From the Department of Plastic and Reconstructive Surgery, Hamamatsu Medical Center; the Departments of Basic Nursing Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine; and the Department of General Internal Medicine, Seirei Hamamatsu General Hospital.
Plast Reconstr Surg. 2018 Jul;142(1):37-41. doi: 10.1097/PRS.0000000000004470.
Wound compression and fixation are important to reduce scarring. Numerous postoperative treatments have been developed to reduce scar formation; however, a simple and effective device that improves the appearance and histochemical properties of incisional scars is needed. Therefore, the authors have devised a novel method, negative-pressure fixation, that applies negative pressure inside polyurethane foam covered with film. In the present study, negative-pressure fixation was applied to incisional wounds resulting from the insertion of a tissue expander in patients undergoing two-stage breast reconstruction. The authors aimed to evaluate the effects of negative-pressure fixation on scar appearance and histochemical properties in comparison to those for film dressing without negative pressure. A prospective, open-label, randomized, single-center study was performed. A half-side test was conducted on the incisional scar resulting from tissue expander insertion during breast reconstruction after mastectomy in 13 female patients. The dressings on both sides of the scar were replaced once per week until the tissue expander was adequately inflated. The outcomes were assessed 6 months later. Scars were photographed before the second operation and were evaluated using a visual analogue scale. All scars were removed and resutured during the final operation, allowing a histochemical analysis. The mean visual analogue scale score for the negative-pressure fixation side was significantly lower compared with that for the film dressing side (p = 0.0025). In addition, the scar on the negative-pressure fixation side was significantly narrower (p = 0.0015). Thus, negative-pressure fixation is a simple and effective device for improving the appearance and histochemical properties of incisional scars.
伤口的压缩和固定对于减少疤痕至关重要。已经开发出许多术后治疗方法来减少疤痕形成；然而，需要一种简单有效的装置来改善切口疤痕的外观和组织化学特性。因此，作者设计了一种新方法，即负压固定，即在薄膜覆盖的聚氨酯泡沫内施加负压。在本研究中，负压固定应用于接受两阶段乳房重建的患者中因组织扩张器插入而产生的切口伤口。作者旨在评估与无负压薄膜敷料相比，负压固定对疤痕外观和组织化学特性的影响。进行了一项前瞻性、开放标签、随机、单中心研究。在 13 名女性乳腺癌根治术后接受乳房重建期间因组织扩张器插入而导致的切口疤痕的半侧试验中进行了半侧测试。在组织扩张器充分膨胀之前，每周更换一次两侧的敷料。6 个月后评估结果。在第二次手术前拍摄疤痕照片，并使用视觉模拟评分进行评估。所有疤痕均在最后一次手术中切除并重新缝合，以便进行组织化学分析。负压固定侧的平均视觉模拟评分明显低于薄膜敷料侧（p = 0.0025）。此外，负压固定侧的疤痕明显更窄（p = 0.0015）。因此，负压固定是一种简单有效的改善切口疤痕外观和组织化学特性的装置。
