Atiyeh Bishara S, Abou Ghanem Odette, Chahine Fadl
Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Plastic and Reconstructive Surgery, Trad Hospital and Medical Center, Beirut, Lebanon.
Aesthetic Plast Surg. 2021 Feb;45(1):296-308. doi: 10.1007/s00266-020-01927-4. Epub 2020 Sep 1.
Demand for safe, less aggressive and cost-efficient treatment modality to improve skin quality and appearance following scarring or photoaging is increasing steadily. A treatment modality that preserves the epidermis while promoting regeneration rather than cicatrization would be ideal. Percutaneous collagen induction (PCI) therapy or microneedling is claimed to approach this ideal objective. The current comprehensive literature review is intended to analyze the scientific basis supporting this therapeutic modality and to evaluate the efficacy of PCI microneedling therapy versus no treatment of patients with photoaged skin and scars of various etiologies on aesthetic skin rejuvenation, skin tightening and scar quality in prospective, retrospective and experimental studies. Twenty-five published studies were identified and included in this review. Four publications are experimental animal studies; most clinical reports are case series or small cohort non-randomized studies or trials lacking methodological unity with a heterogenous mix of scars, wrinkles and skin laxity being treated. The majority are studies about management of scars of various etiologies while only 4 specifically investigated the effect of PCI on wrinkles and aging skin. One study compared burn scar erythema in the treated area to the untreated area, and 5 studies included histologic evaluation of biopsies. Despite PCI promising therapeutic benefits and its increasing cosmetic applications, the current literature review unfortunately revealed a limited number of high-quality studies mostly experimental. Data and conclusions of clinical studies must be carefully interpreted before translating the evidence presented into clinical recommendations. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
对于安全、侵入性较小且成本效益高的治疗方式的需求在稳步增长，这种治疗方式旨在改善瘢痕形成或光老化后的皮肤质量和外观。一种既能保留表皮又能促进再生而非瘢痕形成的治疗方式将是理想之选。经皮胶原诱导（PCI）疗法或微针疗法据称接近这一理想目标。当前的综合文献综述旨在分析支持这种治疗方式的科学依据，并在前瞻性、回顾性和实验性研究中，评估PCI微针疗法与不治疗相比，对各种病因导致的光老化皮肤和瘢痕患者在美学皮肤年轻化、皮肤紧致和瘢痕质量方面的疗效。共识别出25项已发表的研究并纳入本综述。其中4篇为实验动物研究；大多数临床报告为病例系列或小型队列非随机研究或试验，缺乏方法学上的一致性，所治疗的瘢痕、皱纹和皮肤松弛情况各异。大多数研究是关于各种病因瘢痕的管理，而只有4项专门研究了PCI对皱纹和老化皮肤的影响。一项研究比较了治疗区域和未治疗区域的烧伤瘢痕红斑，5项研究包括了活检的组织学评估。尽管PCI有显著的治疗益处且其在美容领域的应用不断增加，但遗憾的是，当前的文献综述显示高质量研究数量有限，大多为实验性研究。在将现有证据转化为临床建议之前，必须仔细解读临床研究的数据和结论。证据级别IV：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
