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自体血小板浓缩物作为常规治疗难治性瘢痕疙瘩手术切除辅助治疗的疗效:一项前瞻性初步研究。

Efficacy of Autologous Platelet Concentrates as Adjuvant Therapy to Surgical Excision in the Treatment of Keloid Scars Refractory to Conventional Treatments: A Pilot Prospective Study.

作者信息

Hersant Barbara, SidAhmed-Mezi Mounia, Picard Frédéric, Hermeziu Oana, Rodriguez Anne-Marie, Ezzedine Khaled, Meningaud Jean Paul

机构信息

Department of Dermatology, Henri Mondor Hospital and EpiDermE, Université Paris-Est Créteil Val-de-Marne, Créteil, France.

出版信息

Ann Plast Surg. 2018 Aug;81(2):170-175. doi: 10.1097/SAP.0000000000001448.

Abstract

BACKGROUND

After conventional treatments, keloid scars show varying degrees of recurrence. The aim of this study was to assess the efficacy and safety of platelet-rich plasma in the treatment of postoperative keloid scars refractory to conventional treatments.

METHODS

This pilot prospective study was conducted in 17 patients with keloid scars who did not respond to 4 injections of cortisone or radiotherapy after extralesional resection of keloid. Platelet-rich plasma was injected intraoperatively and then 3 times with a 1-month interval. The primary end point was the complete remission of keloid scars 2 years posttreatment. Scar pruritus severity was scored before and after treatment. The study protocol was approved by the ethics committee and authorized by the French National Agency. This trial was registered at ClinicalTrials.gov, identifier NCT02922972.

RESULTS

Nine keloid scars (53%) were completely resolved at 2 years, and 5 (29%) completely relapsed after treatment. Pruritus severity score was significantly lower at 2 years compared with baseline (1.33 ± 0.97 before treatment and 0.40 ± 0.63 at 2 years, P < 0.003). The mean Vancouver Scar Scale score significantly improved (8.18 ± 2.38 before treatment and 3.82 ± 1.98 at 2 years, P < 0.001).

CONCLUSIONS

Injecting platelet-rich plasma is an effective and safe method as adjunctive therapy to resection for treating keloid scars refractory to conventional therapy.

摘要

背景

经过传统治疗后,瘢痕疙瘩会出现不同程度的复发。本研究的目的是评估富血小板血浆治疗对传统治疗难治的术后瘢痕疙瘩的疗效和安全性。

方法

这项前瞻性初步研究纳入了17例瘢痕疙瘩患者,这些患者在瘢痕疙瘩病灶外切除术后接受4次皮质类固醇注射或放射治疗均无效。术中注射富血小板血浆,之后每隔1个月注射1次,共注射3次。主要终点是治疗后2年瘢痕疙瘩完全缓解。在治疗前后对瘢痕瘙痒严重程度进行评分。该研究方案已获得伦理委员会批准,并得到法国国家机构的授权。本试验已在ClinicalTrials.gov注册,标识符为NCT02922972。

结果

9个瘢痕疙瘩(53%)在2年后完全消退,5个(29%)在治疗后完全复发。与基线相比,2年时瘙痒严重程度评分显著降低(治疗前为1.33±0.97,2年时为0.40±0.63,P<0.003)。温哥华瘢痕量表平均评分显著改善(治疗前为8.18±2.38,2年时为3.82±1.98,P<0.001)。

结论

注射富血小板血浆作为切除手术的辅助治疗方法,对于治疗对传统疗法难治的瘢痕疙瘩是一种有效且安全的方法。

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