Epidermolysis Bullosa Patients' Perception of Surgical Wound and Scar Healing

Dermatol Surg. 2019 Feb;45(2):280-289. doi: 10.1097/DSS.0000000000001673.

Abstract

Background: There is limited evidence to suggest patients with epidermolysis bullosa (EB) have more postoperative wound complications than the general population. Despite this, the authors have noted reluctance among some surgeons to operate on these patients.

Objective: A cross-sectional study was designed to investigate postoperative wound and scar healing outcomes in patients with EB.

Methods: Patients were asked to complete the "Surgical Wound and Scar Healing in EB" questionnaire, and data gathered were analyzed.

Results: Forty-six patients completed the questionnaire for a total of 94 different surgical procedures. Five patients reported blistering at the surgical wound site. All 5 had generalized forms of EB. Four patients reported wound infections, and 1 patient reported wound dehiscence. The postoperative scar healed with keloid or hypertrophic scarring after 26% of the reported surgical procedures.

Conclusion: Blistering at the postoperative site seems to be uncommon and particularly unlikely to occur in localized forms of EB. Postoperative wound infections and dehiscence are uncommon. Patients with EB may have a propensity to develop keloid or hypertrophic scarring. With these data, the authors hope clinicians have greater confidence in referring patients with EB for surgery, and surgeons more reassured about postoperative wound healing.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blister / physiopathology*
  • Blister / psychology
  • Child
  • Cicatrix, Hypertrophic / physiopathology*
  • Cicatrix, Hypertrophic / psychology
  • Cross-Sectional Studies
  • Epidermolysis Bullosa / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / physiopathology*
  • Postoperative Complications / psychology
  • Surgical Wound / physiopathology*
  • Surgical Wound / psychology
  • Surveys and Questionnaires
  • Wound Healing / physiology*