Inês Correia-Sá1,2,3, Paula Serrão4, Marisa Marques5,6, Maria A Vieira-Coelho4. 1. Department of Plastic, Reconstructive and Aesthetic Surgery, Maxillofacial Surgery and Burn Unit, Centro Hospitalar de São João, EPE, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. inescsa@gmail.com. 2. Department of Pharmacology & Therapeutics, Faculty of Medicine, University of Oporto, Porto, Portugal. inescsa@gmail.com. 3. Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Oporto, Porto, Portugal. inescsa@gmail.com. 4. Department of Pharmacology & Therapeutics, Faculty of Medicine, University of Oporto, Porto, Portugal. 5. Department of Plastic, Reconstructive and Aesthetic Surgery, Maxillofacial Surgery and Burn Unit, Centro Hospitalar de São João, EPE, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. 6. Department of Plastic and Reconstructive Surgery, Faculty of Medicine, University of Oporto, Porto, Portugal.
Abstract
BACKGROUND: Hypertrophic scars are a consequence of wound healing. OBJECTIVE: The objective of the present study is to evaluate vitamin D and inflammatory biomarker plasma levels during wound healing. METHODS: A prospective study was performed in patients (n = 63) submitted to body contouring surgery. Blood samples were collected before (t 0) and 5 days after surgery (t 5). Blood cell count, protein inflammatory biomarkers, and circulating plasma levels of 25(OH)D, vitamin A and vitamin E were quantified. Six months after surgery, scars were evaluated and classified as normal or hypertrophic. RESULTS: At the end of the study, 73% of the patients developed a normal scar (control group, n = 46) and 27% of the patients presented hypertrophic scars (HT group, n = 17). The patients in the HT group presented higher eosinophil (0.145 × 109 /L vs. 0.104 × 109 /L, p = 0.028) and basophil count (0.031 × 109 /L vs. 0.22 × 109 /L, p = 0.049) and C-reactive protein levels (6.12 mg/L vs. 2.30 mg/L, p = 0.015) in t 0 than the patients in the control group. At t 5, the patients in the HT group showed a decrease in neutrophil (3.144 × 109/L vs. 4.03 × 109/L, p = 0.031) and an increase in basophil (0.024 × 109/L vs. 0.015 × 109/L, p = 0.005) and lymphocyte count (1.836 × 109 /L vs. 1.557 × 109/L; p = 0.028). Before surgery, vitamin D plasma levels were found to be decreased by almost 50% (23.52 ng/mL vs. 15.46 ng/mL, p = 0.031) in the patients who developed hypertrophic scars. Thirty-one percent of the patients submitted to bariatric surgery had more hypertrophic scars, versus 24% of the patients with no previous bariatric surgery. CONCLUSION: There is a different systemic inflammatory profile response in the patients during the formation of hypertrophic scars. Vitamin D plasma levels are marked reduced in these patients. Considering the powerful anti-inflammatory effect of vitamin D, these findings could be related.
BACKGROUND:Hypertrophic scars are a consequence of wound healing. OBJECTIVE: The objective of the present study is to evaluate vitamin D and inflammatory biomarker plasma levels during wound healing. METHODS: A prospective study was performed in patients (n = 63) submitted to body contouring surgery. Blood samples were collected before (t 0) and 5 days after surgery (t 5). Blood cell count, protein inflammatory biomarkers, and circulating plasma levels of 25(OH)D, vitamin A and vitamin E were quantified. Six months after surgery, scars were evaluated and classified as normal or hypertrophic. RESULTS: At the end of the study, 73% of the patients developed a normal scar (control group, n = 46) and 27% of the patients presented hypertrophic scars (HT group, n = 17). The patients in the HT group presented higher eosinophil (0.145 × 109 /L vs. 0.104 × 109 /L, p = 0.028) and basophil count (0.031 × 109 /L vs. 0.22 × 109 /L, p = 0.049) and C-reactive protein levels (6.12 mg/L vs. 2.30 mg/L, p = 0.015) in t 0 than the patients in the control group. At t 5, the patients in the HT group showed a decrease in neutrophil (3.144 × 109/L vs. 4.03 × 109/L, p = 0.031) and an increase in basophil (0.024 × 109/L vs. 0.015 × 109/L, p = 0.005) and lymphocyte count (1.836 × 109 /L vs. 1.557 × 109/L; p = 0.028). Before surgery, vitamin D plasma levels were found to be decreased by almost 50% (23.52 ng/mL vs. 15.46 ng/mL, p = 0.031) in the patients who developed hypertrophic scars. Thirty-one percent of the patients submitted to bariatric surgery had more hypertrophic scars, versus 24% of the patients with no previous bariatric surgery. CONCLUSION: There is a different systemic inflammatory profile response in the patients during the formation of hypertrophic scars. Vitamin D plasma levels are marked reduced in these patients. Considering the powerful anti-inflammatory effect of vitamin D, these findings could be related.
Authors: T E Hakvoort; V Altun; R S Ramrattan; T H van der Kwast; R Benner; P P van Zuijlen; A F Vloemans; E P Prens Journal: Virchows Arch Date: 1999-03 Impact factor: 4.064