Guiotto Martino, Sciboz Oana Cristina, Arquero Carmen, Schiraldi Luigi, Di Summa Pietro, Bauquis Olivier, Durand Sébastien
Department of Plastic, Reconstructive and Hand Surgery, Lausanne University Hospital, 1011 Lausanne, Switzerland.
Department of Paediatric Surgery, Lausanne University Hospital, 1011 Lausanne, Switzerland.
J Clin Med. 2024 Aug 20;13(16):4903. doi: 10.3390/jcm13164903.
Ultrasound shear wave elastography (SWE) noninvasively measures the stiffness of tissue by producing and measuring tissue deformation. Scar formation, a crucial aspect of wound healing, can lead to functional and aesthetic complications when pathological. While SWE has shown promise in dermatological evaluations, its role in surgical scar assessment remains underestimated. Our study aims to investigate SWE in evaluating surgical scars at the donor site after forearm free flap surgery in transgender patients. After radial forearm free flap harvesting, the donor site was grafted with a split-thickness skin graft with or without interposition of Matriderm. Eleven patients were evaluated more than one year after surgery, using SWE alongside scar characteristics, sensory outcomes, and patient satisfaction surveys. Our study revealed no significant difference in stiffness ( > 0.15), pigmentation ( = 0.32), or erythema ( = 0.06) between operated and non-operated sides. The interposition of Matriderm did not influence the stiffness. Patients significantly ( < 0.0001) reported a loss of discrimination. Patients' subjective scar evaluation appeared in line with our quantitative and objective results. This study contributes to the evolving understanding of SWE's role in scar assessment, highlighting its feasibility in evaluating surgical scars. However, continued research efforts are necessary to establish SWE as a reliable and objective method for surgical scar evaluation and management.
超声剪切波弹性成像（SWE）通过产生并测量组织变形来无创地测量组织硬度。瘢痕形成是伤口愈合的一个关键方面，病理性瘢痕会导致功能和美观方面的并发症。虽然SWE在皮肤病学评估中已显示出前景，但其在手术瘢痕评估中的作用仍被低估。我们的研究旨在调查SWE在评估变性患者前臂游离皮瓣手术后供区手术瘢痕中的作用。在前臂游离皮瓣切取后，供区用带或不带Matriderm植入的断层皮片移植。11名患者在术后一年多接受了评估，使用SWE并结合瘢痕特征、感觉结果和患者满意度调查。我们的研究显示，手术侧与非手术侧在硬度（>0.15）、色素沉着（=0.32）或红斑（=0.06）方面无显著差异。Matriderm的植入不影响硬度。患者显著（<0.0001）报告辨别力丧失。患者的主观瘢痕评估与我们的定量和客观结果一致。本研究有助于不断加深对SWE在瘢痕评估中作用的理解，突出了其在评估手术瘢痕方面的可行性。然而，需要持续的研究努力来将SWE确立为手术瘢痕评估和管理的可靠且客观的方法。
