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1064nm 掺钕钇铝石榴石激光联合类固醇贴剂治疗增生性瘢痕:40 例剖宫产瘢痕分析

Combination of 1,064-nm Neodymium-doped Yttrium Aluminum Garnet Laser and Steroid Tape Decreases the Total Treatment Time of Hypertrophic Scars: An Analysis of 40 Cases of Cesarean-Section Scars.

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan.

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Keelung Branch, Chang Gung University College of Medicine, Taoyuan, Taiwan.

出版信息

Dermatol Surg. 2020 Aug;46(8):1062-1067. doi: 10.1097/DSS.0000000000002235.

Abstract

BACKGROUND

The 1,064-nm neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (Cutera, Inc., Brisbane, CA) and steroid tape (fludroxycortide tape) have been used to treat keloids and hypertrophic scars.

OBJECTIVE

To evaluate the efficacy of contact-mode 1,064-nm Nd:YAG laser therapy and steroid tape for hypertrophic cesarean-section scars versus conservative therapy (steroid tape only).

MATERIALS AND METHODS

A medical record review identified 40 consecutive Japanese patients who had hypertrophic scars (total Japan Scar Workshop Scar Scale [JSS] 2015 evaluation scores of 9 to 12) for more than 1 year after a vertical cesarean section and who were treated at our scar-specialist clinic from July 2015 to December 2017. All 40 patients continued treatment until the total JSS score dropped below 3. Recurrence was defined as a ≥1-point increase in the total JSW score 6 months after achieving a total JSS score <3.

RESULTS

The patients had a mean age of 34.2 years. The test (n = 25) and control (n = 15) groups took on average 16.9 and 24.3 months to achieve a total JSS score <3, respectively (p < .01). In the following 6 months, none of the scars recurred.

CONCLUSION

Nd:YAG laser treatment effectively decreased the total treatment time of hypertrophic cesarean-section scars. An algorithm for treating mild and severe hypertrophic cesarean-section scars is proposed.

摘要

背景

1064nm 掺钕钇铝石榴石(Nd:YAG)激光(Cutera,Inc.,Brisbane,CA)和类固醇贴剂(氟羟皮质贴剂)已被用于治疗瘢痕疙瘩和增生性瘢痕。

目的

评估接触式 1064nm Nd:YAG 激光治疗联合类固醇贴剂与单纯类固醇贴剂治疗用于增生性剖宫产瘢痕的疗效。

材料与方法

回顾性分析了 2015 年 7 月至 2017 年 12 月在我们瘢痕专科诊所就诊的 40 例连续日本患者的病历,这些患者在垂直剖宫产术后 1 年以上均出现增生性瘢痕(2015 年日本瘢痕工作组瘢痕量表[JSS]总评分为 9 至 12 分)。所有 40 例患者均继续治疗,直至 JSS 总评分降至 3 分以下。复发定义为 JSS 总评分<3 分后 6 个月总 JSS 评分增加≥1 分。

结果

患者平均年龄为 34.2 岁。试验组(n=25)和对照组(n=15)平均分别需要 16.9 和 24.3 个月达到 JSS 总评分<3(p<0.01)。在随后的 6 个月中,无任何瘢痕复发。

结论

Nd:YAG 激光治疗可有效缩短增生性剖宫产瘢痕的总治疗时间。提出了一种治疗轻、重度增生性剖宫产瘢痕的方案。

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