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Wu Y, Hua Z, Xiang Y, Zhu S, Chen W, Wei P. Evaluation of Facial Trauma Scars After Treating by Refining Plastic Surgery Techniques: A Follow-Up Study. J Craniofac Surg 2023; 34:e376-e380. [PMID: 36944605 PMCID: PMC10205111 DOI: 10.1097/scs.0000000000009298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/27/2022] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Although early debridement and refining plastic surgery techniques have been shown to be effective in the treatment of facial scars after trauma, their postoperative outcomes have not been quantitatively evaluated by the relevant Scar Cosmesis Assessment and Rating (SCAR) Scale. This study was designed to provide a fair assessment of the appearance and local symptoms of scars after treatment by refining plastic surgery techniques and to share the operational skills of surgical repairs. PATIENTS AND METHODS Patients who received refining plastic surgery techniques were followed up, and facial scars were taken as high-definition photos, which were presented to 6 professional observers, 6 lay observers, and patients themselves to score the facial scars, including: scar spread, erythema, dyspigmentation, track marks or suture marks, hypertrophy/atrophy, itch and pain according to the SCAR. RESULTS There were 56 patients who met the inclusion criteria and 25 agreed to participate in the study. No hypertrophic scar was found, and all patients were satisfied with the scar control effect. The scores showed that the treatment was achieved good results in scar spread (pro group: 0.85±0.55, lay group: 0.96±0.68, patients: 0.92±0.64), erythema (pro group: 0.34±0.26, lay group: 0.45±0.37, patients: 0.32±0.48), hypertrophy/atrophy (pro group: 0.21±0.27, lay group: 0.21±0.31, patients: 0.32±0.48), and there was no significant difference in the scores of the 3 observation groups ( P >0.05). However, it is difficult to eliminate dyspigmentation (pro group: 0.29±0.26, lay group: 0.30±0.30, patients: 0.40±0.50), track marks or suture marks (pro group: 0.45±0.33, lay group: 0.59±0.30, patients: 0.36±0.49). Two (8%) patients complained of itch and 1 (4%) patient complained of both itch and pain in the past 24 hours. CONCLUSIONS The appearance of facial scars is satisfactory, the local symptoms are mild, and the evaluation among different aesthetics is affirmative after receiving refining plastic surgery techniques, which is just in line with the purpose of seeking beauty for the patients, and meanwhile can provide a good foundation for the comprehensive treatment of late scars, so that the treatment plan should be promoted.
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Transconjunctival Surgical Access With Modified Aesthetic Lateral Canthotomy. J Craniofac Surg 2021; 33:e16-e17. [PMID: 34267137 DOI: 10.1097/scs.0000000000007856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Displaced fractures of the zygomatic bone that require surgical treatment are accessed transcutaneously but these accesses to the skin can cause a hypertrophy scar in patients with this predisposition. This paper indicates a modification in the lateral canthotomy that aim to minimize the hypertrophic scar in the treatment of zygomatic fracture.
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Kaneguchi A, Ozawa J, Yamaoka K. Intra-articular injection of mitomycin C prevents progression of immobilization-induced arthrogenic contracture in the remobilized rat knee. Physiol Res 2020; 69:145-156. [PMID: 31852201 DOI: 10.33549/physiolres.934149] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This study tested whether cell cycle inhibitor mitomycin C (MMC) prevents arthrogenic contracture progression during remobilization by inhibiting fibroblast proliferation and fibrosis in the joint capsule. Rat knees were immobilized in a flexed position to generate flexion contracture. After three weeks, the fixation device was removed and rat knees were allowed to freely move for one week. Immediately after and three days after fixator removal, rats received intra-articular injections of MMC or saline. The passive extension range of motion (ROM) was measured before and after myotomy of the knee flexors to distinguish myogenic and arthrogenic contractures. In addition, both cellularity and fibrosis in the posterior joint capsule were assessed histologically. Joint immobilization significantly decreased ROMs both before and after myotomy compared with untreated controls. In saline-injected knees, remobilization increased ROM before myotomy, but further decreased that after myotomy compared with that of knees immediately after three weeks of immobilization. Histological analysis revealed that hypercellularity, mainly due to fibroblast proliferation, and fibrosis characterized by increases in collagen density and joint capsule thickness occurred after remobilization in saline-injected knees. Conversely, MMC injections were able to prevent the remobilization-enhanced reduction of ROM after myotomy by inhibiting both hypercellularity and joint capsule fibrosis. Our results suggest that joint capsule fibrosis accompanied by fibroblast proliferation is a potential cause of arthrogenic contracture progression during remobilization, and that inhibiting fibroblast proliferation may constitute an effective remedy.
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Affiliation(s)
- A Kaneguchi
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Hiroshima, Japan.
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Qu C, Bao Z, Zhang X, Wang Z, Ren J, Zhou Z, Tian M, Cheng X, Chen X, Feng C. A thermosensitive RGD-modified hydroxybutyl chitosan hydrogel as a 3D scaffold for BMSCs culture on keloid treatment. Int J Biol Macromol 2019; 125:78-86. [DOI: 10.1016/j.ijbiomac.2018.12.058] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 11/29/2018] [Accepted: 12/04/2018] [Indexed: 11/30/2022]
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5
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Munjal S, Kumar J, Kumar P, Mehta VS. Keloid formation on neck after jugular central venous catheter placement: An unsightly unusual complication in a young female. Indian J Anaesth 2018; 62:82-84. [PMID: 29416158 PMCID: PMC5787899 DOI: 10.4103/ija.ija_541_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Satyashiva Munjal
- Department of Neurosurgery, Paras Hospital, Gurugram, Haryana, India
| | - Jitendra Kumar
- Department of Neurosurgery, Paras Hospital, Gurugram, Haryana, India
| | - Pallav Kumar
- Department of Neuroanesthesia, Paras Hospital, Gurugram, Haryana, India
| | - V S Mehta
- Department of Neurosurgery, Paras Hospital, Gurugram, Haryana, India
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Seo BF, Ko HS, Kwon H, Jung SN. V-Y Advancement Flap: Aesthetic Reconstruction for Auriculotemporal Keloid Excision. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2017. [DOI: 10.14730/aaps.2017.23.3.164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Bommie Florence Seo
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Hyo Sun Ko
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Ho Kwon
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Sung-No Jung
- Department of Plastic and Reconstructive Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
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7
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Shin JY, Yun SK, Roh SG, Lee NH, Yang KM. Efficacy of 2 Representative Topical Agents to Prevent Keloid Recurrence After Surgical Excision. J Oral Maxillofac Surg 2016; 75:401.e1-401.e6. [PMID: 27865791 DOI: 10.1016/j.joms.2016.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/08/2016] [Accepted: 10/06/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE Keloids are difficult to remove successfully and there is no universally accepted treatment. After surgical excision of the keloid, there are various management methods for prevention of keloid recurrence, such as intralesional injection, radiation, and topical agents. A few studies have compared topical agents with other treatments. The aim of this study was to investigate effective topical agents for the prevention of recurrent keloid after surgical excision. MATERIALS AND METHODS Eligible articles were sought using core databases, including Medline, Embase, and Cochrane databases, up to April 2016. The predictor variables were mitomycin C (MC) and imiquimod cream treatment after keloid excision. The outcome variable was keloid recurrence rate. RESULTS The search strategy identified 120 publications. After screening, 9 articles were selected for review. Articles were divided into 2 groups: MC and imiquimod cream. The recurrence rate after surgical excision in the MC group was estimated to be 16.5%, and that in the imiquimod cream group was estimated to be 24.7%. CONCLUSION If intralesional injection or radiation is not available, then MC or imiquimod 5% cream could be an effective alternative in preventing keloid recurrence.
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Affiliation(s)
- Jin Yong Shin
- Professor, Department of Plastic and Reconstructive Surgery, Chonbuk National University Hospital, Jeonju, Korea
| | - Seok-Kweon Yun
- Professor, Department of Dermatology, Chonbuk National University Hospital, Jeonju, Korea
| | - Si-Gyun Roh
- Professor, Department of Plastic and Reconstructive Surgery, Chonbuk National University Hospital, Jeonju, Korea
| | - Nae-Ho Lee
- Professor, Department of Plastic and Reconstructive Surgery, Chonbuk National University Hospital, Jeonju, Korea.
| | - Kyung-Moo Yang
- Professor, Department of Plastic and Reconstructive Surgery, Chonbuk National University Hospital, Jeonju, Korea
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Trace AP, Enos CW, Mantel A, Harvey VM. Keloids and Hypertrophic Scars: A Spectrum of Clinical Challenges. Am J Clin Dermatol 2016; 17:201-23. [PMID: 26894654 DOI: 10.1007/s40257-016-0175-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Since their earliest description, keloids and hypertrophic scars have beleaguered patients and clinicians alike. These scars can be aesthetically disfiguring, functionally debilitating, emotionally distressing, and psychologically damaging, culminating in a significant burden for patients. Our current understanding of keloid pathophysiology has grown and continues to advance while molecular biology, genetics, and technology provide ever-deepening insight into the nature of wound healing and the pathologic perturbations thereof. Greater understanding will lead to the development and application of refined therapeutic modalities. This article provides an overview of our current understanding of keloids, highlighting clinical characteristics and diagnostic criteria while providing a comprehensive summary of the many therapeutic modalities available. The proposed mechanism, application, adverse events, and reported efficacy of each modality is evaluated, and current recommendations are summarized.
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Affiliation(s)
- Anthony P Trace
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Clinton W Enos
- The School of Medicine, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Alon Mantel
- Hampton University Skin of Color Research Institute, Hampton University, Hampton, VA, USA
| | - Valerie M Harvey
- Hampton University Skin of Color Research Institute, Hampton University, Hampton, VA, USA.
- Department of Dermatology, Eastern Virginia Medical School, 721 Fairfax Ave., Norfolk, VA, 23507, USA.
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A Comparison of the Effectiveness of Triamcinolone and Radiation Therapy for Ear Keloids after Surgical Excision. Plast Reconstr Surg 2016; 137:1718-1725. [DOI: 10.1097/prs.0000000000002165] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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10
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Bao Z, Gao P, Xia G, Wang Z, Kong M, Feng C, Cheng X, Liu Y, Chen X. A thermosensitive hydroxybutyl chitosan hydrogel as a potential co-delivery matrix for drugs on keloid inhibition. J Mater Chem B 2016; 4:3936-3944. [DOI: 10.1039/c6tb00378h] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A thermosensitive hydroxybutyl chitosan hydrogel could be used as a potential co-delivery matrix for drugs on keloid inhibition.
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Affiliation(s)
- Zixian Bao
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Ping Gao
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Guixue Xia
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Zhiguo Wang
- Department of Plastic Surgery
- The Affiliated Hospital of Medical College Qingdao University
- Qingdao 266013
- China
| | - Ming Kong
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Chao Feng
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Xiaojie Cheng
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Ya Liu
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
| | - Xiguang Chen
- College of Marine Life Science
- Ocean University of China
- Qingdao 266003
- China
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Clinical implications of single- versus multiple-site keloid disorder: a retrospective study in an Asian population. Ann Plast Surg 2015; 74:248-51. [PMID: 24681623 DOI: 10.1097/sap.0b013e3182a2b537] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is strong evidence of genetic susceptibility in individuals with keloid disorder. The purpose of this cross-sectional study was to determine the clinical relevance of our proposed variables on the multiplicity of keloids by further investigating the presence of other keloids and a family history. METHODS This was a retrospective review, using institutional review board-approved questionnaires, of patients with keloids who were seen at Kangbuk Samsung Hospital between December 2002 and February 2010. Eight hundred sixty-eight patients were included in our study. Comparisons between the 2 groups were made using Mann-Whitney tests for continuous variables and χ2 tests for categorical variables. RESULTS In our patient group, younger age of onset and the presence of family history were significantly associated with the occurrence of keloids at multiple sites. The locations of extra-auricular keloids, in order of frequency, included the shoulder; anterior chest, including the breasts; deltoid; trunk and pubic area; upper extremities; lower extremities; and other sites. As compared to secondary keloids, primary keloids were significantly associated with both a lower degree of recurrence and the presence of other keloids. The presence or absence of family history was significantly associated with the presence or absence of other keloids and primary or secondary keloids. CONCLUSIONS Keloid disorder is one of the most frustrating problems in wound healing and advances in our understanding of the differences of occurrence at a single site versus multiple sites might help in understanding pathogenesis and improving treatment.
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Sidgwick GP, McGeorge D, Bayat A. A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring. Arch Dermatol Res 2015; 307:461-77. [PMID: 26044054 PMCID: PMC4506744 DOI: 10.1007/s00403-015-1572-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 04/11/2015] [Accepted: 04/29/2015] [Indexed: 12/22/2022]
Abstract
Wound healing after dermal injury is an imperfect process, inevitably leading to scar formation as the skin re-establishes its integrity. The resulting scars have different characteristics to normal skin, ranging from fine-line asymptomatic scars to problematic scarring including hypertrophic and keloid scars. Scars appear as a different colour to the surrounding skin and can be flat, stretched, depressed or raised, manifesting a range of symptoms including inflammation, erythema, dryness and pruritus, which can result in significant psychosocial impact on patients and their quality of life. In this paper, a comprehensive literature review coupled with an analysis of levels of evidence (LOE) for each published treatment type was conducted. Topical treatments identified include imiquimod, mitomycin C and plant extracts such as onion extract, green tea, Aloe vera, vitamin E and D, applied to healing wounds, mature scar tissue or fibrotic scars following revision surgery, or in combination with other more established treatments such as steroid injections and silicone. In total, 39 articles were included, involving 1703 patients. There was limited clinical evidence to support their efficacy; the majority of articles (n = 23) were ranked as category 4 LOE, being of limited quality with individual flaws, including low patient numbers, poor randomisation, blinding, and short follow-up periods. As trials were performed in different settings, they were difficult to compare. In conclusion, there is an unmet clinical need for effective solutions to skin scarring, more robust long-term randomised trials and a consensus on a standardised treatment regime to address all aspects of scarring.
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Affiliation(s)
- G. P. Sidgwick
- />Plastic and Reconstructive Surgery Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
| | - D. McGeorge
- />Grosvenor Nuffield Hospital, Wrexham Road, Chester, CH4 7QP England, UK
| | - A. Bayat
- />Plastic and Reconstructive Surgery Research, Institute of Inflammation and Repair, Faculty of Medical and Human Sciences, Manchester Institute of Biotechnology, University of Manchester, 131 Princess Street, Manchester, M1 7DN UK
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Awad GA, Wilson P. Umbilical port site keloid extending through rectus sheath. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-0935-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Willett M, Handfield K, Marquart J. Multimodal keloid therapy with excision, application of mitomycin C, and radiotherapy. Dermatol Surg 2014; 40:480-2. [PMID: 24438359 DOI: 10.1111/dsu.12423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Matthew Willett
- Walter Reed National Military Medical Center, Bethesda, Maryland
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Co-delivery of Dexamethasone and Green Tea Polyphenols Using Electrospun Ultrafine Fibers for Effective Treatment of Keloid. Pharm Res 2014; 31:1632-43. [DOI: 10.1007/s11095-013-1266-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/09/2013] [Indexed: 12/11/2022]
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Rieck KL, Fillmore WJ, Ettinger KS. Late revision or correction of facial trauma-related soft-tissue deformities. Oral Maxillofac Surg Clin North Am 2013; 25:697-713. [PMID: 24183375 DOI: 10.1016/j.coms.2013.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Surgical approaches used in accessing the facial skeleton for fracture repair are often the same as or similar to those used for cosmetic enhancement of the face. Rarely does facial trauma result in injuries that do not in some way affect the facial soft-tissue envelope either directly or as sequelae of the surgical repair. Knowledge of both skeletal and facial soft-tissue anatomy is paramount to successful clinical outcomes. Facial soft-tissue deformities can arise that require specific evaluation and management for correction. This article focuses on revision and correction of these soft-tissue-related injuries secondary to facial trauma.
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Affiliation(s)
- Kevin L Rieck
- Division of Oral & Maxillofacial Surgery, Department of Surgery, Mayo College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA.
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Wu Y, Schomisch SJ, Cipriano C, Chak A, Lash RH, Ponsky JL, Marks JM. Preliminary results of antiscarring therapy in the prevention of postendoscopic esophageal mucosectomy strictures. Surg Endosc 2013; 28:447-55. [PMID: 24100858 DOI: 10.1007/s00464-013-3210-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 08/30/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Esophageal endoscopic submucosal dissection (ESD) is an effective minimally invasive therapy for early esophageal cancer and high-grade Barrett dysplasia. However, esophageal stricture formation after circumferential or large ESD has limited its wide adoption. Mitomycin C (MMC), halofuginone (Hal), and transforming growth factor β3 (TGF-β3) exhibits antiscarring effects that may prevent post-ESD stricture formation. METHODS Using endoscopic mucosectomy (EEM) technique, an 8- to 10-cm-long circumferential esophageal mucosal segment was excised in a porcine model. The site was either untreated (control, n = 6) or received 40 evenly distributed injections of antiscarring agent immediately and at weeks 1 and 2. High and low doses were used: MMC 5 mg (n = 2), 0.5 mg (n = 2); Hal 5 mg (n = 2), 1.5 mg (n = 2), 0.5 mg (n = 2); TGF-β3 2 μg (n = 2), 0.5 μg (n = 2). The degree of stricture formation was determined by the percentage reduction of the esophageal lumen on weekly fluoroscopic examination. Animals were euthanized when strictures exceeded 80 % or the animals were unable to maintain weight. RESULTS The control group had a luminal diameter reduction of 78.2 ± 10.9 % by 2 weeks and were euthanized by week 3. Compared at 2 weeks, the Hal group showed a decrease in mean stricture formation (68.4 % low dose, 57.7 % high dose), while both TGF-β3 dosage groups showed no significant change (65.3 % low dose, 76.2 % high dose). MMC was most effective in stricture prevention (53.6 % low dose, 35 % high dose). Of concern, the esophageal wall treated with high-dose MMC appeared to be necrotic and eventually led to perforation. In contrast, low dose MMC, TGF-β3 and Hal treated areas appeared re-epithelialized and healthy. CONCLUSIONS Preliminary data on MMC and Hal demonstrated promise in reducing esophageal stricture formation after EEM. More animal data are needed to perform adequate statistical analysis in order to determine overall efficacy of antiscarring therapy.
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Affiliation(s)
- Yuhsin Wu
- Department of Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., Mail Stop LKS 5047, Cleveland, OH, 44106, USA,
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Park TH, Chang CH. Early postoperative magnet application combined with hydrocolloid dressing for the treatment of earlobe keloids. Aesthetic Plast Surg 2013; 37:439-44. [PMID: 23377145 DOI: 10.1007/s00266-013-0076-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 12/30/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND To prevent the recurrence of earlobe keloids after surgical removal, a reliable and safe postoperative treatment method is critical. To the authors' knowledge, no studies have elucidated the most effective postoperative dressing method for preventing the recurrence of earlobe keloids. This study aimed to compare keloid recurrence rates in patients whose keloids were dressed using conventional methods (plain gauze or a polyvinyl alcohol sponge) with those of a matched cohort of patients whose keloids were dressed using magnets combined with hydrocolloid materials. METHODS This observational case-control study compared a retrospective cohort of patients whose keloids were dressed using conventional methods with a matched prospective cohort of patients whose keloids were dressed using magnets combined with hydrocolloid materials. The study included patients with pathologically confirmed earlobe keloids that were surgically excised with primary closure. Patients 8 years of age or older underwent adjuvant pressure therapy with magnets at the study hospital. Patients were excluded from the study if they were unavailable for follow-up evaluation, if they had received additional adjuvant therapy during treatment, or if histologic confirmation of a keloid was not obtained. Matched-pair analysis was performed using the McNemar test. Treatment outcome was evaluated as recurrence or nonrecurrence. RESULTS Overall, 9 (11.2%) of the 80 study patients experienced recurrence. The recurrence rate was significantly lower in the matched case group (2 of 40, 5%) than in the matched control group (7 of 40, 17.5%) during the follow-up period of 18 months (p=0.0253). CONCLUSIONS The authors' novel dressing of magnets and hydrocolloid materials appears to be effective in reducing earlobe keloid recurrence. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. 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 .
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Affiliation(s)
- Tae Hwan Park
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-Dong, Jongno-Gu, Seoul, 110-746, Republic of Korea
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Roh TS, Hong JW, Lee WJ, Yoo HS, Lew DH, Kim YS. The Effects of Botulinum Toxin A on Collagen Synthesis, Expression of MMP (matrix metalloproteinases)-1,2,9 and TIMP (tissue inhibitors of metalloproteinase)-1 in the Keloid Fibroblasts. ARCHIVES OF AESTHETIC PLASTIC SURGERY 2013. [DOI: 10.14730/aaps.2013.19.2.114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Tai Suk Roh
- Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Seoul, Korea
| | - Jong Won Hong
- Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Seoul, Korea
| | - Won Jai Lee
- Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Han-su Yoo
- Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Seoul, Korea
| | - Dae Hyun Lew
- Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Seok Kim
- Department of Plastic & Reconstructive Surgery, Institute for Human Tissue Restoration, Gangnam Severance Hospital, Seoul, Korea
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