the affected people. Clinical studies as well as basic scientific research have shown that medical needling can significantly increase the quality of burn scars with comparatively low risk and stress for the patient with regards to skin elasticity, moisture, erythema and transepidermal water loss. However, medical needling has no influence on repigmentation of large hypopigmented scars. The goal of this study is to evaluate whether two established methods - needling (for improvement of scar quality) and non-cultured autologous skin cell suspension (for repigmentation) - can be successfully combined. Twenty subjects with mean age of 33 years (6-60 years) with scars from deep second and third degree burns have been treated. The average treated surface area was 94cm (15-250cm) and was focused on prominent areas such as the face, neck, chest and arm. Percutaneous collagen induction or "medical needling" was performed using a roller covered with 3mm long needles. The roller is vertically, horizontally and diagonally rolled over the scar, inducing microtrauma. Then, non-cultured autologous skin cell suspension (NCASCS) was produced and applied using the ReNovaCell Autologous Cell Harvesting Device (Avita Medical), according to the manufacturer's instructions. The patients were followed 12 months postoperatively. Pigmentation changes were measured objectively, as well as with patient and observer ratings. Patient satisfaction/preference was also obtained. Taken together, the pigmentation ratings and objective measures indicate individual improvement in 17 of the study participants. The melanin increases seen 12 months after NCASCS treatment are statistically significant. Medical needling in combination with NCASCS shows promise for repigmentation of burn cars.
烧伤疤痕对患者来说仍然是一个严重的生理和心理问题。临床研究以及基础科学研究表明，医学针刺能够显著改善烧伤疤痕的质量，且就皮肤弹性、水分、红斑和经表皮水分流失而言，给患者带来的风险和压力相对较低。然而，医学针刺对大面积色素减退疤痕的色素沉着没有影响。本研究的目的是评估两种既定方法——针刺（用于改善疤痕质量）和非培养自体皮肤细胞悬液（用于色素沉着）——能否成功结合。对20名平均年龄33岁（6至60岁）、有深二度和三度烧伤疤痕的受试者进行了治疗。平均治疗面积为94平方厘米（15至250平方厘米），主要集中在面部、颈部、胸部和手臂等突出部位。使用覆盖有3毫米长针头的滚轮进行经皮胶原诱导或“医学针刺”。将滚轮在疤痕上垂直、水平和对角滚动，造成微创伤。然后，按照制造商的说明，使用ReNovaCell自体细胞采集装置（Avita Medical）制备并应用非培养自体皮肤细胞悬液（NCASCS）。术后对患者进行了12个月的随访。客观测量色素沉着变化，同时收集患者和观察者的评分。还获得了患者的满意度/偏好。总体而言，色素沉着评分和客观测量结果表明，1/7的研究参与者有个体改善。NCASCS治疗12个月后观察到的黑色素增加具有统计学意义。医学针刺联合NCASCS对烧伤疤痕的色素沉着显示出前景。
