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剥脱性二氧化碳激光联合外用类固醇乳膏与溶液治疗甲状腺切除术后瘢痕的疗效比较:一项前瞻性研究。

Comparative Efficacy of Fractional CO Laser Combined with Topical Steroid Cream versus Solution for Post-Thyroidectomy Scar Treatment: A Prospective Study.

作者信息

Huang Ching-Ya, Yen Yuan-Hao, Lin Cen-Hung, Tsai Yueh-Ju, Lin Ko-Chien, Lin Hui-Ping, Hsieh Ching-Hua

机构信息

Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.

出版信息

Healthcare (Basel). 2024 Aug 12;12(16):1605. doi: 10.3390/healthcare12161605.

Abstract

BACKGROUNDS

Post-thyroidectomy scarring is a common illness impacting patient quality of life. Fractional carbon dioxide (CO) lasers and topical steroids delivered via laser-assisted drug delivery (LADD) have shown potential for scar treatment. However, ideal steroid formulations (cream vs. solution) when combined with laser therapy remain unclear.

METHODS

This study included 12 patients receiving fractional CO laser on post-thyroidectomy scars. After laser treatment, one scar half received topically applied steroid cream, while the other half received steroid solution. The Patient and Observer Scar Assessment Scale (POSAS) was used to measure the scar conditions at the time prior to the first treatment and one year later by the patients themselves and by the surgeon who did the laser treatment. Scar appearance was photographically assessed at baseline and 6 months post-treatment by four blinded evaluators using scales.

RESULTS

This study discovered a modest improvement in the appearance of post-thyroidectomy scars when combining fractional CO laser treatment with either topical steroid cream or solution. Patients and treating physicians examined the POSAS scores one year after treatment found significant improvements in all aspects of the scar conditions, with high efficacy and satisfaction levels reported by patients.

CONCLUSIONS

Fractional CO laser combined with topical steroid delivery, either cream or solution form, significantly enhanced post-thyroidectomy scar appearance with modest effect and high patient satisfaction. This approach may represent a promising scar management strategy along with current scar treatment for the post-thyroidectomy scar.

摘要

背景

甲状腺切除术后瘢痕形成是一种影响患者生活质量的常见疾病。分次二氧化碳(CO)激光和通过激光辅助药物递送(LADD)给予的局部类固醇已显示出治疗瘢痕的潜力。然而,与激光治疗联合使用时理想的类固醇制剂(乳膏与溶液)仍不明确。

方法

本研究纳入了12例接受分次CO激光治疗甲状腺切除术后瘢痕的患者。激光治疗后,瘢痕的一半接受局部应用类固醇乳膏,而另一半接受类固醇溶液。患者和观察者瘢痕评估量表(POSAS)用于在首次治疗前和一年后由患者本人以及进行激光治疗的外科医生测量瘢痕情况。由四名盲法评估者在基线和治疗后6个月使用量表对瘢痕外观进行摄影评估。

结果

本研究发现,分次CO激光治疗与局部类固醇乳膏或溶液联合使用时,甲状腺切除术后瘢痕的外观有适度改善。治疗一年后,患者和治疗医生检查的POSAS评分显示瘢痕情况的各个方面都有显著改善,患者报告的疗效和满意度较高。

结论

分次CO激光与局部类固醇递送(乳膏或溶液形式)联合使用,可显著改善甲状腺切除术后瘢痕的外观,效果适度且患者满意度高。这种方法可能代表了一种有前景的瘢痕管理策略,可与目前用于甲状腺切除术后瘢痕的治疗方法一起使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/11353677/ac9b59b26240/healthcare-12-01605-g001.jpg

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