Scars

围巾
  • 文章类型: Journal Article
    目的:本研究提供了支持使用组合技术/产品和Nd:YAP1340nm点阵激光治疗的临床发现,用于浅色和深色皮肤照型中的软组织增强。背景:面部的衰老过程是复杂的,涉及皮肤的改变,结缔组织,骨头,和面部的脂肪层。方法:使用Nd:YAP1340nm点阵激光联合其他美容疗法对17例女性患者进行皱纹和疤痕治疗。平均每1个月进行4.6(±1.9)次激光治疗。在激光治疗的整个过程中,每3个月进行一次联合治疗。结果:总平均改善为3.64(±0.49)。临床图像显示出明显的美学改善。没有不良事件的报告。结论:所使用的联合疗法在维持安全性和耐受性方面显示出希望,同时改善了患者对皮肤老化的治疗效果。
    Objective: This study provided clinical findings supporting the use of combination techniques/products and Nd:YAP 1340 nm fractional laser therapy, for soft-tissue augmentation in light- and darker-skin phototypes. Background: The face\'s aging process is complex and involves skin alterations, connective tissues, bone, and fat layers of the face. Methods: A total of 17 female patients were treated for wrinkles and for scars with the use of Nd:YAP 1340 nm fractional laser combined with other cosmetic therapies. The mean of 4.6(±1.9) laser treatment sessions every 1 month were performed. The combined therapy was administered every 3 months during the total course of the laser treatments. Results: The total mean improvement was 3.64(±0.49). Clinical images showed a visible aesthetic improvement. No adverse events have been reported. Conclusion: The combination therapies used have shown promise in maintaining safety and tolerability while improving patient results for the management of skin aging.
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  • 文章类型: Journal Article
    疤痕是在深度伤口或烧伤后发生的不愉快的皮肤病变。局部应用曲安奈德是治疗和预防瘢痕的常用方法,在常规剂型中应该重复几次。这里已经努力通过微针技术提供延长的曲安奈德真皮递送。也可用于伤口闭合。
    这项研究旨在开发一种持久的聚乳酸(PLA)微针贴片,用于曲安奈德(TrA)的长期释放,可用于伤口边缘的闭合和疤痕的预防和治疗。
    在这项研究中,使用微模塑-溶剂浇铸方法制造含3%和10%TrA的聚合物微针。光学显微镜,X射线衍射分析(XRD),傅里叶变换红外光谱(FT-IR),和差示扫描量热法(DSC)用于微针的表征。使用压缩试验和亚甲蓝染色评价机械强度。此外,通过人皮肤样品的组织病理学切片以及插入作为皮肤模型的Parafilm®M中确定插入深度。在34天内研究了微针的体外药物释放曲线,并确定了动力学模型。使用Franz扩散池研究TrA的离体皮肤渗透。
    制造的含TrA的PLA微针具有均匀的结构,没有任何故障,恶化,或失去针头。傅里叶变换红外光谱和差示扫描量热法显示TrA和PLA之间没有相互作用,并且未检测到TrA对聚合物的结晶度和热行为的影响。微针表现出适当的机械性能,它们能够穿透到大约900-1000μm的深度。适合Higuchi模型的10%和3%微针的全身释放曲线,在34天内累积量为625µg和201.64µg。从针释放遵循零级动力学,累积量为30.04µg和20.36µg,分别为10%和3%,分别,34天计算出含有10%TrA的微针的渗透为17μg/天。
    结果表明,可以用溶剂流延法成功构建含有具有延长释放行为的TrA的合适PLA微针。
    UNASSIGNED: Scar is an unpleasant skin lesion that occurs following deep wounds or burns. The application of local triamcinolone is a common treatment for scar treatment and prevention, which should be repeated several times in conventional dosage forms. An effort has been made here to provide a prolonged triamcinolone dermal delivery by microneedle technology, which can also be used for wound closure.
    UNASSIGNED: This study aimed to develop a long-lasting polylactic acid (PLA) microneedle patch for the prolonged release of triamcinolone acetonide (TrA) that could potentially be used for closure of wound edges and scar prevention and treatment.
    UNASSIGNED: In this study, 3% and 10% TrA-containing polymeric microneedles were fabricated using the micro molding-solvent casting method. Optical microscopy, X-ray diffraction analysis (XRD), Fourier-transform infrared spectroscopy (FT-IR), and differential scanning calorimetry (DSC) were used for the characterization of microneedles. Mechanical strength was evaluated using a compression test and methylene blue staining. Additionally, the insertion depth was determined by histopathological sectioning of human skin samples and also insertion into Parafilm®M as a skin model. The in vitro drug release profile of the microneedles was studied over 34 days, and the kinetic model was determined. The ex-vivo skin permeation of TrA was studied using a Franz-diffusion cell.
    UNASSIGNED: The TrA-containing PLA microneedles were fabricated with a uniform structure without any failure, deterioration, or loss of needles. Fourier-transform infrared spectroscopy and differential scanning calorimetry showed no interaction between TrA and PLA, and no effect on crystallinity and thermal behavior of TrA on polymer was detected. Microneedles showed appropriate mechanical properties, which were able to penetrate to about 900 - 1000 μm depth. Release profile from the whole body of 10% and 3% microneedle fitted to Higuchi model with cumulative amounts of 625 µg and 201.64 µg over 34 days. Release from the needles followed zero-order kinetic with cumulative amounts of 30.04 µg and 20.36 µg for 10% and 3%, respectively, for 34 days. Permeation was calculated to be 17 µg/day for 10% TrA-containing microneedle.
    UNASSIGNED: The results suggested that suitable PLA microneedles containing TrA with prolonged release behavior can be successfully constructed with the solvent casting method.
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  • 文章类型: Meta-Analysis
    目的:我们的目的是使用最新的荟萃分析评估基质血管分数(SVF)治疗瘢痕的有效性。
    方法:我们使用PubMed,Embase,科克伦,和WebofScience搜索用于评估SVF在瘢痕治疗中的疗效的研究。至少报告了以下结果指标之一:血管分布,色素沉着,厚度,救济,柔韧性,表面积,疼痛,瘙痒和颜色。
    结果:共纳入四篇符合条件的文章,包括145例患者(64例SVF患者和81例非SVF患者)。这项荟萃分析的结果表明,SVF在血管方面具有显着的治疗效果(SMD/MD,95%CI:-1.12,-0.02;p=0.04),瘙痒(SMD/MD,95%CI:-0.61,-0.13;p=0.002),POSAS(SMD/MD,95%CI:-5.93,-1.47;p=0.001),和厚度(SMD/MD,95%CI:-1.04,-0.35;p<0.001)。就OSAS(SMD/MD,95%CI:-9.14,0.59;p=0.09),色素沉着(SMD/MD,95%CI:-1.02,0.06;p=0.08),浮雕(SMD/MD,95%CI:-1.14,0.16;p=0.14),表面积(SMD/MD,95%CI:-0.91,0.26;p=0.27),PSAS(SMD/MD,95%CI:-7.20,0.49;p=0.09),疼痛(SMD/MD,95%CI:-0.87,0.07;p=0.10),柔韧性(SMD/MD,95%CI:-0.57,0.01;p=0.06),和颜色(SMD/MD,95%CI:-1.78,0.48;p=0.26),差异无统计学意义。
    结论:鉴于异质性和潜在的选择偏差,进一步大规模,prospective,需要多中心临床试验来证实SVF治疗瘢痕的有效性和可靠性。
    OBJECTIVE: Our aim was to assess the effectiveness of stromal vascular fraction (SVF) in treating scars using the latest meta-analysis.
    METHODS: We used PubMed, Embase, Cochrane, and Web of Science to search the studies used to evaluate the efficacy of SVF in scar treatment. At least one of the following outcome measures were reported: vascularity, pigmentation, thickness, relief, pliability, surface area, pain, itching and color.
    RESULTS: A total of four eligible articles comprising 145 patients (64 SVF patients and 81 non-SVF patients) were included. The findings of this meta-analysis indicated that SVF had significant therapeutic effects in terms of vascularity (SMD/MD, 95% CI: -1.12, -0.02; p = 0.04), itching (SMD/MD, 95% CI: -0.61, -0.13; p = 0.002), POSAS (SMD/MD, 95% CI: -5.93, -1.47; p = 0.001), and thickness (SMD/MD, 95% CI: -1.04, -0.35; p < 0.001). In terms of OSAS (SMD/MD, 95% CI: -9.14, 0.59; p = 0.09), pigmentation (SMD/MD, 95% CI: -1.02, 0.06; p = 0.08), relief (SMD/MD, 95% CI: -1.14, 0.16; p = 0.14), surface area (SMD/MD, 95% CI: -0.91, 0.26; p = 0.27), PSAS (SMD/MD, 95% CI: -7.20, 0.49; p = 0.09), pain (SMD/MD, 95% CI: -0.87, 0.07; p = 0.10), pliability (SMD/MD, 95% CI: -0.57, 0.01; p = 0.06), and color (SMD/MD, 95% CI: -1.78, 0.48; p = 0.26), there were no significant statistical differences.
    CONCLUSIONS: In view of the heterogeneity and potential selective bias, further large-scale, prospective, and multicenter clinical trials are needed to confirm the efficacy and reliability of SVF in the treatment of scars.
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  • 文章类型: Journal Article
    背景:已提出自体脂肪转移(AFT)作为瘢痕组织及其相关症状的可能治疗方法。然而,其有效性的证据尚未确定。这项荟萃分析的目的是使用经过验证的疤痕测量工具评估现有的关于自体脂肪转移治疗烧伤后和创伤后疤痕的有效性和安全性的证据。
    方法:本研究于2023年11月使用以下电子数据库进行了系统的文献综述:MEDLINE,Scopus,开放存取期刊目录(DOAJ),pubmed,谷歌学者。包括以下关键术语:(脂肪移植或自体脂肪转移)和(身体疤痕或身体烧伤或身体创伤)和(功效或安全性或满意度)。我们根据预定的质量标准评估文章。提取期间包括以下数据:患者人口统计学,AFT指示,AFT会话的数量,后续期,以及患者和观察者疤痕评估量表(POSAS)评分的变化,其中包含患者和观察者的成分。
    结果:本研究包括1326名患者和23篇发表的文章。共有14项前瞻性研究,7个回顾性研究,并对2项随机临床试验进行了评价。这23篇文章来自全球各地,最早发表于1992年,最近发表于2022年。
    结论:我们的研究结果表明,从患者和观察者的角度来看,瘢痕特征都有显著增强。总的来说,AFT有望成为与疤痕相关的疾病的有价值的治疗选择,因为它可以提高疤痕质量。有助于改善患者的预后和满意度。
    方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
    BACKGROUND: Autologous fat transfer (AFT) has been proposed as a possible treatment for scar tissue and its associated symptoms. Its effectiveness\'s evidence is yet unidentified though. The aim of this meta-analysis is to evaluate the currently available evidence on the efficacy and safety of autologous fat transfer in treating post-burn and post-traumatic scars using a validated scar measurement tool.
    METHODS: This study performed a systematic literature review in November 2023 using the following electronic databases: MEDLINE, SCOPUS, Directory of Open Access Journals (DOAJ), PUBMED, and Google Scholar. The following key terms were included: (Fat grafting OR Autologous fat transfer) AND (body scars OR body burns OR body wounds) AND (Efficacy OR Safety OR satisfaction). We evaluated articles according to predefined quality criteria. The following data were included during the extraction period: patient demographics, indications for AFT, the number of AFT sessions, follow-up periods, and changes in the Patient and Observer Scar Assessment Scale (POSAS) scores, which contain both the patient and observer components.
    RESULTS: This study included 1326 patients and 23 published articles. A total of 14 prospective studies, 7 retrospective studies, and 2 Randomized clinical trials studies were evaluated. These 23 articles came from diverse global locations; the earliest was published in 1992, and the most recently published in 2022.
    CONCLUSIONS: Our findings demonstrated significant enhancements in scar characteristics from both patient and observer perspectives. Overall, AFT holds promise as a valuable treatment option for scar-related conditions as it enhances scar quality ,contributing to improved patient outcomes and satisfaction.
    METHODS: 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 Table of Contents or the online Instructions to Authors www.springer.com/00266.
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  • 文章类型: Journal Article
    面部在定义人格中起着最关键的作用,任何妨碍面部美学的东西都会产生大量的心理影响。因此,有效地管理面部损伤并考虑恢复的所有三个要素非常重要,即,心理,医学和美学。目的:评价硅凝胶治疗面部撕裂伤的疗效。
    用P-67、q-52和l-10公式计算每组44例接受挫伤伤伤(CLW)缝合的患者的样本量,使用社会科学统计软件包(SPSS)软件版本23,N=4pq/l2。患者分为两组,A组和B组,其中A组为在缝合伤口上应用有机硅的研究组,而B组为对照组,未应用任何凝胶。
    在有机硅组中,在第7天和第30天之间观察到显着差异,60,第90天和第120天的治疗评分,而在非有机硅组中,在初始阶段没有观察到显著差异.然而,差异从第90天开始出现,一直持续到第120天。
    有机硅凝胶在伤口愈合和防止不美观的瘢痕形成方面具有相当大的效果,从缝合当天立即使用并持续到3个月。
    UNASSIGNED: Face plays the most crucial part in defining personality and anything that hampers the facial esthetics foists a great amount of psychological impact. Hence, it is extremely important to manage the facial injuries efficiently and consider all the three elements of recovery, i.e., psychological, medical and esthetics. Purpose-To evaluate the efficacy of silicone gel in healing of lacerated wounds on face.
    UNASSIGNED: A sample size of 44 patients in each group undergoing suturing of contused lacerated wound (CLW) was calculated with P-67, q-52 and l-10 Using Formula, N = 4pq/l2 using Statistical Package for Social Sciences (SPSS) software version 23. Patients were divided into two groups, Group A and Group B where Group A was study group who applied silicone over sutured wounds, while Group B was control group who did not applied any gel.
    UNASSIGNED: In silicone group, a significant difference was observed between 7th day and 30th, 60th, 90th and 120th day in healing scores, while in non-silicone group, no significant difference was observed at the initial period. However, difference started to appear from 90th day and continued till 120th day.
    UNASSIGNED: Silicone gel has considerable effect in healing of wound and prevention of unesthetic scarring when it is applied immediately from the day of suture removal and continued till 3 months.
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  • 文章类型: Journal Article
    烧伤后,瘢痕结局有相当大的变化,部分原因是遗传因素。疤痕血管是个体之间变化的一个特征,这项研究旨在确定导致不同瘢痕血管结局的遗传变异。对665名欧洲血统烧伤患者的前瞻性队列进行了全外显子组阵列关联研究和基因通路分析。使用他们的瘢痕血管(SV)子评分,修改后的温哥华疤痕量表(mVSS)的一部分,作为结果衡量。使用InfiniumHumanCoreExome-24BeadChip对DNA进行基因分型,归入单倍型参考联盟面板。遗传变异(单核苷酸多态性)和SV之间的关联使用加性遗传模型进行性别调整,年龄,%总身体表面积和外科手术次数,利用线性和多项逻辑回归。没有个体遗传变异达到显著性的截止阈值。还使用功能定位和注释(FUMA)平台分析了基因集,其中与血管生成间接相关的生物过程被显著呈现。这项研究表明,与血管生成相关的基因中的SNP可能会影响SV,但更大数据集的进一步研究对于验证这些发现至关重要.
    After burn injury there is considerable variation in scar outcome, partially due to genetic factors. Scar vascularity is one characteristic that varies between individuals, and this study aimed to identify genetic variants contributing to different scar vascularity outcomes. An exome-wide array association study and gene pathway analysis was performed on a prospective cohort of 665 patients of European ancestry treated for burn injury, using their scar vascularity (SV) sub-score, part of the modified Vancouver Scar Scale (mVSS), as an outcome measure. DNA was genotyped using the Infinium HumanCoreExome-24 BeadChip, imputed to the Haplotype Reference Consortium panel. Associations between genetic variants (single nucleotide polymorphisms) and SV were estimated using an additive genetic model adjusting for sex, age, % total body surface area and number of surgical procedures, utilising linear and multinomial logistic regression. No individual genetic variants achieved the cut-off threshold for significance. Gene sets were also analysed using the Functional Mapping and Annotation (FUMA) platform, in which biological processes indirectly related to angiogenesis were significantly represented. This study suggests that SNPs in genes associated with angiogenesis may influence SV, but further studies with larger datasets are essential to validate these findings.
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  • 文章类型: Case Reports
    背景:莫雷尔-拉瓦利病变(MLL)是一种闭合性病变,脱套软组织损伤,其中皮肤和皮下组织与下面的筋膜分离。这种综合征导致伤口愈合中断。红外热成像是一种无创无痛的工具,可用于评估疤痕和整骨手法治疗的影响。
    目的:评估术后整骨手法治疗(OMT)对Morel-Lavallee病变(MLL)的影响。
    方法:在一名志愿者患者的四次整骨治疗中,28岁男性,导致摩托车事故后左膝盖的MLL。使用红外热成像相机和骨病功能障碍的定性触诊检查评估OMT的效果,评分为1-4。
    结果:和讨论:OMT后瘢痕和瘢痕周围区域温度均升高。OMT后,疤痕和疤痕周围区域之间的温度差减小。当在疤痕周围施加OMT时,温度的升高要大于在距疤痕部位一定距离处施加OMT时的温度升高。末次治疗后,MLL瘢痕部位功能障碍的触诊评分从4/4降至2/4。
    结论:对于获得值得注意的结果,有必要对MLL瘢痕部位进行几次OMT研究。OMT改善了移动性并增加了疤痕和疤痕周围区域的温度。
    BACKGROUND: The Morel-Lavallee lesion (MLL) is a closed, degloving soft-tissue injury, wherein the skin and subcutaneous tissue are separated from the underlying fascia. This syndrome causes disruption of wound healing. Infrared thermography is a noninvasive and pain-free tool that can be used to evaluate scar and the influence of osteopathic manipulative treatment.
    OBJECTIVE: To evaluate the influence of post-operative osteopathic manipulative treatment (OMT) of Morel-Lavallee lesions (MLL).
    METHODS: During four osteopathic sessions on one volunteer patient, 28-year-old male, resulting in MLL of the left knee after motorcycle accident. The effects of OMT were assessed using an infrared thermal imaging camera and qualitative palpation examination of osteopathic dysfunction, scored on a scale of 1-4.
    RESULTS: and discussion: Both scar and peri-scar area temperatures increased after OMT. The difference in temperature between the scar and the peri-scar area decreased after OMT. Increase in temperature was greater when the OMT was applied around the scar than when applied at a distance from the scar site. The palpation score for dysfunction of the MLL scar site decreased from 4/4 to 2/4 after the final session.
    CONCLUSIONS: Several OMT sessions focusing on the MLL scar site appear necessary to obtain noteworthy results. OMT improved mobility and increased the temperature of the scar and the peri-scar area.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:皮肤切口疤痕在外观上令人不快;目前治疗的效果有限,需要找到减少疤痕形成的新方法。
    目的:我们试图确定术后立即注射基质血管部分凝胶(SVF凝胶)是否可以减少皮肤切口部位的瘢痕形成。
    方法:前瞻性,随机化,双盲,在接受乳房缩小术的患者中进行了自我对照试验.将SVF凝胶皮内注射到随机选择的一侧的手术切口中,另一侧接受生理盐水作为对照。在6个月的随访中,采用温哥华瘢痕量表(VSS)和视觉模拟量表(VAS)评价切口瘢痕.采用Antera3D相机进行客观评价。
    结果:SVF凝胶处理侧(3.80±1.37,3.37±1.25)和对照侧(5.25±1.18,4.94±1.28)之间的VSS评分和VAS评分显着不同。此外,SVF凝胶处理的一侧在疤痕外观方面显示出统计学上的显着改善,基于来自Antera3D相机的证据。
    结论:这是一个单中心,单种族,和单性别研究。此外,该结果仅适用于6个月的临时随访期.
    结论:手术切口术后立即注射SVF凝胶可减少瘢痕形成,并对疤痕起到预防作用。
    方法:从至少一项适当设计的随机对照试验获得的证据。该期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266.
    BACKGROUND: Skin incision scars are cosmetically displeasing; the effects of current treatments are limited, and new methods to reduce scar formation need to be found.
    OBJECTIVE: We sought to determine whether immediate postoperative injection of stromal vascular fraction gel (SVF-gel) could reduce scar formation at skin incision sites.
    METHODS: A prospective, randomized, double-blind, self-controlled trial was conducted in patients who underwent breast reduction. SVF-gel was intradermally injected into the surgical incision on one randomly selected side, with the other side receiving saline as a control. At the 6-month follow-up, the incision scars were evaluated using the Vancouver scar scale (VSS) and visual analog scale (VAS). Antera 3D camera was used for objective evaluation.
    RESULTS: The VSS score and VAS score were significantly different between the SVF-gel-treated side (3.80 ± 1.37, 3.37±1.25) and the control side (5.25 ± 1.18, 4.94 ± 1.28). Moreover, the SVF-gel-treated side showed statistically significant improvements in scar appearance, based on evidences from Antera 3D camera.
    CONCLUSIONS: This was a single-center, single-race, and single-gender study. Furthermore, the results were available only for the 6-month interim follow-up period.
    CONCLUSIONS: Postoperative immediate SVF-gel injection in surgical incisions can reduce scar formation, and exert a preventive effect on scars.
    METHODS: Evidence obtained from at least one properly designed randomized controlled trial. 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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  • 文章类型: Journal Article
    Scars are classified into 5 types: Superficial scars, hypertrophic scars, atrophic scars, depressed scars, and keloid. These types are primarily characterized by abnormal production of fibroblasts and collagen, as well as the disorderly arrangement of connective tissue. Laser treatment for scars involves the coordinated activation of various signaling pathways and cytokines. However, the exact pathological mechanism for scar formation remains unclear, leading to a lack of radical treatment. Recently, laser treatment has gained popularity as a new minimally invasive approach for scar treatment. The emergence of new theories such as fractional, picosecond laser, and laser-assisted drug delivery has led to continuous advance in laser treatment. Up to now, it has been developed numerous novel treatments, including combined with drug, physical, and other treatments, which have shown superior therapeutic effects. In order to optimize laser treatment in the future, it is crucial to combine new materials with postoperative care. This will help clinicians develop more comprehensive treatment strategies. Therefore, it is important to explore treatment options that have broader applicability.
    瘢痕主要包括浅表性瘢痕、增生性瘢痕、萎缩性瘢痕、凹陷性瘢痕和瘢痕疙瘩5种类型,以成纤维细胞和胶原蛋白的异常产生及结缔组织的排列紊乱等为特点。激光治疗瘢痕涉及多种信号转导通路和细胞因子的协调激活,然而瘢痕形成的确切病理机制仍不清楚,导致缺乏根治性的治疗手段。近年来,激光治疗作为一种新的瘢痕微创治疗方法越来越受欢迎。点阵、皮秒激光及激光辅助药物传输等新理论的出现,使得激光治疗不断进步,并衍生出许多新颖的治疗方式,包括激光联合药物、物理治疗等,均显示出良好的治疗效果。另外,新型材料与术后护理的结合对优化激光治疗至关重要,这将有助于临床医生制订更完善的治疗策略。因此,探索适用性更广的治疗方案具有非常重要的意义。.
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