Clinical effects of a combination treatment with narrow-spectrum intense pulsed light and fractional carbon dioxide laser on hypertrophic scar pruritus / 中华烧伤杂志

Objective@#To observe the effects of a combination treatment with narrow-spectrum intense pulsed light and fractional carbon dioxide laser on hypertrophic scar pruritus in clinic.@*Methods@#A prospective randomized controlled study was conducted. A total of 90 patients with hypertrophic scars conforming to the inclusion criteria who were hospitalized in our ward from March to December 2017 were divided into combination treatment group and control group according to the random number table, with 45 patients in each group. For scar pruritus, patients in control group were treated twice by narrow-spectrum intense pulsed light with a one-month interval, while patients in combination treatment group were firstly treated by narrow-spectrum intense pulsed light combined with fractional carbon dioxide laser once, and with narrow-spectrum intense pulsed light once one month later. Before and 3 months after treatment, scar pruritus was evaluated by the Visual Analogue Scale and the Four-item Itch Questionnaire, and the improvement of scar was assessed by photography. Three months after treatment, the treatment satisfaction of scar pruritus was self-rated by patients. Meanwhile, adverse effects were recorded during the procedures and follow-up periods. Data were processed with Chi-square test, paired t test, Wilcoxon rank-sum test, and Fisher′s exact probability test.@*Results@#Before treatment, there was no statistically significant difference in scar pruritus degree evaluated by the Visual Analogue Scale and score distribution of scar pruritus location, extent, frequency, and sleep effect of the Four-item Itch Questionnaire between patients of two groups (Z=-1.08, -0.91, -0.03, -0.69, -1.49, P>0.05). Three months after treatment, there was reducing degree of scar pruritus of patients evaluated by the Visual Analogue Scale in control group or combination treatment group compared with before treatment within the same group (Z=-1.98, -4.65, P<0.05 or P<0.01), while the latter was more obvious than the former (Z=-2.14, P<0.05). There were reducing scores of scar pruritus extent and frequency of patients in control group, along with location, extent, frequency, and sleep effect of patients in combination treatment group compared with those before treatment within the same group (Z=-2.33, -2.34, -3.53, -4.96, -3.32, -4.84, P<0.05 or P<0.01). However, scores of scar pruritus location and sleep effect of patients in control group were similar to those before treatment within the same group (Z=-0.58, -1.34, P>0.05). The scores of scar pruritus location, extent, frequency, and sleep effect of patients were obviously lower in combination treatment group compared with control group (Z=-2.09, -2.69, -1.99, -2.23, P<0.05 or P<0.01). It was much better of scar improvement of patients in combination treatment group compared with control group (Z=-4.00, P<0.01). The percentages of treatment satisfaction of scar pruritus of patients with 0, 1%-25%, 26%-50%, 51%-75%, 76%-100% were 0, 2.2% (1/45), 17.8% (8/45), 48.9% (22/45), and 31.1% (14/45) respectively in combination treatment group, which were obviously better than 0, 11.1% (5/45), 53.3% (24/45), 28.9% (13/45), and 6.7% (3/45) in control group (Z=-4.42, P<0.01). During the treatment and follow-up periods, the adverse effect ratio of patients in control group was 6.7% (3/45), similar to 2.2% (1/45) of combination treatment group (P>0.05).@*Conclusions@#The combination of narrow-spectrum intense pulsed light and fractional carbon dioxide laser can greatly reduce pruritus, improve effect of scar treatment, and bring higher patient satisfaction compared with narrow-spectrum intense pulsed light alone in treating hypertrophic scar pruritus.@*Clinical trial registration@#Chinese Clinical Trial Registry, ChiCTR-ONH-17012350.

Advances in the research of techniques for traumatic scars intervention with photoelectric acoustic therapy / 中华烧伤杂志

Traumatic scar is a common complication of skin injury, such as burn, trauma, and surgery. The mechanism for scar formation still remains unclear. Traumatic scar has a negative impact on the quality of patients′ life, due to the appearance of scar always causes physical or/and psychological problems to patients. The treatments for scar include surgery, chemotherapy, radiotherapy, and pressure, depending on the kind of scar present. Recently, a great progress in treating scar has been achieved by novel techniques with laser, intense pulsed light, micro-plasma radiofrequency, and ultrasound. The aim of this review is introducing the advances of these techniques for traumatic scars intervention.

Cheiloplasty by incising along the outline for correction of the defection caused by cheiloschisis operation / 中华医学美学美容杂志

Objective To find a satisfied repairing method which can complete the functional cheiloplasty while avoiding the visible scar after the cheiloschisis II operation for bilateral cleft lip. Methods The functional operation was carried out in subcutaneous layer by incising along the outline of the nose and the mouth. Results A satisfied effect was achieved after 6 months to 2 years' follow up in 15 cases of the patients (4 cases of bilateral cleft, 11 cases of cheiloschisis). Conclusions The new operation method has improved the traditional method of cheiloplasty. It can effectively repair the secondary defection in nose and mouth resulted from the cheilochisis operation. It can rebuild the orbicularis oris muscle and repair the diseased alar catilage as well. Furthermore, it not only brings a natural looking appearance, but also a natural function and an invisible incision scar. [

Treatment of recurrent cavernous hemangiomas by ethanol thrombosis and pinyangmycin sclerothery / 中华医学美学美容杂志

Objective To investigate a safe, effective and mini-invasive method in the treatment of recurrent cavernous hemangiomas. Methods Under local or ketamine anesthesia, ethanol was injected into hemangioma to embolize the draining vessels, and 8～16 mg pinyangmycin was then injected into the lesion slowly. After 7～10 days, second injection of pinyangmycin and total 3～5 times were needed as a course of treatment. Results In the 6 cases reported, shrinkage and degradation were observed and finally tumor was disappeared. There was no skin necrosis, no recurrence and other complications in the 1～5 years follow-up period. Conclusion Ethanol embolization and pinyangmycin injection is a safe, simple, mini-invasive, and effective method in treating the recurrent cavernous hemangiomas.