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Obes Surg. 2017 Dec;27(12):3170-3178. doi: 10.1007/s11695-017-2740-4.

Hypertrophic Scars: Are Vitamins and Inflammatory Biomarkers Related with the Pathophysiology of Wound Healing?

Author information

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.

KEYWORDS:

Bariatric; Hypertrophic; Inflammation; Scar; Vitamin D; Wound healing

PMID:
28569361
DOI:
10.1007/s11695-017-2740-4
[Indexed for MEDLINE]

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