Chew Joshua T, Xu Joshua J, Goff Thomas A J, Fogarty Karen A, Symes Michael J, Sivakumar Brahman S, Wines Andrew P
Royal North Shore Hospital, St Leonards, NSW, Australia.
Mid Yorkshire Hospitals NHS Trust, Wakefield, United Kingdom.
Foot Ankle Orthop. 2025 Jun 26;10(2):24730114251345821. doi: 10.1177/24730114251345821. eCollection 2025 Apr.
Numerous ointments may be applied to surgical incisions in the postoperative period to minimize scar formation. There is little evidence assessing their efficacy on wound healing following foot and ankle procedures. This trial was conducted to assess the efficacy of (Urucu) ointment in the treatment of postoperative elective foot and ankle incisions, compared with conventional postoperative wound care using a control ointment.
A prospective, single-center, randomized controlled trial of adults who had undergone elective foot and ankle surgery was performed. Participants were randomized into receiving either a protocol of ointment application or conventional postoperative wound care with a control ointment. These ointments were applied 2 weeks postoperatively for a 4-week duration. The primary outcome assessed was the Patient and Observer Scar Assessment Scale (POSAS) 6 weeks postoperatively.
Significant improvements were noted in observer-reported wound vascularity, pigmentation, thickness, relief, pliability, and surface area with the use of Urucu, when compared to the control ointment. Overall, observers reported that scars treated with Urucu cream were found to more closely resemble normal skin with an overall POSAS score of 2.56 compared with 3.33 for the control ointment ( < .01). Lower scores in this instance indicate a more favorable result. Similarly, patients also reported a similar finding with an overall POSAS score of 3.70 for Urucu compared with a control ointment, 4.80 ( = .012). No difference was noted in terms of antibiotic use, delayed wound healing, or return to theatre. Two patients had adverse effects on the application of Urucu ointment in the form of a localized reaction and pruritis that improved with treatment cessation ( = .08). Neither patient required any further intervention.
Topical Urucu ointment demonstrated promising early improvements in POSAS scores from both patients and observers, particularly in pigmentation and pliability domains, but findings should be interpreted cautiously because of the small sample size and short follow-up.
Level I, randomized controlled trial.
术后可使用多种药膏涂抹手术切口，以尽量减少疤痕形成。但评估其对足踝手术后伤口愈合效果的证据较少。本试验旨在评估乌鲁古（Urucu）药膏治疗择期足踝手术后切口的疗效，并与使用对照药膏的传统术后伤口护理进行比较。
对接受择期足踝手术的成年人进行了一项前瞻性、单中心、随机对照试验。参与者被随机分为接受乌鲁古药膏涂抹方案或使用对照药膏的传统术后伤口护理。这些药膏在术后2周开始使用，持续4周。评估的主要结局是术后6周的患者和观察者疤痕评估量表（POSAS）。
与对照药膏相比，使用乌鲁古药膏时，观察者报告的伤口血管分布、色素沉着、厚度、平整度、柔韧性和表面积有显著改善。总体而言，观察者报告称，使用乌鲁古药膏治疗的疤痕与正常皮肤更相似，总体POSAS评分为2.56，而对照药膏为3.33（P＜0.01）。在此情况下，分数越低表明结果越理想。同样，患者也报告了类似的结果，乌鲁古药膏的总体POSAS评分为3.70，对照药膏为4.80（P = 0.012）。在抗生素使用、伤口愈合延迟或返回手术室方面未发现差异。两名患者在使用乌鲁古药膏时出现局部反应和瘙痒等不良反应，停药后症状改善（P = 0.08）。两名患者均无需进一步干预。
外用乌鲁古药膏在患者和观察者的POSAS评分方面均显示出早期有希望的改善，尤其是在色素沉着和柔韧性方面，但由于样本量小和随访时间短，研究结果应谨慎解读。
I级，随机对照试验。
