Dr. Tsao's Clinic of Plastic Surgery, Kaohsiung, Taiwan.
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Cosmet Dermatol. 2022 Nov;21(11):5969-5976. doi: 10.1111/jocd.15291. Epub 2022 Sep 19.
Dermal layer injuries can result in depressed or indented scars even when there is no subcutaneous injury. These scars can result from acne, chickenpox, trauma, or skin infection. Several procedures, including primary closure, subcision, microneedling, and dermal grafting, have been reported to be used to treat depressed scars, boxcars, or acne cosmetics. These procedures have not, however, been shown to be very effective when applied to the treatment of deep depressed scars, boxcars, or acne cosmetics. In this retrospective study, we assessed scar improvement in patients with deep depressed facial scars and boxcars treated with our novel combination of techniques.
This study included all patients treated for deep depressed scars and boxcars at our clinic from 2018 to 2021. To be included, patients had to present in our clinic for the treatment of deep depressed scars or boxcars, have no prominent subcutaneous layer injury, and have full set of clear pre-and post-procedure photographs. All patients initially received technique combination including scar subcision, inner purse-string suturing, and dermal grafting for the first stage surgery treatment. In cases of residual uneven superficial scars, laser dermabrasion resurfacing was used as second-staged treatment. Preoperative and six-month postoperative scar appearance photographs were assessed for improvement by our three nonmedical staff members and divided into four improvement groups, as minimal, moderate, good, and excellent.
This study included a total of 24 patients (20 females and four males) with facial scarring. Two patients (8.3%) had moderate, 13 (54.2%) good and nine (37.5%) excellent improvement post-treatment. There were no instances of minimal improvement. Four patients received second stage laser dermabrasion resurfacing for residual uneven superficial scars.
We concluded deep depressed scars and boxcars can be easily, safely, and effectively treated using our novel combined scar subcision, inner purse-string suturing, and dermal grafting treatment with possible second-staged laser dermabrasion, and without major complications.
即使没有皮下损伤，真皮层损伤也会导致凹陷或凹陷的疤痕。这些疤痕可能由痤疮、水痘、外伤或皮肤感染引起。已经报道了几种程序，包括直接闭合、皮下切开术、微针和皮片移植，用于治疗凹陷性疤痕、箱车或痤疮性化妆品。然而，当应用于治疗深度凹陷性疤痕、箱车或痤疮性化妆品时，这些程序并没有显示出非常有效。在这项回顾性研究中，我们评估了我们新的联合技术治疗深度面部凹陷性疤痕和箱车患者的疤痕改善情况。
本研究包括 2018 年至 2021 年在我们诊所接受深度凹陷性疤痕和箱车治疗的所有患者。纳入标准为：患者必须在我们诊所接受深度凹陷性疤痕或箱车治疗，无明显皮下层损伤，且术前和术后有完整的清晰照片。所有患者最初接受的治疗方案均包括疤痕皮下切开术、内荷包缝合术和真皮移植术，作为第一阶段手术治疗。在存在残留不均匀的浅表性疤痕的情况下，使用激光磨皮术作为第二阶段治疗。由我们的三名非医疗人员评估术前和术后 6 个月的疤痕外观照片，并将改善情况分为四个改善组，即轻微、中度、良好和优秀。
本研究共纳入 24 例（20 名女性和 4 名男性）面部疤痕患者。2 例（8.3%）患者治疗后有中度改善，13 例（54.2%）患者有良好改善，9 例（37.5%）患者有优秀改善。没有轻微改善的病例。4 例患者因残留的不均匀浅表性疤痕接受了第二阶段激光磨皮术。
我们认为，使用我们新的联合疤痕皮下切开术、内荷包缝合术和真皮移植术治疗深度凹陷性疤痕和箱车，结合可能的第二阶段激光磨皮术，既简单、安全又有效，且无重大并发症。
