Hypertrophic scars, keloids Littekenhypertrofie
Conditions
Interventions
Ten days following surgery (after reepithelialization had been established), participants received a pair of ointment packages, marked ‘R’ and ‘L’, which were kindly provided by Leo Pharmaceutical Pro
Sponsors
VU University Medical Center, Amsterdam.
This investigation was supported by a grant of the Dutch Burns Foundation and the Cornelis Visser Foundation.
Eligibility
Inclusion criteria
Inclusion criteria: Women aged above 18 years that were planned for bilateral reduction mammoplasty at the University Medical Center of Groningen received written information about the study prior to surgery.
Exclusion criteria
Exclusion criteria: Exclusion criteria for participation were current or planned pregnancy in the first year following surgery and postoperative complications (e.g. haematoma, infection).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Evaluations took place under standardized circumstances at 3 weeks, 3 months and 12 months following surgery and were performed by the same observer (IEW). During all evaluations, the scar’s clinical aspect was scored as normotrophic (when flat) or hypertrophic (when raised above surrounding skin level). Scoring and measuring was done at 3 cm from the scars lateral and medial extremes. To quantify the scar’s macroscopic properties, its thickness was measured ultrasonographically at 3 and 12 months postoperative, using a 7,5 MHz-probe (SSD-680 EX/STD, Aloka Co., Ltd., Japan). In order to obtain a reliable image, a gel pad (Aquaflex®, Parker Laboratories Inc., Fairfield, USA) was placed between the probe and the skin. The distance (in mm) between the echogenic stratum corneum and subcutaneous tissue (appearing as a ‘black circle’) was measured. This method has proven to be valuable in the morphological assessment of the skin, but also in distinguishing normal from hypertrophic scars. | — |
Secondary
| Measure | Time frame |
|---|---|
| During all evaluations 3 mm punch biopsies were collected, consecutively at 5 cm, 4 cm and 3 cm from the lateral confines of both lateral scars after local anaesthesia with 5 ml lidocaine HCL (10 mg/ml) combined with epinephrine (0.01 mg/ml). Prior to immunohistochemical staining, the frozen biopsy samples were further processed into 5 ìm cryostat sections, embedded on glass slides. Monoclonal antibodies were used for staining the sections. The number of epidermal layers (acanthosis) was counted in the haematoxylin-eosin stained sections. The percentage of proliferating basal keratinocytes was evaluated in anti-Ki-67 stained sections, by counting both the total number of basal keratinocytes (heamatoxilin-stained) and the number of Ki-67-positive basal keratinocytes. The presence or absence of activated keratinocytes was evaluated in anti-keratin-16 stained sections, by scoring suprabasal staining as absent or present. The percentage of epidermal Langerhans cells was calculated using computer-assisted microscopic evaluation using NIS-Elements AR, version 2.3 (Nikon Inc.). After a representative part of the epidermis was outlined, running from basal membrane to stratum corneum, the surface area of CD1a-positive tissue within the selection was expressed as a percentage of the total area in the selection. | — |
Contacts
Public ContactF.B. Niessen
VU University Medical Center Department of Plastic and Reconstructive Surgery PO Box 7057
Outcome results
None listed