Qu Yixin, Gao Wuyou, Huang Danping, Li Xingyi, Chen Rongxin, Mao Zhen, Lin Xianchai
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University.
Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science.
Ophthalmic Plast Reconstr Surg. 2025;41(2):166-173. doi: 10.1097/IOP.0000000000002765. Epub 2024 Aug 28.
Keloid (KD) and hypertrophic scars are prevalent and result from excessive growth of dermal tissue after skin damage. This review focused on the clinical application of the ultra-pulsed CO 2 fractional laser combined with recombinant human epidermal growth factor (rHEGF) gel in patients with eyelid KD.
Patients (N = 98) with KD who underwent surgery were randomly divided into a study group (ultra-pulsed CO 2 fractional laser combined with rHEGF gel therapy, N = 49) and a control group (ultra-pulsed CO 2 fractional laser therapy, N = 49). Besides, 5 cases dropped out of the study, including 2 cases in the study group and 3 cases in the control group. Finally, 47 cases of the study group and 46 cases of the study group were included in the analysis. The clinical baseline data such as sex, age, body mass index, scar area, etiology, Vancouver Scar Scale score, Patient and Observer Scar Assessment Scale score, four-item itch questionnaire score, serum interleukin-6 (IL-6), IL-10, and tumor necrosis factor-α level expression were recorded in the study group (N = 47) and the control group (N = 46).
There was no significant difference in gender, age, body mass index, scar area, etiology, Vancouver Scar Scale score, Patient and Observer Scar Assessment Scale score, 4-item itch questionnaire score, IL-6, IL-10, and tumor necrosis factor-α levels between the patients treated with ultra-pulse CO 2 fractional laser + rHEGF gel and those only treated with ultra-pulse CO 2 fractional laser ( p > 0.05). Vancouver Scar Scale scores, Patient and Observer Scar Assessment Scale scores, and four-item itch questionnaire scores of patients with eyelid KD decreased to a greater extent than those treated with ultra-pulsed CO 2 fractional laser combined with rHEGF gel ( p <0.01). Compared with ultra-pulsed CO 2 fractional laser treatment, ultra-pulsed CO 2 fractional laser combined with rHEGF gel was more efficacious in treating patients with eyelid KD, with a lower incidence of adverse effects and a 1-year recurrence rate.
Ultra-pulsed CO 2 fractional laser combined with rHEGF gel can significantly improve the scar status and scar itching in patients with eyelid KD, with an obvious therapeutic effect, a low incidence of adverse effects, a 1-year recurrence rate, and high safety, which is worthy of popularization and application.
瘢痕疙瘩（KD）和增生性瘢痕较为常见，是皮肤损伤后真皮组织过度生长所致。本综述聚焦于超脉冲二氧化碳点阵激光联合重组人表皮生长因子（rHEGF）凝胶在眼睑KD患者中的临床应用。
98例行手术治疗的KD患者被随机分为研究组（超脉冲二氧化碳点阵激光联合rHEGF凝胶治疗，n = 49）和对照组（超脉冲二氧化碳点阵激光治疗，n = 49）。此外，5例退出研究，其中研究组2例，对照组3例。最终，研究组纳入47例，对照组纳入46例进行分析。记录研究组（n = 47）和对照组（n = 46）的临床基线数据，如性别、年龄、体重指数、瘢痕面积、病因、温哥华瘢痕量表评分、患者和观察者瘢痕评估量表评分、四项瘙痒问卷评分、血清白细胞介素-6（IL-6）、IL-10和肿瘤坏死因子-α水平表达。
超脉冲二氧化碳点阵激光+rHEGF凝胶治疗的患者与仅接受超脉冲二氧化碳点阵激光治疗的患者在性别、年龄、体重指数、瘢痕面积、病因、温哥华瘢痕量表评分、患者和观察者瘢痕评估量表评分、四项瘙痒问卷评分、IL-6、IL-10和肿瘤坏死因子-α水平方面无显著差异（p>0.05）。眼睑KD患者的温哥华瘢痕量表评分、患者和观察者瘢痕评估量表评分及四项瘙痒问卷评分下降幅度大于超脉冲二氧化碳点阵激光联合rHEGF凝胶治疗的患者（p<0.01）。与超脉冲二氧化碳点阵激光治疗相比，超脉冲二氧化碳点阵激光联合rHEGF凝胶治疗眼睑KD患者疗效更佳，不良反应发生率更低，1年复发率更低。
超脉冲二氧化碳点阵激光联合rHEGF凝胶可显著改善眼睑KD患者的瘢痕状态和瘢痕瘙痒，治疗效果明显，不良反应发生率低，1年复发率低，安全性高，值得推广应用。
