Cotellese Roberto, Hu Shu, Belcaro Gianni, Ledda Andrea, Feragalli Beatrice, Dugall Mark, Hosoi Morio, Ippolito Edmondo
IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy.
International Agency for Pharma Standard Supplements (IAPPS), Chieti, Italy.
Minerva Chir. 2018 Apr;73(2):151-156. doi: 10.23736/S0026-4733.18.07666-6.
Formation of scars after surgical incisions requires the proper appositions of elements contributing to the scarring process. The structural rebuilding of damaged tissues is essential in producing a linear scar. The excess of blood, foreign particles, exuberant sutures, necrotic tissue, possible infective agents, as well as the ongoing inflammatory process may produce a non-linear, sometimes painful keloidal scar. Centella asiatica (CA) extracts have been used topically since ancient times for preventing keloids (i.e. after extensive burns) and for other applications including ulcer healing. The aim of this registry study was to evaluate the effect of supplementation with Centellicum® (Horphag Research Ltd.) on the healing of surgical wounds in subjects with previous hypertrophic or keloid scars, and to identify with ultrasound the collagen components of the scar in order to assess the quality (or linearity) of surgical wounds.
Subjects with history of hypertrophic scars or keloid following previous surgery were included in this registry. Short term antibiotic prophylaxis was used as per surgical standards with cephalosporins for three days maximum after surgery. Only patients receiving abdominal or knee surgery were included. A total of 129 patients were included: 64 in the control group treated only with standard management, and 65 in the active treatment group where CA supplementation with Centellicum® was used at the dose of two 225 mg capsules/day from the 2nd to 6th week after surgery.
A total of 64 scars were analyzed within the control group and 65 in the supplement group. The tolerability to Centellicum® was overall good, and no side effects were reported. Compliance to treatment was optimal, with >98% of the CA capsules correctly used. The ultrasound-assessed scar tissue regularity was on average lower in controls than in supplemented subjects (P<0.05). Scars also appeared to be significantly more homogeneous in CA patients than in controls.
Supplementation with Centellicum® is safe and does not interfere with other concomitant treatments. It is well tolerated and compliance to treatment is optimal.
手术切口后瘢痕的形成需要对瘢痕形成过程中的各种因素进行适当对位。受损组织的结构重建对于形成线性瘢痕至关重要。血液过多、异物颗粒、过多缝线、坏死组织、可能的感染因子以及持续的炎症过程可能会产生非线性的、有时疼痛的瘢痕疙瘩瘢痕。积雪草提取物自古以来就被局部用于预防瘢痕疙瘩（如大面积烧伤后）以及其他用途，包括溃疡愈合。本登记研究的目的是评估补充积雪草制剂（霍法格研究有限公司）对既往有增生性或瘢痕疙瘩瘢痕的受试者手术伤口愈合的影响，并通过超声识别瘢痕的胶原蛋白成分，以评估手术伤口的质量（或线性度）。
本登记研究纳入了既往手术有增生性瘢痕或瘢痕疙瘩病史的受试者。按照手术标准使用短期抗生素预防，术后最多使用头孢菌素三天。仅纳入接受腹部或膝关节手术的患者。共纳入129例患者：64例在仅接受标准治疗的对照组，65例在积极治疗组，术后第2至6周每天服用两粒225毫克胶囊剂量的积雪草制剂。
对照组共分析了64个瘢痕，补充组分析了65个瘢痕。积雪草制剂的耐受性总体良好，未报告副作用。治疗依从性最佳，超过98%的积雪草胶囊正确使用。超声评估的瘢痕组织规则性平均而言，对照组低于补充组（P<0.05）。积雪草制剂治疗的患者瘢痕也明显比对照组更均匀。
补充积雪草制剂是安全的，且不干扰其他同时进行的治疗。耐受性良好，治疗依从性最佳。
