Park Jun Ho, Jeong Ji Won, Park Ji-Ung
Department of Plastic and Reconstructive Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-ro 5-gil, Dongjak-gu, 07061, Republic of Korea.
Aesthetic Plast Surg. 2025 Jan;49(2):576-583. doi: 10.1007/s00266-024-04433-z. Epub 2024 Oct 7.
Keloids, characterized by protruding scars that extend beyond the original skin damage site, cause significant emotional stress and reduced quality of life. Their exact pathogenesis remains unclear, with various hypotheses including growth factor imbalances and extracellular matrix changes. No single treatment is universally accepted, but multiple modalities like triamcinolone acetonide injection (TAC), laser therapies, and surgery are commonly used.
This retrospective study involved East Asian patients who underwent keloid scar excision between March 2019 and June 2022. Patients were divided into two groups: one receiving only TAC injections and the other a combination of TAC and Nd:YAG laser therapy. The efficacy of treatments was evaluated using the modified Vancouver Scar Scale (mVSS) and the Patient and Observer Scar Assessment Scale (POSAS), with follow-ups at six and twelve months after operation.
The study involved 111 patients. Both treatment groups showed significant improvements in mVSS and POSAS scores, but the combination therapy group demonstrated a statistically significant improvement in POSAS scores and lower recurrence rates at 12 months compared to the TAC-only group. However, there was no significant difference in patient satisfaction between the groups.
Dual therapy involving TAC injection and Nd:YAG laser treatment was more effective than TAC injection alone for managing keloid scars after surgery. This combination therapy showed better outcomes in preventing keloid recurrence and improving scar status at 12 months after operation, along with significant improvements in patient-reported outcomes.
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瘢痕疙瘩以突出于原始皮肤损伤部位之外的瘢痕为特征，会导致严重的情绪压力并降低生活质量。其确切发病机制尚不清楚，有多种假说，包括生长因子失衡和细胞外基质变化。没有一种单一的治疗方法被普遍接受，但曲安奈德注射（TAC）、激光治疗和手术等多种方式常用。
这项回顾性研究纳入了2019年3月至2022年6月间接受瘢痕疙瘩切除手术的东亚患者。患者分为两组：一组仅接受TAC注射，另一组接受TAC和Nd:YAG激光治疗联合应用。使用改良温哥华瘢痕量表（mVSS）和患者与观察者瘢痕评估量表（POSAS）评估治疗效果，术后6个月和12个月进行随访。
该研究纳入了111例患者。两个治疗组的mVSS和POSAS评分均有显著改善，但联合治疗组在POSAS评分方面有统计学意义的改善，且与仅接受TAC治疗的组相比，12个月时复发率更低。然而，两组患者满意度无显著差异。
TAC注射和Nd:YAG激光治疗联合应用的双重治疗在处理手术后瘢痕疙瘩方面比单独使用TAC注射更有效。这种联合治疗在预防瘢痕疙瘩复发和改善术后12个月的瘢痕状况方面显示出更好的效果，同时患者报告的结果也有显著改善。
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