瘢痕疙瘩的临床综合治疗进展

Advances in clinical comprehensive treatment of keloid

瘢痕疙瘩是整形科及皮肤科常见病。好发于瘢痕体质人群,继发于各种不同原因的皮肤外伤,具有强大的增生力,瘢痕疙瘩的治疗包括手术,局部封闭治疗、放射、冷冻,加压,硅胶膜贴敷,药物外用等几种。依照瘢痕的特点而选用不同的方法,以综合治疗为主。目前治疗较大瘢痕疙瘩最有效的方法仍是手术切除,辅以类固醇激素注射,术后放疗及加压硅胶膜治疗等综合治疗,可降低瘢痕疙瘩的复发率。切口缝合的张力是决定瘢痕疙瘩术后是否复发的关键。手术可采用分次切除缝合,局部皮瓣,植皮,扩张器等方法,小的瘢痕疙瘩早期可应用冷冻,局部药物注射,硅胶膜贴抑制及软化瘢痕。

Keloid is a common disease in the department of plastic surgery and department of dermatology,which occurs mainly in people with scar diathesis and is induced by skin injury,with strong proliferative activity. The treatment methods of keloid include surgery,local closed treatment,radiation,freezing,compression,silicone film sticking,and external medicine,and the doctors apply different methods according to the characteristics of keloid on the basis of comprehensive treatment. At present,the most effective method for the treatment of large keloid is surgical resection combined with the comprehensive treatment of steroid hormone injection,postoperative radiotherapy and pressure silica gel film,to reduce the recurrence rate of keloid. The incision suture tension is the key to determine the recurrence after the operation of the keloid. Multiple resection and suture,local skin flap,skin grafting,and dilator can be used in the surgery. The early treatment methods for small keloid are mainly freezing,local drug injection,and silica gel film,to inhibit and soften the keloid.