综合治疗躯干部瘢痕疙瘩50例临床研究.docVIP

综合治疗躯干部瘢痕疙瘩50例临床研究[摘要]目的：探讨综合方法治疗躯干部瘢痕疙瘩的疗效。方法：50例患者，位于躯干部的瘢痕疙瘩共60处，手术直接切除或埋置扩张器II期切除后采用皮下改良减张缝合,术后24h内即开始接受电子线照射治疗，总量15～20Gy，拆线后局部使用硅凝胶6个月。结果：59处切口I期愈合（98.3%）。切口隆起处在术后2～3个月左右开始变平，12个月左右基本平复。经1年定期随访观察，仅1处复发（1.7%），治愈率达98.3%。结论：手术切除瘢痕疙瘩后采用皮下改良减张缝合,可以充分降低切口处的张力，同时联合术后早期电子线照射以及局部使用硅凝胶等方法，可以有效降低躯干部瘢痕疙瘩的复发率，值得临床推广。 [关键词]瘢痕疙瘩；综合治疗；减张缝合；电子线照射 [中图分类号]R619+.6 [文献标识码]A[文章编号]1008-6455（2011）06-0901-03 Analysis of 50 cases of integrated therapy of trunk keloids WANG Lian-zhao1, WANG Hua-bing2, LI Bin-bin1, WANG Huan1 (1. The Sixteenth Department of Plastic Surgery, Plastic Surgery Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100041, China; 2. Beijing Hospital) Abstract:ObjectiveTo discuss the efficacy of an integrated therapy in treating trunk keloids.MethodsThere were 50 patients with total 60 keloids on the trunk. The keloids were excised by surgery directly or removed in the second stage surgery by implanting expenders in the primary stage surgery, both of these two methods used subcutaneous modified tension-reduced suture. The patients received electron beam irradiation treatment within 24 hours after the surgery with total dosage of 15～20 Gy; then apply silicone gel regionally for 6 month after suture removal.Results59 incisions sites achieved primary healing (98.3%). The bumps at the incision sites started flattening out in 2～3 months post surgery and were almost flat after 12 months. Only one case (1.7%) of relapse was observed through 1 year of periodical follow up checks. The cure rate was 98.3%.ConclusionsUsing subcutaneous modified tension-reduced suture after the surgical excision of keloids can greatly decrease the tension at the incision. Combing postoperative electron beam irradiation and regional application of silicone gel can effectively decrease the relapse rate of the trunk keloids. It is worth adopting in clinical practice. Key words: keloids; integrated therapy; tension-reduced suture; electron