Topische Externa zur Prävention und Therapie hypertropher Narben und Keloide: Eine Literaturrecherche

Zusammenfassung

Hintergrund: Die Prävention und Therapie von hypertrophen Narben und Keloiden stellt eine besondere Herausforderung für den plastischen Chirurgen dar. Topische Externa sind aufgrund ihrer einfachen, nicht invasiven und schmerzfreien Anwendung eine attraktive Therapieoption. Von Seiten der Patienten kommt dabei regelmäßig die Frage nach der Wirksamkeit topischer Externa auf, deren Klärung Gegenstand der vorliegenden Arbeit ist.

Material und Methoden: Es wurde eine systematische Literaturrecherche in den Datenbanken Medline, Medline Plus, Oldmedline und Cochrane Library durchgeführt. Eingeschlossen und gegenübergestellt wurden sämtliche randomisierten kontrollierten Studien, Meta-analysen, systematische Übersichtsarbeiten, Anwendungsbeobachtungen und Fallbeispiele aus der deutschen und englischen Literatur, die sich mit im deutschsprachigen Raum zugelassenen Narbentopika befassen.

Ergebnisse: Es konnten 14 topische Externa identifiziert werden. Es existieren jedoch wenige Daten bezüglich ihrer Wirksamkeit im Vergleich untereinander, mit anderen Therapieoptionen oder unbehandelten Kontrollen. Lediglich zu 6 Präparaten existierten Studien mit hohem Evidenzgrad. Contractubex zeigt dabei in der Prävention pathologischer Narben die besten Ergebnisse.

Schlussfolgerung: Obwohl bei aktueller Datenlage Contractubex präventive Wirkung zeigt und empfohlen werden kann, sind weitere Studien notwendig, um die Evidenzlage zu stärken und vor allem auch die therapeutische Wirksamkeit topischer Externa zu belegen.

Abstract

Background: The treatment and prevention of hypertrophic scars and keloids represents a special challenge particularly in plastic surgery. Given their simple, non-invasive and painless application, topical preparations are an attractive therapeutic option. On the part of the patients, the efficacy in prevention of and therapy for hypertrophic scars and keloids of these topical preparations is regularly questioned. The clarification of this issue is subject of this review.

Material and Methods: A systematic literature research on the databases Medline, Medline Plus, Oldmedline and Cochrane Library was conducted. All randomised controlled trials, meta-analyses, systematic reviews, case series and case studies from the German and English literature, dealing with topical preparations approved in the German speaking area, were included.

Results: In this research, 14 topical preparations were identified. However, there is limited data regarding their efficacy as compared to each other, to other treatment options or untreated controls. Only for 6 topical preparations studies with high evidence level exist. Contractubex showed best results in the prevention of pathological scars.

Conclusion: Even though Contractubex shows preventive effects and can be recommended based on current data, further studies are needed to strengthen the body of evidence and to prove the therapeutic efficacy of topical preparations in general.

Schlüsselwörter

Wundheilung - Haut - hypertrophe Narbe - Keloid - topische Externa

Key words

wound healing - skin - hypertrophic scars - keloid - topical preparations

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