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Obesity Surgery
Published in: Obesity Surgery 12/2017

01-12-2017 | Original Contributions

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

Authors: Inês Correia-Sá, Paula Serrão, Marisa Marques, Maria A. Vieira-Coelho

Published in: Obesity Surgery | Issue 12/2017

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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.
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Metadata
Title
Hypertrophic Scars: Are Vitamins and Inflammatory Biomarkers Related with the Pathophysiology of Wound Healing?
Authors
Inês Correia-Sá
Paula Serrão
Marisa Marques
Maria A. Vieira-Coelho
Publication date
01-12-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2740-4

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