Perez Justin L, Rohrich Rod J
Dallas, Texas.
From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and the Dallas Plastic Surgery Institute.
Plast Reconstr Surg. 2017 Dec;140(6):782e-793e. doi: 10.1097/PRS.0000000000003894.
Scar management is critical for every plastic surgeon's practice and, ultimately, the patient's satisfaction with his or her aesthetic result. Despite the critical nature of this component of routine postoperative care, there has yet to be a comprehensive analysis of the available literature over the past decade to assess the best algorithmic approach to scar care. To this end, a systematic review of best practices in preventative scar management was conducted to elucidate the highest level of evidence available on this subject to date.
A computerized MEDLINE search was performed for clinical studies addressing scar management. The resulting publications were screened randomized clinical trials that met the authors' specified inclusion/exclusion criteria.
This systematic review was performed in May of 2016. The initial search for the Medical Subject Headings term "cicatrix" and modifiers "therapy, radiotherapy, surgery, drug therapy, prevention, and control" yielded 13,101 initial articles. Applying the authors' inclusion/exclusion criteria resulted in 12 relevant articles. All included articles are randomized, controlled, clinical trials.
Optimal scar care requires taking into account factors such as incisional tension, anatomical location, and Fitzpatrick skin type. The authors present a streamlined algorithm for scar prophylaxis based on contemporary level I and II evidence to guide clinical practice.
瘢痕管理对每位整形外科医生的业务至关重要，最终也关乎患者对其美学效果的满意度。尽管术后常规护理的这一组成部分至关重要，但在过去十年中，尚未对现有文献进行全面分析，以评估瘢痕护理的最佳算法方法。为此，开展了一项关于预防性瘢痕管理最佳实践的系统评价，以阐明迄今为止该主题可获得的最高级别证据。
对涉及瘢痕管理的临床研究进行计算机化的医学文献数据库（MEDLINE）检索。对检索结果中的出版物进行筛选，纳入符合作者指定的纳入/排除标准的随机临床试验。
该系统评价于2016年5月进行。最初检索医学主题词“瘢痕”以及修饰词“治疗、放射治疗、手术、药物治疗、预防和控制”，得到13101篇初始文章。应用作者的纳入/排除标准后，得到12篇相关文章。所有纳入的文章均为随机对照临床试验。
最佳的瘢痕护理需要考虑诸如切口张力、解剖位置和菲茨帕特里克皮肤类型等因素。作者基于当代I级和II级证据提出了一种简化的瘢痕预防算法，以指导临床实践。
