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应用于背阔肌皮瓣乳房再造术后的激光疗法瘢痕管理

Postoperative Scar Management Using Laser Therapy for Breast Reconstruction With Latissimus Dorsi Flap.

机构信息

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

出版信息

In Vivo. 2024 Mar-Apr;38(2):842-848. doi: 10.21873/invivo.13509.

Abstract

BACKGROUND

Postoperative scar formation is inevitable, and a gold standard management has not been established to date. Due to the fact long and large scar formation occurs in reconstructive surgery, this study analyzed the relationship between various factors in patients who received breast reconstruction using latissimus dorsi (LD) flap to investigate appropriate and effective management approaches.

PATIENTS AND METHODS

Twenty-seven patients who underwent breast reconstruction between June 2014 and January 2015 received laser therapy on their LD donor site at the Kyungpook National University Chilgok Hospital. Scar evaluation was performed on both the surgical scar and intact skin on the contralateral side. Scar evaluation was conducted at five specific points, 2 cm from the midpoint of the scar on each side. Laser treatment was performed at 4-week intervals, and patients were then followed-up for 6 months. To assess scars, gross images were taken using the same settings. In addition, spectrophotometry was used for color assessment, durometer for texture and pressure evaluation, and Vernier calipers and height gauges for a more precise and objective approach.

RESULTS

The mean age of the participants was 45.7 years, and the mean body mass index was 22.1 kg/m The operator-evaluated scar scale scores were 107.2 and 97.3 in the experimental and control groups, respectively. In the patient-rated questionnaire, the scores were 62.3 and 59.4 in the experimental and control groups, respectively.

CONCLUSION

When analyzing early-stage postoperative scars based on various factors, laser therapy is considered a very useful scar management approach. Additionally, when performing reconstructive surgery, tension force is regarded as a significant factor to take into account since it affects scar widening.

摘要

背景

术后瘢痕形成是不可避免的,目前尚未建立金标准的管理方法。由于重建手术后会形成长而大的瘢痕,本研究分析了接受背阔肌(LD)皮瓣乳房重建的患者中各种因素之间的关系,以探讨合适和有效的管理方法。

患者和方法

2014 年 6 月至 2015 年 1 月期间,在庆北国立大学 Chilgok 医院,27 例接受乳房重建的患者在 LD 供区接受激光治疗。对手术瘢痕和对侧完整皮肤进行瘢痕评估。在每个侧面的瘢痕中点 2cm 处的 5 个特定点进行瘢痕评估。激光治疗每 4 周进行一次,然后对患者进行 6 个月的随访。为了评估瘢痕,使用相同的设置拍摄大体图像。此外,分光光度法用于颜色评估,硬度计用于纹理和压力评估,游标卡尺和高度计用于更精确和客观的评估。

结果

参与者的平均年龄为 45.7 岁,平均体重指数为 22.1kg/m2。实验组和对照组的手术评估瘢痕量表评分分别为 107.2 和 97.3。在患者自评问卷中,实验组和对照组的评分分别为 62.3 和 59.4。

结论

基于各种因素分析早期术后瘢痕时,激光治疗被认为是一种非常有用的瘢痕管理方法。此外,在进行重建手术时,张力被认为是一个需要考虑的重要因素,因为它会影响瘢痕增宽。

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Scar assessment scales: a dermatologic overview.瘢痕评估量表:皮肤病学概述。
Skin Res Technol. 2009 Feb;15(1):1-5. doi: 10.1111/j.1600-0846.2008.00327.x.
10
Laser scar revision: a review.激光瘢痕修复:综述
Dermatol Surg. 2007 Feb;33(2):131-40. doi: 10.1111/j.1524-4725.2006.33030.x.

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