Farokh Forghani Siamak, Ahmadi Farham, Moghimi Hamid Reza, Naderi Gharahgheshlagh Soheila, Hedayatyanfard Keshvad, Montazer Fatemeh, Barati Maedeh, Esfandyari-Manesh Mehdi, Varshochian Reyhaneh, Irilouzadian Rana
Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.
Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Aesthetic Plast Surg. 2025 Jan;49(1):356-366. doi: 10.1007/s00266-024-04385-4. Epub 2024 Sep 25.
Hypertrophic scars are defined as visible lesions formed by excessive wound healing that cause cosmetic and, in some cases, functional challenges in patients. This study aimed to assess the efficacy of intralesional injections of losartan-loaded in situ forming gel and compare it with the common treatment (triamcinolone) in preventing scar formation. The formulation was prepared using a thermosensitive PLGA-PEG-PLGA triblock copolymer. Ear scar tissue in rabbits represented the hypertrophic scar, and the animals were treated with three treatments in three groups. Nine weeks following the single treatment, images of the scars were obtained and quantitatively analyzed using ImageJ and light microscopy was used to evaluate the fibroblast cell number, vascularization, inflammation and collagen deposition and fibrosis in H&E-stained sample tissue. According to the results based on the ImageJ and the Vancouver criteria, the losartan in situ forming gel (F-LG) indicated significantly higher improving effects on decreased vascularity and pigmentation in comparison with triamcinolone (F-TA) and placebo as a control (F-Ctl), although the effect F-LG was almost similar to F-TA on pliability and scar height, and they were better than the control. Histological findings showed F-LG and F-TA have less inflammatory and fibroblast cells compared to F-Ctl. Also, results indicated the dermal layers of the F-TA and F-LG groups' scar were thinner, and the deposition of collagens was reduced compared to the control. Consequently, F-LG was found to be an effective treatment in reducing scarring and promoting wound healing.No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
肥厚性瘢痕被定义为由过度伤口愈合形成的可见病变,会给患者带来美容问题,在某些情况下还会造成功能障碍。本研究旨在评估病灶内注射载有氯沙坦的原位形成凝胶的疗效,并将其与预防瘢痕形成的常用治疗方法(曲安奈德)进行比较。该制剂使用热敏性聚乳酸-羟基乙酸共聚物-聚乙二醇-聚乳酸-羟基乙酸共聚物三嵌段共聚物制备。兔耳部瘢痕组织代表肥厚性瘢痕,将动物分为三组进行三种治疗。单次治疗九周后,获取瘢痕图像,使用ImageJ进行定量分析,并使用光学显微镜评估苏木精-伊红染色样本组织中的成纤维细胞数量、血管生成、炎症以及胶原沉积和纤维化情况。根据基于ImageJ和温哥华标准的结果,与曲安奈德(F-TA)和作为对照的安慰剂(F-Ctl)相比,氯沙坦原位形成凝胶(F-LG)在减少血管生成和色素沉着方面显示出显著更高的改善效果,尽管F-LG在柔韧性和瘢痕高度方面的效果与F-TA几乎相似,且二者均优于对照组。组织学结果显示,与F-Ctl相比,F-LG和F-TA的炎症和成纤维细胞较少。此外,结果表明,与对照组相比,F-TA和F-LG组瘢痕的真皮层更薄,胶原沉积减少。因此,发现F-LG是减少瘢痕形成和促进伤口愈合的有效治疗方法。未指定证据级别 本期刊要求作者为每篇适用循证医学排名的投稿指定证据级别。这排除了综述文章、书评以及涉及基础科学、动物研究、尸体研究和实验研究的手稿。有关这些循证医学评级的完整描述,请参考目录或作者在线指南www.springer.com/00266 。