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The effect of surgical skin tension reduction combined with early electronic line irradiation on keloid treatment after median sternotomy

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【作者】 孙传伟黄志锋赖文卞徽宁吴敏郑少逸熊兵刘族安罗红敏马亮华李汉华李成志

【Author】 SUN Chuan-wei;HUANG Zhi-feng;LAI Wen;BIAN Hui-ning;WU Min;ZHENG Shao-yi;XIONG Bing;LIU Zu-an;LUO Hong-min;MA Liang-hua;LI Han-hua;LI Cheng-zhi;Deparment of Burns and wound repair Surgery,Guangdong General Hospital,Guangdong Academy Medical Sciences;Department of Cardiology,Guangdong General Hospital,Guangdong Academy Medical Sciences;Department of General Surgery,The first people’s Hospital of Kashi region;

【机构】 Deparment of Burns and wound repair Surgery,Guangdong General Hospital,Guangdong Academy Medical SciencesDepartment of Cardiology,Guangdong General Hospital,Guangdong Academy Medical SciencesDepartment of General Surgery,The first people’s Hospital of Kashi region

【摘要】 Background Median sternotomy remains the preferred technique in open heart surgery. The middle part of the chest is a predilection site for keloids. Keloids are often accompanied by itching and pain, and seriously affect the beauty and quality of life. The main treatments of keloids include surgical resection, local injection of drugs,laser, cryotherapy, compression therapy, and topical application of silica gel. Unfortunately, there is no way to achieve superior results. Therefore, there is a need to find an effective way to treat keloid after median sternotomy. Our study was designed to investigate the effect of reducing the tension of the skin and the early electronic line irradiation on the treatment of keloid after median sternotomy. Methods A retrospective analysis was performed in 54 patients with keloid after median sternotomy treated by reducing the tension of the skin and removing the keloid, followed with electron beam irradiation treatment 24 hours after the operation. For each patient,5 Gy electron beam irradiation was used every day after the operation for 4 days with the total dose of 20 Gy.The patients were followed up at 6 months and 12 months after surgery. Results Fifty-four cases of patients werefollowed up for at least 6 months. In 6 months follow-up, there were significant effects in 34 cases with a total effective rate of 98.1%. In 12 months follow-up, 33 cases were cured with the total effective rate was 96.3%.Conclusion The treatment of keloid after median sternotomy can be achieved by the combination of tension reduction surgery and early electronic line irradiation.

【Abstract】 Background Median sternotomy remains the preferred technique in open heart surgery. The middle part of the chest is a predilection site for keloids. Keloids are often accompanied by itching and pain, and seriously affect the beauty and quality of life. The main treatments of keloids include surgical resection, local injection of drugs,laser, cryotherapy, compression therapy, and topical application of silica gel. Unfortunately, there is no way to achieve superior results. Therefore, there is a need to find an effective way to treat keloid after median sternotomy. Our study was designed to investigate the effect of reducing the tension of the skin and the early electronic line irradiation on the treatment of keloid after median sternotomy. Methods A retrospective analysis was performed in 54 patients with keloid after median sternotomy treated by reducing the tension of the skin and removing the keloid, followed with electron beam irradiation treatment 24 hours after the operation. For each patient,5 Gy electron beam irradiation was used every day after the operation for 4 days with the total dose of 20 Gy.The patients were followed up at 6 months and 12 months after surgery. Results Fifty-four cases of patients werefollowed up for at least 6 months. In 6 months follow-up, there were significant effects in 34 cases with a total effective rate of 98.1%. In 12 months follow-up, 33 cases were cured with the total effective rate was 96.3%.Conclusion The treatment of keloid after median sternotomy can be achieved by the combination of tension reduction surgery and early electronic line irradiation.

【基金】 supported by Medical Scientific Research Foundation of Guangdong Province(No.A2015441/A2017004);Guangdong General Hospital special application foundation
  • 【文献出处】 South China Journal of Cardiology ,岭南心血管病杂志(英文版) , 编辑部邮箱 ,2017年02期
  • 【分类号】R654.2
  • 【下载频次】26
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