Chen Bo, Ding Jinping, Jin Ji, Song Nan, Liu Yuanbo
Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Plastic Surgery, Beijing Hospital, National Center of Gerontology, Beijing, China.
Dermatol Ther. 2020 Jul;33(4):e13553. doi: 10.1111/dth.13553. Epub 2020 May 25.
Surgical excision combined with postoperative radiotherapy is considered one of the most radical but most effective keloid therapeutic option. However, radiotherapy may not be appropriate for all keloid patients. In this study, we propose an alternate approach to prevent keloid recurrence and provide preliminary assessment in clinical efficacy of this treatment for keloids. Forty consecutive patients with different keloid sites underwent excision without postoperative radiation. After surgery, the tension offloading device was used at least 6 months for the purpose of continuous tension reduction at surgery incision. Scars were assessed independently using scar scale at before and 24-month follow-up. Overall, 38 patients completed this research. Clinical results showed that 35 patients achieved healing with an esthetic appearance at 24-month follow-up. Three patients showed relapse and the recurrence rate was 7.9%. Both of VSS (Vancouver Scar Scale) and JSW (Japan Scar Workshop Scar Scale) scores decreased significantly at 24-month follow-up visit than before. No severe complications were reported. Using the tension offloading device could greatly decrease tension on the surgical incision. The technique of continuous tension reduction could be used as an alternative method to prevent keloid recurrence under the condition of without radiotherapy.
手术切除联合术后放疗被认为是治疗瘢痕疙瘩最彻底但也是最有效的方法之一。然而，放疗可能并不适用于所有瘢痕疙瘩患者。在本研究中，我们提出了一种预防瘢痕疙瘩复发的替代方法，并对该治疗瘢痕疙瘩的临床疗效进行了初步评估。40例瘢痕疙瘩部位不同的连续患者接受了手术切除且未进行术后放疗。术后，使用减张装置至少6个月，以持续减轻手术切口处的张力。在术前和随访24个月时，使用瘢痕量表对瘢痕进行独立评估。总体而言，38例患者完成了本研究。临床结果显示，35例患者在随访24个月时达到美观愈合。3例患者出现复发，复发率为7.9%。在随访24个月时，温哥华瘢痕量表（VSS）和日本瘢痕研讨会瘢痕量表（JSW）评分均较术前显著降低。未报告严重并发症。使用减张装置可大大减轻手术切口处的张力。在不进行放疗的情况下，持续减张技术可作为预防瘢痕疙瘩复发的替代方法。
