单纯压力治疗与硅酮联合治疗预防增生性瘢痕的疗效和安全性:随机对照试验的系统评价和荟萃分析。
Efficacy and Safety of Pressure Therapy Alone and in Combination with Silicone in Prevention of Hypertrophic Scars: A Systematic Review with Meta-analysis of Randomized Controlled Trials.
机构信息
Department of Plastic and Reconstructive Surgery, Senior Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
Medical School of Chinese PLA, Beijing, China.
出版信息
Aesthetic Plast Surg. 2023 Oct;47(5):2159-2174. doi: 10.1007/s00266-023-03591-w. Epub 2023 Aug 30.
BACKGROUND
At present, there are many kinds of hypertrophic scar treatment methods, among which pressure therapy and silicone therapy are very common and standard therapies, but whether they are used alone or in combination is still controversial. Therefore, the purpose of this systematic review was to compare the efficacy and safety of the combination of pressure therapy and silicone therapy (PTS) with pressure therapy alone (PT) in the treatment of hypertrophic scars to provide clinicians with information so that they can make better decisions.
METHODS
Relevant randomized controlled trials (RCTs) were collected by searching PubMed, Ovid MEDLINE, Embase, ScienceDirect, Web of Science, The Cochrane Library, Scopus, and Google Scholar databases to assess scar scores (The Vancouver Scar Scale, VSS; Visual Analog Scale, VAS) and adverse effects.
RESULTS
We screened 1270 articles and included 6 RCTs including 228 patients. We found that height (MD = 0.15, 95%CI 0.10-0.21, p < 0.01) and pliability (MD = 0.35, 95%CI 0.25-0.46, p <0.01) had a significant difference, these two measures showed that the PTS group was superior to the PT group. Results in other aspects, such as VSS, vascularity, pigmentation, VAS, and adverse effects were similar between the two groups.
CONCLUSIONS
There was no significant difference between PTS and PT in the overall treatment efficacy of hypertrophic scars with similar VSS and adverse effects, but PTS might have potential benefits for height and pliability. Additional studies with larger sample size and sound methodological quality are needed to confirm our conclusions. 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 .
背景
目前,治疗增生性瘢痕的方法有很多种,其中压力治疗和硅酮治疗是非常常见和标准的治疗方法,但单独使用或联合使用仍存在争议。因此,本系统评价的目的是比较压力治疗和硅酮治疗联合(PTS)与单纯压力治疗(PT)治疗增生性瘢痕的疗效和安全性,为临床医生提供信息,以便他们做出更好的决策。
方法
通过检索 PubMed、Ovid MEDLINE、Embase、ScienceDirect、Web of Science、The Cochrane Library、Scopus 和 Google Scholar 数据库,收集相关的随机对照试验(RCT),评估瘢痕评分(温哥华瘢痕量表,VSS;视觉模拟评分,VAS)和不良反应。
结果
我们筛选了 1270 篇文章,纳入了 6 项 RCT 研究,共 228 名患者。我们发现高度(MD = 0.15,95%CI 0.10-0.21,p < 0.01)和柔韧性(MD = 0.35,95%CI 0.25-0.46,p < 0.01)有显著差异,这两个指标表明 PTS 组优于 PT 组。在其他方面,如 VSS、血管、色素沉着、VAS 和不良反应,两组之间结果相似。
结论
PTS 与 PT 在增生性瘢痕的整体治疗效果方面没有显著差异,且不良反应相似,但 PTS 可能在高度和柔韧性方面具有潜在的益处。需要更大样本量和更高方法学质量的研究来证实我们的结论。
证据等级 IV 本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述,请参考目录或在线作者指南 www.springer.com/00266 。