冷凍治療（CryoShape）

有效治療疤痕增生的方法：冷凍治療（CryoShape）

目前醫學界有多種治療瘢瘤的方法，惟未能全面徹底阻止組織增生，復發機會亦較高，容易長出更大的瘢痕。近年獲美國食品藥物管理局（FDA）確認其治療瘢瘤功效的冷凍治療（CryoShape），便能打破以往其他治療方法的限制。

透過溫度的改變破壞細胞，令壞死的細胞結痂脫落，減低復發機會。其實早在70至80年代，醫學界已採用冷凍治療，以液化氣體消除疣及痣等，直至90年代後期，醫學界更開始研究冷凍治療應用在瘢瘤上的可行性。

 

冷凍治療過程

手術約需時10至60分鐘，視乎個人情況及瘢瘤大小而定，並以局部麻醉方式進行。手術進行時，外科醫生先將長針插入瘢瘤內，小樽內的液態氮會灌入冷凍治療槍內，令長針急速變冷藉著超低溫度使細胞結晶，導致脫水，使細胞冷凍壞死，破壞瘢瘤內的深層組織。

外科醫生會在適當情況下，停止再輸入液態氮，讓瘢瘤解凍。患者在包紮傷口後，便可離開，不用留院，如常活動。一般情況下，傷口約在2至4星期內痊癒，壞死的細胞會結痂脫落。

 

冷凍治療的術後護理

術後部分患者的傷口會出現疼痛、紅斑、皮下水腫、皮下出血及色素減弱等，惟很快便會痊癒，患者只要每日清洗傷口及保持乾爽，防止傷口受感染便可。

 

冷凍治療的風險

對麻醉藥敏感, 傷口發炎等一般手術風險。




參考資料: http://keloid.com.hk/
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向外科醫生查詢，而不應單倚賴以上提供的資料 

How to prevent the growth of scars?

 

There aren’t any detection methods to prevent the growth of scars within medical community on patients regardless of gender and age. Patients who had scarring before or have a genetic background should prevent wounds arise, avoid piercing and clean acne scars with proper care. Whenever there is new wound, consider using silicone gel sheet and consult a doctor if necessary.









Reference information: http://keloid.com.hk/keloid-removal-english.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above

Other Keloid Treatments

Steroid Injection: The injection of steroids can inhibit the growth of fibroblasts, causing the keloids to shrink. Results from patients vary and the success rate is only 50%, Long-term injections, usually once a month, are needed to be effective. Some patients need continuous injection, from few months to one year, in order to be effective. However, Long-term steroid injections will cause the skin to atrophy and sink in, and injection process also leads to pain in patients.
 

Surgical Removal: Keloid treatment by surgical removal method seems to a relatively simple method, its drawback is high recurrence rate of 80 to 100%. Since new wounds will be developed, it may stimulate keloid to grow back, and may even develop into a bigger keloid.
  

According to literature reviews, regular steroid injections after surgery can prevent the formation of keloid, but the recurrence rate can reach 50 to 80%, while postoperative radiotherapy can reduce the recurrence rate to 20 to 30%. Since radiotherapy is originally applied to treat cancer, if it is used to treat keloid that is grown in the neck and chest, thyroid cancer or breast cancer may be induced, thus radiotherapy is only limited to the area of hands, feet and ears.
  

Silicone Gel Sheet: It is regarded as preventive treatment, which is applied to new wounds after two weeks, and is associated with anti-scar ointment to reduce the growth of keloid and scars.
  

Interferons or anti-cancer drug: Research on their effects are still processing. Application of interferons or anti-cancer drug on eliminating keloid cannot sustain for a long time and may also cause side effects to the body.




Reference information: http://keloid.com.hk/hypertrophic-scar-treatment.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above

Treatment for Keloid Scarring-Cryosurgery

Effective treatment for Keloid scarring

Different kinds of Keloid treatments nowadays cannot totally prevent the growth of scarring tissues, it may stimulate the keloid to grow back, and may even develop into a bigger keloid. In recent years, U.S. Food and Drug Administration (FDA) has verified the therapeutic efficacy of "Cryosurgery" on Keloids treatment, which overcomes the limitations of traditional and conventional treatment methods.

By damaging cells with the change in temperature, the destroyed cells will scab and fall off, thereby reducing recurrence rate. In fact, "Cryosurgery" has already been used in the early 1970s and 1980s to eliminate Keloids by contacting with liquid nitrogen. Medical professionals then started to investigate on the application of CryShape to treat Keloid and scarring tissues.

Process

"Cryosurgery" treatment takes around 10-60 minutes, depending on the size and location of the keloid. Local anesthesia will be performed before the treatment. During surgery, the doctor will first insert a needle into the Keloid, liquid nitrogen of very low temperatures contained will then be injected. The scar will rapidly decrease in temperature, causing the cells to crystallize, dehydrate and finally be frozen and destroyed.
The doctor will stop injecting liquid nitrogen at suitable time in order to let keloid thaw. After surgery and wound dressing, patients can return to daily activities without the need of hospitalization. Under normal circumstances, the wound can be recovered in 2 to 4 weeks and the destroyed cells will scab and fall off.

Postoperative care

After surgery, patients may experience different levels of pain, red spots, subcutaneous edema, subcutaneous hemorrhage and pigmentation, as well as other conditions. Most of these conditions will completely disappear. Therefore, patients must clean their wounds and keep them dry in order to prevent infections.

Risk

General surgical risks include sensitive to anesthetics, wound infection etc.






Reference information: http://keloid.com.hk/cryoshape-english.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above

屬良性腫瘤 或影響吞咽 無創消融甲狀腺結節

甲狀腺結節在香港十分常見，大部分屬於良性腫瘤。由於甲狀腺位於頸部氣管兩旁，腫瘤可能會壓著食道或氣管，影響患者發聲、吞咽或呼吸，嚴重可致窒息。傳統 治療良性結節的手術都會於手術處留有疤痕，需留院數天；但今年引入的無創射頻消融術，不但傷口幾乎看不見，住院時間亦較短、手術費較便宜。

甲狀腺是位於頸部甲狀軟骨下方，氣管兩旁的內分泌器官。而甲狀腺結節是該部分組織細胞突然產生腫瘤或癌細胞等小腫塊，發病率非常高。外科專科醫生陳東飛指，本港有約五成成年人有甲狀腺結節良性腫瘤，女性患者較多，每三個女患者才有一個男患者。

陳東飛指，若腫瘤太小，一般人不會察覺患有腫瘤；但若感到有硬塊壓迫著食道或氣管，或外觀上有突起物，便應求診及照超聲波檢查，然後需抽取組織化 驗，判斷腫瘤屬良性或惡性。他說，有約三分二甲狀腺結節患者屬良性腫瘤，惡性腫瘤只屬少數；更強調只要化驗後肯定腫瘤是良性，便可進行甲狀腺結節手術。

現時，治療良性結節的手術有傳統切除及內窺鏡切除手術。傳統切除術需全身麻醉，不但會留有疤痕，亦因要切除部分甲狀腺，有機會使聲線轉變或造成吞咽問題；而內窺鏡切除術雖於腋下及兩邊乳暈進行微創手術，但仍會留有1至3厘米的傷口。

陳東飛表示，今年4月首次於本港應用無創甲狀腺腫瘤消融技術，利用微針震動的摩擦力產生高溫，使腫瘤細胞壞死收縮，使腫瘤體積於六個月內縮少85%，並不用切除任何的甲狀腺組織。消融技術的手術費約4.5萬元，比傳統手術便宜約四成半，術後只有約1毫米疤痕，毋須住院。

不過，他指手術存有風險，「施行手術的醫生必須非常熟悉組織結構，否則會因微針太熱而傷到附近組織，出現內出血或使喉返神經受傷。」

兩年前，李小姐(圓圖)發現頸部左邊近氣管位置有硬物突起，拖了年半，發覺硬物變大約直徑1厘米，才到醫生檢查，確診有甲狀腺結節良性腫瘤。但因 曾進行換腎手術，免疫力低而不適合進行有感染風險的傳統切除手術。最終選擇無創消融術，腫瘤體積由原本的約9mL降指現時的約1mL。醫生建議，術後患者 仍需複診至少半年，以便檢查腫瘤的變化。






參考資料:  www.genesis-surgery.com/
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的外科醫生查詢，而不應單倚賴以上提供的資料。