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旧战伤再探。

Old War Scar Revisited.

作者信息

Wozniak Susan E, Zuo Stephanie, Khan Kamran, Coleman JoAnn

机构信息

Department of General Surgery, Sinai Hospital, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.

出版信息

J Am Coll Clin Wound Spec. 2016 Oct 3;7(1-3):35-39. doi: 10.1016/j.jccw.2016.09.001. eCollection 2015 Dec.

Abstract

In 1828, Jean Nicholas Marjolin, a French surgeon, first described the findings of a neoplastic development arising from a burn scar, now more commonly referred to as a Marjolin's ulcer. A Marjolin's ulcer describes malignant degeneration in any chronic wound. The majority of cases arises in burn scars and are often latent for decades. Marjolin ulcers have been widely identified in post-war time injuries. These ulcers may arise in almost any anatomical location. We report a case of an 82-year-old male that presented with a painful fluctuating mass on the right arm localized to the site of an old grenade blast injury he sustained many years earlier. While the presentation of these cases may be variable, the significance of proper management of the wounds is essential to optimal patient outcomes. An aggressive course and poor prognosis is associated with Marjolin's ulcers that degenerate into squamous cell carcinoma. Early detection and aggressive treatment/management with wide local excision and prompt coverage yield the best results when treating patients with Marjolin's ulcers.

摘要

1828年,法国外科医生让·尼古拉斯·马尔若林首次描述了烧伤瘢痕发生肿瘤性病变的情况,现在更常称之为马尔若林溃疡。马尔若林溃疡指任何慢性伤口发生的恶性退变。大多数病例发生于烧伤瘢痕,且往往潜伏数十年。马尔若林溃疡在战后创伤中已被广泛发现。这些溃疡几乎可发生于任何解剖部位。我们报告一例82岁男性病例,其右臂出现一个疼痛性、大小波动的肿块,位于他多年前遭受的旧手榴弹爆炸伤部位。虽然这些病例的表现可能各不相同,但正确处理伤口对于实现最佳患者预后至关重要。发生鳞状细胞癌退变的马尔若林溃疡与病程进展迅速和预后不良相关。对于马尔若林溃疡患者,早期发现并采用广泛局部切除和及时覆盖的积极治疗/处理可取得最佳效果。

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本文引用的文献

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6
Basal cell carcinoma presenting late in a shotgun scar.基底细胞癌在猎枪伤瘢痕中晚期出现。
Am J Clin Dermatol. 2009;10(4):271-2. doi: 10.2165/00128071-200910040-00009.
7
Marjolin's ulcer: modern analysis of an ancient problem.马乔林溃疡:对一个古老问题的现代分析
Plast Reconstr Surg. 2009 Jan;123(1):184-191. doi: 10.1097/PRS.0b013e3181904d86.

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