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打孔钻削联合浅表X线放疗及瘤内药物注射治疗瘢痕疙瘩的疗效回顾性研究

Retrospective study on the effectiveness of punch drilling combined with superficial X-ray radiotherapy and intralesional drug injection for keloid treatment.

作者信息

An Juan, Wang Gaofeng, Xu Dan, Yin Hualian, Hua Ying, Wang Chunmei

机构信息

Department of Plastic and Aesthetic Surgery, Dermatology Hospital of Southern Medical University, Guangzhou, China.

Department of Plastic and Aesthetic Surgery, Dongguan Kanghua Hospital, Guangdong, China.

出版信息

JPRAS Open. 2025 Jul 17;45:395-405. doi: 10.1016/j.jpra.2025.07.008. eCollection 2025 Sep.

Abstract

BACKGROUND

Keloids, pathological scars with complex etiology including genetic predisposition and trauma, remain a therapeutic challenge due to high recurrence rates. This study intends to conduct a retrospective study on the patients who received punch drilling therapy for keloid in our hospital to provide a new method and objective basis for the treatment of keloid.

METHODS

A retrospective analysis of 13 patients (20 keloids) treated at Dermatology Hospital of Southern Medical University was conducted. Outcomes were assessed using Vancouver Scar Scale (VSS) and Visual Analogue Scale (VAS) scores preoperatively and scar image data were collected, alongside complication rates and patient satisfaction surveys.

RESULTS

Significant reductions were observed in both scar scores: Median VAS decreased from 3.5 (range: 2.0-8.0) to 1.5 (1.0-4.0), and VSS from 7.0 (3.0-12.0) to 5.0 (1.0-8.0) ( < 0.001). Postoperative complications were minimal, with 95 % of patients reporting marked improvement in scar appearance and satisfaction.

CONCLUSION

The combination of punch drilling, adjuvant radiotherapy, and intralesional steroids injection demonstrates high efficacy in keloid treatment, characterized by low invasiveness, rapid recovery, and reduced recurrence. This protocol provides a promising strategy for refractory keloid management.

摘要

背景

瘢痕疙瘩是一种病因复杂(包括遗传易感性和创伤)的病理性瘢痕,由于复发率高,仍然是一个治疗难题。本研究旨在对我院接受瘢痕疙瘩钻孔治疗的患者进行回顾性研究,为瘢痕疙瘩的治疗提供新方法和客观依据。

方法

对南方医科大学皮肤病医院治疗的13例患者(20个瘢痕疙瘩)进行回顾性分析。术前使用温哥华瘢痕量表(VSS)和视觉模拟量表(VAS)评分评估结果,并收集瘢痕图像数据,同时统计并发症发生率并进行患者满意度调查。

结果

两个瘢痕评分均显著降低:VAS中位数从3.5(范围:2.0 - 8.0)降至1.5(1.0 - 4.0),VSS从7.0(3.0 - 12.0)降至5.0(1.0 - 8.0)(<0.001)。术后并发症极少,95%的患者报告瘢痕外观和满意度有明显改善。

结论

钻孔治疗、辅助放疗和病灶内注射类固醇联合应用在瘢痕疙瘩治疗中显示出高效性,具有微创、恢复快和复发率低的特点。该方案为难治性瘢痕疙瘩的管理提供了一种有前景的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4c7/12414282/d2ff0162b527/gr1.jpg

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