Maghfour Jalal, Meisenheimer John, Kantor Jonathan
Department of Dermatology, Henry Ford Health, Detroit, Michigan.
Department of Dermatology, University of Minnesota, Minneapolis, Minnesota.
JAAD Int. 2025 Jul 5;22:100-110. doi: 10.1016/j.jdin.2025.05.016. eCollection 2025 Oct.
Data regarding short-term and long-term cosmesis and functional outcomes of excisional surgical wounds healed by secondary intention healing (SIH) are limited.
To conduct a systematic review and assess the cosmetic and functional acceptability of SIH for acute excisional surgical wounds.
Full-text articles queried from PubMed and Embase databases between January 1964 and April 2024 with cosmetic outcome data of human subjects with acute surgical wounds healed by SIH were included. Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed.
A total of 1655 surgical wounds, of which 1518 (91.7%) healed by SIH, from 35 studies, were included in this review. The most frequent indication for SIH was a defect resulting from excision of nonmelanoma skin cancer (keratinocyte carcinoma), which was identified in 1439 (86%) of patients. Common sites for SIH included the nose (23.3%), periocular region (15.46%), and forehead (13.5%). The majority of wounds on the forehead, medial canthus, lower eyelid, nasal ala, cheeks, lips, postauricular area, and feet resulted in good to excellent cosmetic results, whereas those on the scalp, nasal dorsum, nasal tip, nasal sidewall, and chin yielded less acceptable cosmetic results. Given the baseline variability in cosmesis of primarily closed wounds in some anatomic locations, however, these data suggest the need for future prospective studies.
SIH may produce an acceptable cosmetic and functional outcome for selected defects and may be of clinical benefit in the appropriate setting. This must be weighed against the potentially improved cosmesis and more rapid healing seen with primarily closed defects.
关于通过二期愈合（SIH）治愈的切除性手术伤口的短期和长期美容及功能结果的数据有限。
进行系统评价并评估SIH对急性切除性手术伤口的美容和功能可接受性。
纳入1964年1月至2024年4月期间从PubMed和Embase数据库中检索到的、有通过SIH治愈的急性手术伤口的人类受试者美容结果数据的全文文章。遵循系统评价和Meta分析的首选报告项目指南。
本评价纳入了来自35项研究的总共1655个手术伤口，其中1518个（91.7%）通过SIH愈合。SIH最常见的指征是切除非黑色素瘤皮肤癌（角质形成细胞癌）导致的缺损，在1439例（86%）患者中发现。SIH的常见部位包括鼻子（23.3%）、眼周区域（15.46%）和前额（13.5%）。前额、内眦、下眼睑、鼻翼、脸颊、嘴唇、耳后区域和足部的大多数伤口产生了良好至极佳的美容效果，而头皮、鼻背、鼻尖、鼻侧壁和下巴的伤口美容效果不太理想。然而，鉴于某些解剖部位一期缝合伤口美容的基线变异性，这些数据表明未来需要进行前瞻性研究。
对于选定的缺损，SIH可能产生可接受的美容和功能结果，并且在适当的情况下可能具有临床益处。这必须与一期缝合缺损可能改善的美容效果和更快的愈合相权衡。
