颜面部瘢痕的美容综合治疗

目的：从美容角度探讨颜面部瘢痕的综合治疗效果。方法：手术切除瘢痕,切口下注射康宁克通－Ａ,皮内间断内翻缝合,加压包扎,外贴瘢痕敌。结果：所有病例作品均Ｉ期愈合仅留“线形”瘢痕或无易见瘢痕。结论：颜面部瘢痕综合治疗可获得满意美容效果。     

瘢痕子宫与非瘢痕子宫剖宫产临床对比研究

目的 探讨瘢痕子宫与非瘢痕子宫剖宫产的临床效果.方法 前瞻性纳入2018-09—2020-04间在中牟县人民医院妇产科行剖宫产手术的产妇,依据剖宫产史分为首次剖宫产组(非瘢痕子宫组)和二次剖宫产组(瘢痕子宫组).比较2组的分娩相关指标及子宫异常情况.结果 共纳入90例产妇,每组45例.2组产妇的基线资料差异无统计学意义...     

耳部瘢痕疙瘩综合治疗的临床分析

目的评价耳部瘢痕疙瘩手术后联合放射治疗及局部注射激素类抗瘢痕药物治疗的临床效果。方法采用手术切除直接缝合或转移皮瓣修复术，术后1周内行放射治疗，每日1次，连续照射3次，每次剂量5Gy，总剂量15Gy。对有复发倾向者行局部注射激素类抗瘢痕药物，以曲安奈德40mg加2％利多卡因稀释一倍后瘢痕内注射，每周1次，视瘢痕消退情况逐渐撤药。结果本组10例患者，术后随访1．5～5．0年，治愈6例（6096），显效4例（4096），有效率10096。结论手术联合放射治疗及局部注射激素类抗瘢痕药物是治疗耳部瘢痕疙瘩的有效方法。     

甲状腺切口瘢痕最小化综合技术的应用

目的:研究在甲状腺开放手术中,采用切口瘢痕最小化综合技术的临床效果。方法:98例行甲状腺切除手术患者采用新方法(切口瘢痕最小化综合技术),96例患者采用常规方法,比较两组术后早期(1周)、晚期(3月和12月)瘢痕评分,以及患者本人对切口瘢痕的满意度。结果:新方法组和常规方法组的早期瘢痕评分分别为4.91±0.66和4.08±0.90(P<0.05);术后3月切口评分各为8.71±0.66和6.08±0.90(P<0.05),术后12月切口评分各为9.32±0.66和7.24±0.90(P<0.05);新方法组和常规方法组对切口瘢痕表示满意的分别有62例和48例(P<0.05)。结论:在甲状腺开放手术中,采用切口瘢痕最小化综合技术能有效减轻术后瘢痕,提高患者的满意度。     

尿道瘢痕切除器的研制和临床应用

1985年,作者用自制“尿道瘢痕切除器”治疗6例尿道瘢痕性狭窄的患者,取得了较满意的效果。一、临床资料本组6例均为男性。年龄17～53岁。为骨盆骨折致后尿道狭窄,其中4例为后尿道完全闭锁行膀胱造瘘患者。6例均有尿道手术史(共11次),病程6个月～5年。用尿道瘢痕切除器治疗7次。术后随诊5个月～2年5个月,除1例每月行尿道扩张1次外,其他均排尿通畅。     

瘢痕内切除术在治疗瘢痕疙瘩中的临床应用

目的：探讨一种较为经济有效地综合治疗瘢痕疙瘩的临床途径，方法：在瘢痕内切除大部分瘢痕组织，将保留的创缘两侧瘢痕皮肤修薄，无张力缝合，拆线后给予曲安缩松注射，一般3-5次，共治疗220例。结果：213例痊愈，随访6个月未复发，7例因月经紊乱等原因而放弃治疗，导致部分复发。结论：该方法简单、经济，不产生新的供皮区，给予曲安缩松注射次数少，较传统方法留瘢痕小。     

耳廓瘢痕疙瘩综合治疗的临床观察

目的评价手术联合曲安奈德局部注射治疗耳廓瘢痕疙瘩的临床效果。方法对12例(20侧)患者采用部分或全部切除耳廓瘢痕,皮瓣恢复耳廓正常外形。术后10 d切口及残余瘢痕内注射曲安奈德注射液,曲安奈德10~20 mg以2%利多卡因稀释1倍后注射,每2周1次,视瘢痕消退情况逐渐撤药。结果随访6~36个月,治愈8例,显效4例,有效率100%,疗效满意。结论手术联合曲安奈德局部注射是治疗耳廓瘢痕疙瘩的有效方法。     

自配瘢痕软化液的临床应用

1　临床资料自 1 993年始 ,我们结合临床 ,自配瘢痕软化液行瘢痕内注射治疗。1 998年～ 2 0 0 0年治疗 86例 ,增生性瘢痕 70例 ,瘢痕体质、瘢痕疙瘩 6例 ,外伤及术后缝线瘢痕 1 0例 ;年龄最大 60岁 ,最小 1 .5岁。2　治疗方法与结果2 .1　方法　瘢痕软化液由人体胎盘组织液、糜旦白酶、维生素 B6、强的松龙、 2 %利多卡因混合而成。一般根据瘢痕组织的硬度、厚度、范围配好所需药量 ,根据临床观察和治疗经验 ,5× 1 0 cm增生性瘢痕大约需注射人体胎盘组织液 2 ml,维生素 B61 ml( 2 5 mg) ,糜旦白酶 5 0万 u,强的松龙 1 ml ( 2 5 mg) ,注射…     

皮肤外牵拉扩张器的研制与皮肤瘢痕的治疗

目的 为了达到在一定范围内皮肤瘢痕及其他病损皮肤切除后刨面可以直接拉拢缝合.方法 用自行研制的皮肤外牵拉扩张器,定时定量行病损区周围正常皮肤的外牵张,使之逐渐扩延和松动.结果 对28例大面积皮肤瘢痕患者行皮肤外牵引扩张后,一次性切除瘢痕,可以直接拉拢缝合创面,均达到Ⅰ期愈合.结论 应用皮肤外牵拉扩张器行皮肤外牵引扩张,是治疗皮肤瘢痕及其他病损较理想的方法.     

六瓣Z成形术在蹼状瘢痕挛缩中的应用

蹼状瘢痕挛缩常见于烧伤后期，易发生于指蹼、颈前、腋窝、肘部及足背等功能部位，其矫正方法较多。利用蹼状挛缩瘢痕周边组织的松动性，通过总Ｚ角达１３５°、实际主轴的延长率约为１８０％的六瓣Ｚ成形术，矫治刀例不同部位的蹼状瘢痕挛缩，经１～２年随访，疗效稳定，功能及外观满意。六瓣Ｚ成形术，手术设计简单，勿需游离皮片移植，术后瘢痕不易再挛缩，外观满意。     

瘢痕硬度测定计的研制及临床应用

为了达到无创伤、客观、定量测定瘢痕硬度的目的,设计制造出瘢痕硬度测定计,并用以测定了50例病人增生性瘢痕治疗前、治疗后1、2、3个月瘢痕的硬度以及相邻正常皮肤的硬度。研究结果表明:本硬度测定计重复性好,精密度达到质控标准;所测定的硬度值在瘢痕和正常皮肤有极显著差异,作为判断瘢痕特征指标有特异性;瘢痕硬度在治疗后3个月<2个月<1个月<治疗前,说明用于监测瘢痕疗效和成熟度具有临床实用价值。     

瘢痕硬度测定计的研制及临床应用

为了达到无创伤、客观、定量测定瘢痕硬度的目的，设计制造出瘢痕硬度测定计，并用以测定了５０例病人增生性瘢痕治疗前、治疗后１、２、３个月瘢痕的硬度以及相邻正常皮肤的硬度。研究结果表明：本硬度测定计重复性好，精密度达到质控标准；所测定的硬度值在瘢痕和正常皮肤有极显著差异，作为判断瘢痕特征指标有特异性；瘢痕硬度在治疗后３个月＜２个月＜１个月＜治疗前，说明用于监测瘢痕疗效和成熟度具有临床实用价值。     

Effectiveness of silastic sheet coverage in the treatment of scar keloid (hypertrophic scar)

Several methods for the treatment of scar keloids have been reported. In this article, use of a 1-mm-thick silastic sheet placed over the scar keloid for 8–12 hours daily is reported. This procedure produced better results than the so-called pressure method.     

脂肪抽吸术在瘢痕修复中的应用

目的　探讨脂肪抽吸术在瘢痕修复中的应用。方法　在瘢痕所在区域先行膨胀法脂肪抽吸 ,然后在局部皮肤松弛、张力减小的情况下 ,切除瘢痕 ,伤口直接拉拢缝合。结果　自 2 0 0 0年以来 ,采用此方法为 2 7例瘢痕患者治疗 ,切除瘢痕最大面积为 40 0cm× 9 5cm ,最宽为 11cm ,伤口均一期愈合 ,效果满意。结论　对于有脂肪堆积处的较大面积的瘢痕 ,经吸脂减张后可一次性切除 ,手术操作简单安全 ,出血量少 ,既有减肥塑形的作用 ,又能切除瘢痕达到治疗的目的。     

Incorporation of 3D stereophotogrammetry as a reliable method for assessing scar volume in standard clinical practice

Significant disfigurement and dysfunction is caused by hypertrophic scarring, a prevalent complication of burn wounds. A lack of objective tools in the assessment of scar parameters makes evaluation of scar treatment modalities difficult. 3D stereophotogrammetry, obtaining measurements from 3D photographs, represents a method to quantitate scar volume, and a 3D camera may have use in clinical practice. To validate this method, scar models were created and photographed with a 3D camera. Measurements from 3D image analysis of these scar models were compared to physical measurements of scar model volume. Reliability of 3D image analysis was assessed with both scar models and burn patient scars. Measurements of scar models by two independent observers were compared to determine inter-rater reliability, and measurements from 3D images of burn patient hypertrophic scars were compared to determine the consistency of the method between observers. The time taken for patient photography was recorded. No significant differences were found between the two methods of volume calculation (p = 0.89), and a plot of the differences showed agreement between the methods. The correlation coefficient between the two observers’ measurements of scar model volume was 0.92, and the intra-class correlation coefficient for patient scar volume was 0.998, showing good reliability. The time required to capture 3D photographs ranged from 2 to 6 min per patient, showing the potential for this tool to be efficiently incorporated into clinical practice. 3D stereophotogrammetry is a valid method to reliably measure scar volume and may be used to objectively measure efficacy of scar treatment modalities to track scar development and resolution.     

超大面积植皮──一种治疗瘢痕挛缩的新方法

目的　用超大面积植皮方法修复和预防关节功能部位的瘢痕挛缩。方法　切除或松解关节功能部位的瘢痕挛缩 ,并将创缘向四周潜行分离 10～ 3 5mm使创缘呈外翻状 ,扩大受皮区面积 ,切取比创面面积大 5 0 %～ 14 0 %的供区皮片 ,厚度在 0 .3～ 0 .4mm之间 ,覆盖创面 ,然后将创面填充碎纱布使其成为周边高中间低平打包固定。植皮处理按常规方法处理。结果　 5年应用于颈部等 60例患者的 68个关节功能部位 ,随访 1～ 5年 ,效果满意。结论　这一新方法有较广泛的临床应用价值     

点阵模式激光在瘢痕治疗中的临床应用

目的 评价两种剥脱性点阵模式激光治疗浅表瘢痕的安全性及有效性.方法 共88例患者,其中痤疮瘢痕66例,烧伤瘢痕12例,其他瘢痕10例.所有患者均经以下任何一种治疗:像柬激光≥3次;或点阵激光≥2次;或像束激光+点阵激光综合治疗≥3次.治疗过程中视病情需要配合应用脉冲染料激光抑制瘢痕增生,减轻红斑.结果 本组共88例,瘢痕改善程度评价标准:改善程度>25%视为有效,>50%视为显效,本组患者显效率50%(44/88),有效治疗达80%(70/88).像束激光治疗共244人次,点阵激光治疗共86人次,色素沉着共7例,均在半年内消退,无其他严重并发症.结论 点阵模式的激光治疗创伤小,风险低,是治疗浅表瘢痕,尤其是痤疮瘢痕的有效手段,其作用的机制包括组织气化、磨削作用及热损伤带来的促进组织修复的强大动力.     

Measurement of vascularity in the scar: A systematic review

BackgroundVascularity is an important parameter closely associated with the scar maturation. Reliable and accurate measurement of vascularity helps to monitor the scar change and adopt targeted interventions to prevent excessive scarring and achieve promising outcomes. However, there is no consensus on the assessment tools for the vascularity measurement in scars. This systematic review presents evidence on the available vascularity measurement tools.MethodsA systematic literature search was done using PubMed, CINAHL, Embase and Science Direct databases. Studies, which used non-invasive measurement tools and explored their clinimetric properties, were identified and included in this review.ResultsA total of 1458 articles were obtained, and 26 articles were finally included in this review. Subjective vascularity measurement scales include the Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale (VSS) and the modified Vancouver Scar Scale (mVSS) while objective vascularity measurement devices consist of the color-measuring device, the blood flow measuring device and the morphological imaging device.ConclusionSubjective scales are easy to use and have acceptable reliability to give a preliminary impression of the scar vascularity. Three types of objective devices are not equivalent and are mainly based on the blood flow and angiogenesis to quantify the scar vascularity.