Plastic and Reconstructive Surgery Research, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, England, United Kingdom.
MRC-SA Wound Healing Unit, Division of Dermatology, University of Cape Town, Cape Town, South Africa.
Adv Wound Care (New Rochelle). 2022 Mar;11(3):132-149. doi: 10.1089/wound.2020.1387. Epub 2021 Aug 24.
Many treatments are utilized in the management of skin scarring; however, difficulties arise due to the high rates of recurrence and the identification of treatment efficacy in each patient, in particular, in the case of raised dermal scarring. Therefore, evaluation of treatments and the provision of objective scar assessment pre-therapy and post-therapy is of paramount importance to identify changes in scar characteristics using noninvasive devices. There have been a number of emerging noninvasive objective quantitative devices, which assess specific scar parameters such as pliability, volume, color, perfusion, and depth. These can include three-dimensional imaging, optical coherence tomography, confocal microscopy, full-field laser perfusion imaging, and spectrophotometric intracutaneous analysis. Clinical assessment and grading scales are most commonly used to assess scarring; however, there is a need for more objective quantitative measures to monitor their maturation and response to therapy. Currently, there is no consensus as to which objective measuring device is most optimal when assessing skin scarring. There is a need for a predictor tool that allows early implementation of treatment and addresses diagnosis, therapy, and prognosis. Validation of noninvasive objective scar assessment tools is essential as well as further development of technologies. There are currently more modalities that assess physical scar characteristics and only few that measure the physiological parameters. Therefore, the development of a technology that quantifies the metabolic and cellular activity in skin scars is necessary to allow for bespoke strategies for each patient.
许多治疗方法被用于皮肤瘢痕的管理；然而，由于高复发率和在每个患者中识别治疗效果的困难，特别是在隆起性真皮瘢痕的情况下，这给治疗带来了困难。因此，评估治疗方法，并在治疗前和治疗后提供客观的瘢痕评估，对于使用非侵入性设备识别瘢痕特征的变化至关重要。已经出现了许多新兴的非侵入性客观定量设备，这些设备可以评估特定的瘢痕参数，如柔韧性、体积、颜色、灌注和深度。这些设备包括三维成像、光学相干断层扫描、共聚焦显微镜、全视野激光灌注成像和分光光度皮肤内分析。临床评估和分级量表最常用于评估瘢痕；然而，需要更客观的定量措施来监测其成熟度和对治疗的反应。目前，对于评估皮肤瘢痕最理想的客观测量设备尚无共识。需要一种预测工具，以便早期实施治疗，并解决诊断、治疗和预后问题。验证非侵入性客观瘢痕评估工具是必要的，同时还需要进一步开发技术。目前，评估物理瘢痕特征的方式较多，而测量生理参数的方式较少。因此，需要开发一种量化皮肤瘢痕代谢和细胞活性的技术，以便为每个患者制定定制化的策略。
