Abstract

VILLAFUERTE-VELEZ, César-Kelly; CASTRO-CABRERA, Andrea C.  and  RESTREPO-VILLAFUERTE, Carolina. Trans-surgery prophylactic corticotherapy of cicatricial hyperplasia: clinic-stadistic prospective study. Cir. plást. iberolatinoam. [online]. 2017, vol.43, n.1, pp.33-39. ISSN 1989-2055.

Background and Objective. Cicatricial hyperplasia, denomination which gathers the hypertrophic scar and keloid, represents a big challenge in surgical practice. These pathologies rushing only on human beings have been associated by different works, in particular the keloid, with black and yellow races, confirmed fact in the state of Bahia - Brazil, where large number of reduction mammoplasty, they are accompanied by hyperplasic scars and where the afro-descendant genetic is very significant. These anomalies generate great insatisfaction in patients and surgeons. Our objective is to demonstrate than we can prevent this type of scars before the skin incision, and before the firing of the cascade of repair, molding the early stages of healing using an specific corticoid. Methods. We conduct a prospective study of longitudinal prevalence and self-controlled, on 60 breast from 30 women with diagnostic of gigantomasty, all subject to reduction mammoplasty with T inverted and graft-mammillary areola plate (Thorek-Pitanguy), and comparing between 2 groups: the first one with 30 right breast infiltrated with a solution of corticoid anti-chemoattractant in the dermis and subcutaneous, under the surgical predial design ink and before incisions (intervention group); and the second one with 30 left breast whithout infiltration (control group), to statistically determine, after a period of monitoring, the prophylactic efficacy of dexamethasone acetate in preventing the hyperplasic scar. Patients were accompanied between 6-15 months, and their kind of healing was classified by the scale of Vancouver with photographic documentation. Statistical studies were made by the Chi-square test and the Kruskal-Wallis test for experimental analysis. Results. It is shown a significant reduction, statistically, in hyperplasic scar when compared the 2 breasts (p=0.02): the right breast infiltrated with corticoid had minor incidence (p=0.06). Data confirmed by the statistical experimental test. Conclusions. Prophylactic therapeutic intervention, intra-local, with dexamethasone acetate in the transoperative is highly effective, reducing significantly the presence of the hyperplasic scar.

Keywords : Scar; Cicatricial hyperplasia; Keloid; Hypertrophic scar; Corticoid.

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