Evidence-Based Medicine Center, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 441000, P.R. China.
Department of Plastic Surgery, Xiangyang Hospital, Hubei University of Medicine, Xiangyang 441000, P.R. China.
Sci Rep. 2017 Jan 5;7:40185. doi: 10.1038/srep40185.
Although pressure therapy (PT) represents the standard care for prevention and treatment of hypertrophic scar (HS) from burns, its practice is largely based on empirical evidence and its effectiveness remains controversial. To clarify the effect of PT (15-25 mmHg) for HS, we performed the systematic review and meta-analysis. Several electronic databases were screened to identify related randomized controlled trials (RCTs). 12 RCTs involving 710 patients with 761 HS resulting from burn injuries were included. Compared with non/low-PT, cases treated with PT (15-25 mmHg) showed significant differences in Vancouver Scar Scale score (MD = -0.58, 95% CI = -0.78--0.37), thickness (SMD = -0.25, 95% CI = -0.40--0.11), brightness (MD = 2.00, 95% CI = 0.59-3.42), redness (MD = -0.79, 95% CI = -1.52--0.07), pigmentation (MD = -0.16, 95% CI = -0.32--0.00) and hardness (SMD = -0.65, 95% CI = -1.07--0.23). However, there was no difference in vascularity (MD = 0.03, 95% CI = -0.43-0.48). Our analysis indicated that patients with HS who were managed with PT (15-25 mmHg) showed significant improvements. Due to limitations, more large and well-designed studies are needed to confirm our findings and the side-effects of the PT may also need to be evaluated.
尽管压力治疗(PT)是预防和治疗烧伤后增生性瘢痕(HS)的标准护理方法,但其实践主要基于经验证据,其疗效仍存在争议。为了阐明 PT(15-25mmHg)对 HS 的作用,我们进行了系统评价和荟萃分析。我们筛选了多个电子数据库以确定相关的随机对照试验(RCT)。纳入了 12 项涉及 710 例烧伤后 761 例 HS 患者的 RCT。与非/低 PT 相比,接受 PT(15-25mmHg)治疗的病例在温哥华瘢痕量表评分(MD=-0.58,95%CI=-0.78--0.37)、厚度(SMD=-0.25,95%CI=-0.40--0.11)、亮度(MD=2.00,95%CI=0.59-3.42)、红色(MD=-0.79,95%CI=-1.52--0.07)、色素沉着(MD=-0.16,95%CI=-0.32--0.00)和硬度(SMD=-0.65,95%CI=-1.07--0.23)方面存在显著差异。然而,在血管生成方面没有差异(MD=0.03,95%CI=-0.43-0.48)。我们的分析表明,接受 PT(15-25mmHg)治疗的 HS 患者有显著改善。由于存在局限性,需要更多大型和精心设计的研究来证实我们的发现,还需要评估 PT 的副作用。