Bristol Center for Surgical Research and Bristol Biomedical Research Center, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
Faculty of Health, School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia.
Adv Wound Care (New Rochelle). 2021 Oct;10(10):557-570. doi: 10.1089/wound.2020.1386. Epub 2021 Jul 14.
Keloid and hypertrophic scarring are common following acute wounds. However, the variability in scarring outcomes between individuals and in particular, the association between genetic factors and scarring, is not well understood. This scoping review aims to summarize the methodology used in studies of genetic influences on the development of keloid or hypertrophic scarring in adults and children after acute wounding. The objectives were to determine the study designs used, the characteristics of participants included, the tools used to assess scarring and the length of follow-up after wounding. The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Medline, Excerpta Medica Database (EMBASE), Web of Science, Biosciences Information Service (BIOSIS), Prospective Register of Systematic Reviews (PROSPERO), The Human Genetic Epidemiology (HuGE) Navigator (database of genetic association studies), and the genome-wide association study Catalog were searched from January 2008 to April 2020. Cohort studies and case-control studies that examined the association between one or more genetic variations and the development of keloid or hypertrophic scarring were eligible for inclusion. A narrative synthesis that grouped studies by wound type was conducted. Nine studies met the inclusion criteria (five in burns, four surgical wounds, and none in other types of acute wounds). Seven assessed hypertrophic scarring, one keloid scarring, and one both scar types. Seven studies used a prospective cohort design. All studies used subjective methods (clinician or patient observation) to assess scarring. There was considerable variation in how scar scales were operationalized. This review identified a small body of evidence on genetic susceptibility to scarring after acute wounding. Further studies are needed, and in a wide range of populations, including patients with wounds caused by trauma.
瘢痕疙瘩和增生性瘢痕是急性创伤后常见的并发症。然而，个体之间瘢痕形成结果的可变性，特别是遗传因素与瘢痕形成之间的关联，尚不完全清楚。本范围综述旨在总结研究遗传因素对成人和儿童急性创伤后瘢痕疙瘩或增生性瘢痕形成影响的方法学。目的是确定所使用的研究设计、纳入参与者的特征、用于评估瘢痕的工具以及创伤后随访的时间长度。该综述按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。从 2008 年 1 月至 2020 年 4 月，检索了 Medline、Excerpta Medica Database（EMBASE）、Web of Science、Biosciences Information Service（BIOSIS）、前瞻性系统评价登记册（PROSPERO）、人类遗传流行病学（HuGE）导航仪（遗传关联研究数据库）和全基因组关联研究目录。纳入了研究一个或多个遗传变异与瘢痕疙瘩或增生性瘢痕形成之间关联的队列研究和病例对照研究。对按伤口类型分组的研究进行了叙述性综合分析。有 9 项研究符合纳入标准（5 项烧伤，4 项手术伤口，无其他类型的急性伤口）。7 项研究评估了增生性瘢痕，1 项研究评估了瘢痕疙瘩，1 项研究评估了两种瘢痕类型。7 项研究采用前瞻性队列设计。所有研究均使用主观方法（临床医生或患者观察）评估瘢痕。瘢痕量表的操作方法存在很大差异。本综述确定了一小部分关于急性创伤后遗传易感性的证据。需要进一步的研究，并且需要在广泛的人群中进行，包括创伤引起的伤口患者。
