Correia-Sá Inês, Serrão Paula, Marques Marisa, Vieira-Coelho Maria A
Department of Plastic, Reconstructive and Aesthetic Surgery, Maxillofacial Surgery and Burn Unit, Centro Hospitalar de São João, EPE, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Department of Pharmacology & Therapeutics, Faculty of Medicine, University of Oporto, Porto, Portugal.
Obes Surg. 2017 Dec;27(12):3170-3178. doi: 10.1007/s11695-017-2740-4.
Hypertrophic scars are a consequence of wound healing.
The objective of the present study is to evaluate vitamin D and inflammatory biomarker plasma levels during wound healing.
A prospective study was performed in patients (n = 63) submitted to body contouring surgery. Blood samples were collected before (t ) and 5 days after surgery (t ). Blood cell count, protein inflammatory biomarkers, and circulating plasma levels of 25(OH)D, vitamin A and vitamin E were quantified. Six months after surgery, scars were evaluated and classified as normal or hypertrophic.
At the end of the study, 73% of the patients developed a normal scar (control group, n = 46) and 27% of the patients presented hypertrophic scars (HT group, n = 17). The patients in the HT group presented higher eosinophil (0.145 × 10 /L vs. 0.104 × 10 /L, p = 0.028) and basophil count (0.031 × 10 /L vs. 0.22 × 10 /L, p = 0.049) and C-reactive protein levels (6.12 mg/L vs. 2.30 mg/L, p = 0.015) in t than the patients in the control group. At t , the patients in the HT group showed a decrease in neutrophil (3.144 × 10 vs. 4.03 × 10/L, p = 0.031) and an increase in basophil (0.024 × 10/L vs. 0.015 × 10/L, p = 0.005) and lymphocyte count (1.836 × 10 /L vs. 1.557 × 10/L; p = 0.028). Before surgery, vitamin D plasma levels were found to be decreased by almost 50% (23.52 ng/mL vs. 15.46 ng/mL, p = 0.031) in the patients who developed hypertrophic scars. Thirty-one percent of the patients submitted to bariatric surgery had more hypertrophic scars, versus 24% of the patients with no previous bariatric surgery.
There is a different systemic inflammatory profile response in the patients during the formation of hypertrophic scars. Vitamin D plasma levels are marked reduced in these patients. Considering the powerful anti-inflammatory effect of vitamin D, these findings could be related.
增生性瘢痕是伤口愈合的结果。
本研究的目的是评估伤口愈合过程中维生素D和炎症生物标志物的血浆水平。
对接受身体塑形手术的患者（n = 63）进行了一项前瞻性研究。在手术前（t₀）和手术后5天（t₁）采集血样。对血细胞计数、蛋白质炎症生物标志物以及25(OH)D、维生素A和维生素E的循环血浆水平进行定量分析。手术后6个月，对瘢痕进行评估并分为正常或增生性。
在研究结束时，73%的患者形成了正常瘢痕（对照组，n = 46），27%的患者出现增生性瘢痕（HT组，n = 17）。HT组患者在t₁时的嗜酸性粒细胞（0.145×10⁹/L对0.104×10⁹/L，p = 0.028）和嗜碱性粒细胞计数（0.031×10⁹/L对0.022×10⁹/L，p = 0.049）以及C反应蛋白水平（6.12 mg/L对2.30 mg/L，p = 0.015）均高于对照组患者。在t₁时，HT组患者的中性粒细胞减少（3.144×10⁹/L对4.03×10⁹/L，p = 0.031），嗜碱性粒细胞增加（0.024×10⁹/L对0.015×10⁹/L，p = 0.005），淋巴细胞计数增加（1.836×10⁹/L对1.557×10⁹/L；p = 0.028）。在手术前，出现增生性瘢痕的患者维生素D血浆水平下降了近50%（23.52 ng/mL对15.46 ng/mL，p = 0.031）。接受减肥手术的患者中有31%有更多增生性瘢痕，而未接受过减肥手术的患者中这一比例为24%。
增生性瘢痕形成过程中患者存在不同的全身炎症反应特征。这些患者的维生素D血浆水平明显降低。考虑到维生素D强大的抗炎作用，这些发现可能存在关联。
