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手术切除与超减张缝合联合浅层放射治疗瘢痕疙瘩的疗效

Efficacy of surgical resection and ultra-reduced tension suture combined with superficial radiation in keloid treatment.

作者信息

Hu Xiao-Ying, Yang Qiao, Guan Xiao-Yu, Li Jin-Ying, Wang Ling-Ling, Li Kun, Zhang Xiao-Tao

机构信息

Department of Cosmetic Medicine, Qingdao Eighth People's Hospital, Qingdao 266100, Shandong Province, China.

Department of Radiation Oncology, The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao 266042, Shandong Province, China.

出版信息

World J Clin Cases. 2023 Dec 16;11(35):8310-8319. doi: 10.12998/wjcc.v11.i35.8310.

Abstract

BACKGROUND

There are many available treatment options for keloid; however, single treatments are usually less effective. Therefore, more scientifically rational and effective combined treatment methods should be sought to solve the pain associated with keloids.

AIM

To explore the efficacy and safety of surgical resection and ultra-reduced tension suture combined with superficial radiation as keloid treatment.

METHODS

Fifteen keloid patients admitted to Qingdao Eighth People's Hospital from June 2020 to January 2022 were enrolled in this retrospective analysis. All patients underwent a comprehensive treatment approach comprising surgical resection, ultra-reduced tension suture incision, and superficial radiation therapy within 24 h postoperatively. The modified Vancouver Scar Scale (mVSS) and Patient and Observer Scar Assessment Scale (POSAS) were used to evaluate the treatment effect, whereas the efficacy, adverse effects, and recurrence rate were observed according to the 12-mo follow-up after treatment.

RESULTS

The mVSS and POSAS scores at 1 and 6 mo after combination treatment decreased compared to before treatment ( < 0.001), and the overall response rate was 93.3%. Only one case recurred, yielding a 6.7% recurrence rate. The incidence of local chromour sedimentation rate in 1-3 mo after radiotherapy was 33.3% (5 patients), all subsiding after 6-9 mo, without complications, such as delayed wound healing or dermatitis.

CONCLUSION

Surgical resection, super subtraction sutures, and superficial radiotherapy are treatment methods with short courses, low recurrence rates, and good safety profiles.

摘要

背景

瘢痕疙瘩有多种可用的治疗方法;然而,单一治疗通常效果较差。因此,应寻求更科学合理且有效的联合治疗方法来解决瘢痕疙瘩相关的疼痛问题。

目的

探讨手术切除、超减张缝合联合浅层放射治疗瘢痕疙瘩的疗效及安全性。

方法

选取2020年6月至2022年1月在青岛市第八人民医院收治的15例瘢痕疙瘩患者进行回顾性分析。所有患者均接受了综合治疗,包括手术切除、术后24小时内超减张缝合切口及浅层放射治疗。采用改良温哥华瘢痕量表(mVSS)和患者及观察者瘢痕评估量表(POSAS)评估治疗效果,并在治疗后随访12个月观察疗效、不良反应及复发率。

结果

联合治疗后1个月和6个月时的mVSS和POSAS评分较治疗前降低(<0.001),总有效率为93.3%。仅1例复发,复发率为6.7%。放疗后1 - 3个月局部色素沉着发生率为33.3%(5例患者),6 - 9个月后均消退,无伤口愈合延迟或皮炎等并发症。

结论

手术切除、超减张缝合及浅层放射治疗疗程短、复发率低且安全性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed3c/10731203/7db96e5003a5/WJCC-11-8310-g001.jpg

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