用术前超高频超声波图对化脓性扁桃体炎病变进行术后并发症评估。

IF 1.5 4区 医学 Q3 DERMATOLOGY
Valentina Dini, Alessandra Michelucci, Giammarco Granieri, Nicola Zerbinati, Flavia Manzo Margiotta, Marco Romanelli
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引用次数: 0

摘要

目的:化脓性扁平湿疹(HS)是一种慢性毛囊炎性疾病。其治疗通常需要采用手术方法。我们的研究旨在评估新标准手术治疗后并发症的发生率。这包括在手术前使用 70MHz 探头进行超高频超声波(UHFUS)病灶测绘。术后管理基于 HS-TIME(时间、炎症/感染、湿度、边缘)原则:方法:比萨大学皮肤病学系开展了一项单中心回顾性研究。研究对象为中度和重度HS患者,这些患者对之前的药物和手术疗法均无效。所有患者都接受了大范围病灶手术切除治疗,此前曾使用 VEVO MD(富士胶片 VisualSonics 公司,加拿大)的 48MHz 和 70MHz 超声波探头进行过超高频超声波评估。手术后,所有患者都按照 HS-TIME 的原则进行了二次意向性愈合治疗。在手术后六个月的随访中,我们对每位患者的术后并发症发生情况进行了评估。在手术后的每次随访中,我们都会对每位患者的术后早期并发症发生情况进行评估,直至伤口完全愈合。然后对所有伤口完全愈合后观察时间超过 3 个月的患者(23 人)进行延迟并发症发生率评估:结果:共有 26 名患者参与了研究。没有关于术后出血或血肿病例的报告,但有三名患者(11.5%)出现了轻微的手术部位感染。术后疼痛的平均严重程度从术后即刻的 5.3 分下降到四周后的 1.3 分。平均愈合时间为(33.3±16.8)天,只有五名(19.2%)患者的伤口完全愈合时间超过六周。重点关注延迟并发症:1/23(4.3%)例患者出现增生性瘢痕;2/23(8.7%)例患者报告出现疼痛;2/23(8.7%)例患者报告出现临床复发。没有手术部位活动受限的病例:研究结果表明,新手术方案(包括术前超声波评估和适当的术后伤口处理)具有疗效。但我们认为,低复发率和术后并发症证实了我们提出的方案是治疗符合手术治疗条件的 HS 患者的有效策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of post-surgical complications of hidradenitis suppurativa lesions explored with presurgical ultra-high frequency ultrasound mapping.

Objective: Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicle. Its treatment often requires a surgical approach. The aim of our study was to evaluate the occurrence of post-surgical complications following a new standard of surgical management. This included presurgical lesion mapping by ultra-high frequency ultrasound (UHFUS) with a 70MHz probe. Postoperative management was based on the principles of HS-TIME (time, inflammation/infection, moisture, edges).

Method: A single-centre, retrospective study was conducted by the Department of Dermatology of the University of Pisa. Patients with moderate and severe HS, refractory to previous medical and surgical therapies, were enrolled. All of the patients were treated with wide surgical excision of lesions, previously explored through a UHFUS evaluation with VEVO MD (Fujifilm VisualSonics, Inc., Canada) using a 48MHz and a 70MHz ultrasound probe. Following surgery, all patients were treated with secondary intention healing following the principles of HS-TIME. For each patient, we assessed the occurrence of post-surgical complications at follow-up visit six months after surgery. For each patient we assessed the occurrence of early post-surgical complications at every follow-up visit after surgery until complete wound healing. The occurrence of delayed complications was then assessed in all patients with an observation time after complete healing of >3 months (n=23).

Results: A total of 26 patients were enrolled in the study. There were no reported cases of post-surgical bleeding or haematoma occurrence, while three (11.5%) patients developed minor surgical site infection. The average severity of pain decreased from a numerical rating scale of 5.3 immediately after surgery to 1.3 after four weeks. The average healing time was 33.3±16.8 days, and only five (19.2%) patients reported a complete wound healing time of >6 weeks. Focusing on delayed complications: 1/23 (4.3%) patient had hypertrophic scarring; 2/23 (8.7%) patients reported dysaesthesia; and 2/23 (8.7%) cases of clinical relapse were reported. No cases of limited mobility at the surgery site were registered.

Conclusion: The findings of the study demonstrated the efficacy of a novel surgical protocol, including a preoperative ultrasound evaluation and appropriate postoperative wound management. Further prospective studies are needed to validate the observed results; however, we conclude that the low recurrence rates and post-surgical complications confirmed that our proposed protocol would represent an effective strategy for the management of patients with HS eligible for surgical therapy.

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来源期刊
Journal of wound care
Journal of wound care DERMATOLOGY-
CiteScore
2.90
自引率
10.50%
发文量
215
期刊介绍: Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.
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