Can Single Use Negative Pressure Wound Therapy be an alternative method to manage keloid scarring? A preliminary report of a clinical and ultrasound/colour‐power‐doppler study

Abstract

Keloid scarring represents a pathological healing where primary healing phenomenon is deviated from normal. Pico is a single use negative pressure wound therapy system originally introduced to manage open or just closed wounds. Pico dressing is made of silicone, and distributes an 80 mmHg negative pressure across wound bed. Combination of silicon layer and continuous compression could be a valid method to manage keloid scarring. Since November 2011, three patients were enrolled and evaluated before negative pressure treatment, at end of treatment (1 month) and 2 months later, through Vancouver Scar Scale (VSS), Visual Analog Scale (VAS) and a scoring system for itching. Ultrasound (US) and colour-power-doppler (CPD) examination was performed to evaluate thickness and vascularisation of the scar. One patient was discharged from study after 1 week. In last two patients, VSS, VAS and itching significantly improved after 1 month therapy and the results were stable after 2 months without any therapy. At end of therapy, the 'appearance of palisade vessels' disappeared in both cases at CPD exam; US showed a thickness reduction (average 43·8%). We propose a well-tolerated, non invasive treatment to manage keloid scarring. Prospective studies are necessary to investigate whether these preliminary observations are confirmed.

Evaluating the Therapeutic Success of Keloids Treated With Cryotherapy and Intralesional Corticosteroids Using Noninvasive Objective Measures

“…Sonography represents a frequently used noninvasive observation tool in the treatment of pathologic scars. 4,[26][27][28][29] In dermatological research, high frequency ultrasound with 7.5 MHz and above is used. It offers a sufficient penetration depth as well as high resolution and thereby achieves reliable measurement results in scar assessment.…”

“…Nevertheless, over the last decade, various studies have highlighted ultrasound as an objective tool to determine changes in scar size. 4,[26][27][28][29][30] More recently, the application of an 3D topographic imaging devices (PRIMOS pico ) has also been studied in this context. 31,32 Based on current data, both tools seem reliable to deliver objective data on changes of physical scar characteristics.…”

Ultrasound and dermatology: basic principles and main applications in dermatologic research

“…Another interesting feature of keloid has been described using US and color-power-Doppler: a typical appearance of 'palisade vessels' that disappeared one month after treatment with a negative-pressure device in two patients, together with decrease of the scar thickness [81]. The value of US as an objective improvement measure is illustrated in a study where a symptomatic improvement in terms of pruritus noted after treatment was not accompanied by an objective reduction in scar thickness [82].…”

Prophylactic negative pressure wound therapy in colorectal surgery. Effects on surgical site events: current status and call to action

“…It has been estimated that SSI are responsible of over 1.5 billion dollar excess costs per year in the US [10]. Surgical site complications affect the quality of wound healing and the perceived health-related quality of life (HRQoL), which is a major concern in general surgery, especially in young patients [11], in whom SSI represent the commonest hospitalacquired complication. The highest incidence is observed in patients undergoing small bowel and colon surgery [1][2][3][4].…”