蟹足肿体质的人，身上一有伤痕，就会长出凸出而且肥厚的疤痕，令爱美人士深恶痛绝。在组织学上，可以看到未成熟的胶原蛋白过度增生，而且无法排列整齐成熟，也就是说伤口愈合的最后步骤无法正常完成。
由于医界对蟹足肿的发生原因仍然不清楚，所以无法针对原因来做治疗。而根据过去的经验和一些揣测，现在临床上用来处理或减轻蟹足肿的方法有：1.外科手术切除; 2. 注射类固醇; 3.用绷带压; 4. 贴矽胶片; 5. 放射线照射
但是上述这些方法无论是单独或是综合使用，都无法让复发率达到70%以上。 另外有一些药剂也有些人声称有效，如 5-FU(化疗药物), retinoids(A酸), Vit. A derivatives (维生素A衍生物), 及 interferon alpha-2b(干扰素) 等等。本文即在测试干扰素是否真的对蟹足肿的再发有抑制作用。
Author Davison, Steven P. M.D., D.D.S.; Mess, Sarah M.D.; Kauffman, Lisa C. M.D.; Al-Attar, Ali M.D., Ph.D.
Institution Washington, D.C.
From the Department of Plastic Surgery and the Division of Dermatology, Georgetown University Medical Center.Title Ineffective Treatment of Keloids with Interferon Alpha-2b.
Source Plastic & Reconstructive Surgery. 117(1):247-252, January 2006.
Abstract
Background: Keloids are exuberant, disfiguring scars that result from an abnormal healing process. Current established treatment strategies include surgical resection, triamcinolone steroid injection, pressure therapy, silicone therapy, and radiotherapy. None of these therapies, either alone or in combination, offers consistent recurrence-free rates above 70 to 80 percent. The antiproliferative, antifibrotic cytokine, interferon alpha-2b, may be useful in keloid management because of its ability to interfere with collagen synthesis and fibroblast proliferation.Methods: To determine the efficacy of interferon alpha-2b in keloid management, the authors prospectively evaluated the effects of interferon alpha-2b as postexcisional adjuvant therapy for keloids. Thirty-nine keloids in 34 patients were photographed, measured, and surgically excised. The wound bed was injected twice with either interferon alpha-2b (treatment group; n = 13 keloids) or triamcinolone (control group; n = 26 keloids) at surgery and 1 week later. The patients were followed up in the plastic surgery clinic.
Results: The trial protocol was terminated at midtrial surveillance. Among the 13 keloids that were treated with postoperative intralesional interferon alpha-2b, seven recurred (54 percent recurrence rate). In contrast, in the 26 keloids that received triamcinolone (control group), only four recurred (15 percent recurrence rate). Recurrence in either group did not correlate with location of the keloid or race.
Conclusion: Interferon does not appear to be effective in the clinical management of keloids.
这个实验用了39处蟹足肿，先手术切除后，其中的13处注射干扰素alpha 2b; 另外26处注射类固醇(triamcinolone)。结果实验做到一半就被迫中止了。因为注射干扰素的13处中, 有7处复发；而注射类固醇的26处，只有4处复发。 因此，这个实验简单的说就是注射干扰素对抑制蟹足肿的复发没有帮助。
顺便一提，门诊时常有人问我擦一些什么 080 之类的去疤膏有没有用？比较中庸和谨慎的回答是：看一看这些药膏的成份，是不是含有我上面列的那些药物？若是有，那可能会有效；若是没有？至少医学界尚无法证实有效。
