From Main Line Health, Claytor/Noone Plastic Surgery; the Division of Plastic Surgery, Cooper University Hospital; and Chantilly Cosmetic Surgery.
Plast Reconstr Surg. 2022 Sep 1;150(3):557e-561e. doi: 10.1097/PRS.0000000000009466. Epub 2022 Jun 28.
Scars are a vexing sequela of surgery. Microneedling, also known as minimally invasive percutaneous collagen induction, has demonstrated impressive improvements in chronic acne scars; however, no evidence exists for treating postsurgical scars during active wound healing. The purpose of this study was to demonstrate the utility and safe use of minimally invasive percutaneous collagen induction in acute postsurgical scars.
Twenty-five patients who underwent surgery had scars treated with three treatments of minimally invasive percutaneous collagen induction in the postoperative period. Scar assessment was measured by Vancouver Scar Scale, Patient and Observer Scar Assessment Scale, and Global Aesthetic Improvement Scale after each of the three treatments and at final 2-month follow-up.
Patients had positive improvement in Vancouver Scar Scale, Patient and Observer Scar Assessment Scale, and Global Aesthetic Improvement Scale scores at 16-week posttreatment initiation evaluation compared to initial measurement ( p < 0.001). No statistically significant differences were noted when comparing the age of the patient, location of scars, or Fitzpatrick phototype scales among patients. When comparing patients who began treatment early (6 to 7 weeks postoperatively) to those who began treatment late (13 to 16 weeks postoperatively), there was a statistically significant difference in the Patient and Observer Scar Assessment Scale group ( p < 0.04).
Postsurgical scars treated with minimally invasive percutaneous collagen induction in the maturation and remodeling phase had no adverse outcomes. Interestingly, the data show treatment initiated early in the maturation phase (6 to 7 weeks postoperatively), while natural collagen formation was tapering off, demonstrated improved aesthetic outcomes compared to treatments initiated late in the maturation phase (13 to 16 weeks postoperatively).
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
疤痕是手术的一个令人烦恼的后遗症。微针（也称为微创性经皮胶原诱导术）已证明在慢性痤疮疤痕方面有显著的改善效果；然而，在伤口愈合的活跃期，尚无治疗术后疤痕的证据。本研究旨在展示微创性经皮胶原诱导术在急性术后疤痕中的应用和安全使用。
对 25 名术后有疤痕的患者，在术后期间接受了三次微创性经皮胶原诱导术治疗。在每次治疗后和最终的 2 个月随访时，使用温哥华疤痕量表、患者和观察者疤痕评估量表以及整体美学改善量表来评估疤痕。
与初始测量值相比，在治疗开始后 16 周的评估中，患者的温哥华疤痕量表、患者和观察者疤痕评估量表以及整体美学改善量表评分均有明显改善（p < 0.001）。在患者年龄、疤痕位置或 Fitzpatrick 光型量表方面，患者之间没有统计学上的显著差异。在比较早期（术后 6 至 7 周）开始治疗的患者和晚期（术后 13 至 16 周）开始治疗的患者时，在患者和观察者疤痕评估量表组中存在统计学上的显著差异（p < 0.04）。
在成熟和重塑阶段，使用微创性经皮胶原诱导术治疗的术后疤痕没有不良后果。有趣的是，数据显示在成熟阶段早期（术后 6 至 7 周）开始治疗，而自然胶原蛋白形成逐渐减少时，与在成熟阶段晚期（术后 13 至 16 周）开始治疗相比，美学效果得到了改善。
临床问题/证据水平：治疗，IV。
