CHOICE OF THE TREATMENT AND PREVENTION METHOD FOR SCAR DEFECTS AFTER SURGERIES FOR BENIGN BREAST DISEASES
DOI:
https://doi.org/10.11603/2415-8798.2019.1.9937Keywords:
mammary gland scar defects, keloid scar, hypertrophic scar, recurrenceAbstract
Nowadays there is no unique algorithmic approach to the selection of pathway for the treatment and prevention of scar defects in the mammary gland, and literature data on the impact of different scar elimination methods on the quality of life remains controversial.
The aim of the study – to compare the effectiveness of the combined use of therapeutic and anti-relapse measures in the elimination of cicatricial defects on the mammary glands with the results of their simple surgical excision.
Materials and Methods. A comparison of the effectiveness of therapeutic and prevention tactics in three groups of patients (104 people in total) with scar defects (SD) of mammary glands not related to oncology was performed. The study groups consisted of group 1 (33 patients) who received a non-invasive treatment of the defect scar with a solution of corticosteroid and anesthetic as well as the use of a patch and compression (in case scar width did not exceed 2 mm above the skin level) and the group 2 with 36 patients who underwent a combined surgical scar excision with the injection of corticosteroid with anesthetic in the base of fresh cicatrix – under the scar area along with patch and compression application. The comparison group consisted of 35 patients who were treated only surgically. The control examinations were performed on the 3rd week after the intervention, after 4 and 5 weeks, after 3, 6, 9 and 12 months, respectively.
Results and Discussion. After the application of surgical excision of scar defects, the number of hypertrophic scars decreased by 70m %, and keloid scars – by one third. However, after the use of the complex treatment method, a complete regression of hypertrophic and keloid defective scars was observed, and a cohort of patients with hypothrophic and normotrophic scars arose. Histological examination revealed that the occurrence of keloid and hypertrophic scars was significantly different in patients who had a tendency towards them, which was manifested by excessive deposition of type II and VII collagen. A combined approach improved the treatment outcomes and prevented the recurrence of defective scars.
Conclusions. The pathological scar formation in the mammary glands is triggered by numerous factors including concomittant metabolic disorders, connective tissue diseases, infectious diseases, etc., a compensation of which may prevent defective scarring. A combined use of corticosteroids, silicone patch and compression in surgical or minimally invasive treatment of scar defects on the mammary gland significantly improves the treatment results, prevents relapse of such defects and reduces the timing of the scar maturation.
References
Abulezz, T. (2009). Mammoplasty in Correcting Scar-Induced Breast Deformities. Annals of Burns and Fire Disasters, 22 (4), 208-211.
Jarjis, R.D., & Matzen, S.H. (2016). Release and Reconstruction of a Postburn Deformed Breast in a Young Woman. Plastic and Reconstructive Surgery Global Open, 4 (3), e643.
Baranovskyi, Yu.H. (2011). Operatyvne likuvannia hipertrofichnykh i koloidnykh rubtsiv, yikh rannia kliniko-morfolohichna dyferentsialna diahnostyka i profilaktyka [Operative treatment of hypertrophic and colloidal scars, their early clinical and morphological differential diagnosis and prophylaxis]. Extended abstract of candidate’s thesis. Simferopol, p. 22 [in Ukrainian].
Grishkevich, V.M. (2009). Restoration of the shape, location and skin of the severe burn-damaged breast. Burns, 35, 1026-1035.
Losken, A., & Hamdi, M. (2009). Partial breast reconstruction: current perspectives. Plast Reconstr Surg., 124 (3), 722-736.
Hamdi, M. (2013). Oncoplastic and reconstructive surgery of the breast. Breast, 22 (2), S100-105.
Joyce, C.W., Murphy, S., Murphy, S., Kelly, J.L., & Morrison, C.M. (2015). Scar Wars: Preferences in Breast Surgery. Archives of Plastic Surgery, 42 (5), 596-600. doi:10.5999/aps.2015.42.5.596.
Bailey, S.H., Saint-Cyr, M., Oni, G., Maia, M., Andry, D., Shirvani, A., … & Rohrich, R. (2012). Aesthetic subunit of the breast: an analysis of women's preference and clinical implications. Ann Plast Surg, 68, 240-245.
Yueh, J.H., Slavin, S.A., Adesiyun, T., Nyame, T.T., Gautam, S., Morris, D.J., … & Lee, B.T. (2010). Patient satisfaction in postmastectomy breast reconstruction: a comparative evaluation of DIEP, TRAM, latissimus flap, and implant techniques. Plast Reconstr Surg., 125, 1585-1595.
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