4 " ^ 4 " .ilNGHIEN CUtJ KHOA HOC
DI^U TR! seo LOM DO TRUNG CA BANG BOI ACID TRICHLORACETIC
vA SAN PHAM TU CONG NGH^ T^ BAO G6C JUVIAN
TrSn Thj Thai Ha*, Nguyin Thj Hai Van**
TOM TAT
TrUng cd Id mpt binh da hay gap nhiiu d tuoi thanh, thiiu niin. Binh thudng dilqi hdu qud Id nhUng vit thdm hodc dd, seo phi dai, seo loi, seo Idm... Seo thudng gap d 95% binh nhdn bi trUng ed trong dd seo Idm ehiem khodng 3%.
TU 8/2008- 8/2009, tql Binh viin Da liiu Trung Uang, 60 binh nhdn bi seo Idm dan thudn sau trUng ed dupe chia ngau nhien thdnh hai nhdm nghiin cdu: Nhdm 1:30 binh nhdn dupe diiu tri bdng chdm acid trichloracetic 100% phoi hap vdi bdi sdn pham tU edng nghi tibdo goc Juvian; Nhdm 2:30 binh nhdn dupe chdm acid trichloracetic 100% dan thudn.
Sau 12 tudn diiu tri, so luat binh nhdn ed seo trd vi mdu da blnh thudng dphdc do 1 cao gdp 17,5 Idn so vdi phac do 2. So lupt binh nhdn ed seo ddy lin bdng mat da dphdc do 1 cao gdp 1,7 Idn so vdi phdc do 2 nhung sukhdc biit khdng ed y nghia thong ki (p > 0,05). So lUpt binh nhdn cd seo dat loai tot dphdc do 1 eao gdp 7 Idn so vdi phdc do 2 mdt cdch ed y nghia vdi p < 0,05. Diiu ndy ehdng td, sd dung acid trichloracetic 100% phoi hop vdi bdi sdn pham tUeong nghe tibdo goc Juvian dat hieu qud cao han viec sUdung acid dan thudn trong diiu tri seo Idm do trUng ed.
Tfl khod: seo Idm, TCA, te bao gdc
I.OATVAND^
Trflng ed la mdt benh da hay gap nhieu d tudi thanh, thieu nien gay viem nhiim d trong va xung quanh nang Idng. Sau qua trinh viem, benh thudng de lai hau qud la nhflng vet tham, seo Idi, seo Idm, seo phi dai... Seo thudng gap 6 95% benh nhan bj trflng cd trong dd seo Idm chiem khodng 3% [1, 5] gay dnh hudng den tham my, lam benh nhan mat tutin, dnh hudng den chat lupng eude sdng.
*Binh viin Da khoa Thdi Blnh
**Binh viin Da liiu Trung uang
Nhieu phuong phap da dupe flng dung trong dieu trj seo Idm do trflng cd nhU cat bd seo, bao da bang laser, kich thfeh day seo bang sdng RF ... nhUng hieu qud dieu trj eung v i n ehUa dupe nhu mong mudn. Benh vien Da lilu Trung UOng da tien hanh mdt sd phuong phdp dieu trj seo Idm nhu cham acid triehloraeetie don thuan tai tdn thuong, bao bd seo Idm bang may bao da hodc laser... nhUng hieu qud cua nhflng phuong phdp nay van ehUa dupe tdng hpp, ddnh gid.
Juvian - mdt sdn pham tfl edng nghe te bao gdc gan day da dupe dp dung de tai tao da, kich thfeh lien seo. Sdn pham nay ehUa dupe nghien
S6 04 (Thang 06/2011) D A L l E U H Q C l 3 9
NGHIEN CUU KHOA HOC
eflu mdt cdch he thdng trong viec dieu trj seo Idm do trflng cd.
Nham nang eao hieu qud dieu trj seo Idm do trflng ed gay ra, gdp phan dap flng nhu cau tha'm my eua ngUdi benh, ehung tdi da tien hanh nghien eflu de tai nay nham muc tieu:
Ddnh gid hiiu qud diiu tri seo Idm trdng ed bdng acid trichloracetic 100% phoi hap sdn pham tUedng nghi tibdo goc Juvian.
2. DOI TUONG VA PHUONG P H A P N G H I £ N C U U
2.1. Ddi tUOng nghien eflu
- Nghien eflu ti le seo Idm do trflng cd trong sd cdc benh da: ehung tdi sfl dung sd lieu thdng ke tai khoa Khdm benh Benh vien Da l i l u Trung UOng tfl thdng 8/2008 - 8/2009.
- Ddnh gia hieu qud dieu trj seo Idm do trflng ed bang acid triehloraeetie 100% phdi hpp sdn pha'm tfl edng nghe te bao gdc Juvian: ddi tupng la 60 benh nhan bj seo Idm do trflng ed dupe chia thanh hai nhdm:
-I- Nhdm nghien cflu: dieu trj bang acid triehloraeetie 100% phdi hpp sdn pham tfl edng nghe te bao gdc Juvian.
+ Nhdm ddi chflng: dieu trj bang acid trichloracetic 100% don thuan.
2.7.7. Tiiu ehuan ehdn doan
Nhflng benh nhan bj seo Idm do trflng cd cd mau sac seo nhU da blnh thudng,. khdng ed tdn thuong cua benh trflng ed kem theo.
2.7.2. Tiiu ehuan IWa chpn
Benh nhan nam, nfl, khdng phan biet dp tudi, t u nguyen tham gia nghien eflu, khdng mac ede benh toan than dnh hUdng den qua trinh lien seo nhu dai thdo dudng, ede benh ve mdu, ung thu ... den khdm va dieu trj day du, theo dung Ijch hen; khdng nhiim HIV.
2.1.3. Tiiu ehuan logi trW
Nhflng benh nhan bj loai ra khdi nghien eflu neu tfl chdi tham gia nghien cflu; Khdng den kham theo Ijch hen va khdng dieu trj day du;
Mae eae benh toan than nhu dai thao dudng, cdc benh ve mdu, ung t h u . . . hoac nhiim HIV.
2.2. Phuong phap nghien eflu: thfl nghiem lam sang cd ddi chflng.
2.2.7. Cdch thWe tien hanh
- Cdn bd nghien eflu tham khdm va lam benh dn theo m i u eho tat ed nhflng benh nhan bj seo Idm do trflng ed cd day du tieu chuan tham gia nghien eflu.
- Cdch phan nhdm dieu trj: benh nhan den tham gia nghien cflu dMc chpn ngau nhien vao hai nhdm nhUsau:
-I- Nhdm 1: gdm 30 benh nhan den khdm va dieu trj vao ngay I I , dUpc dieu trj bang acid trichloracetic 100% phdi hpp sdn pha'm tfl cdng nghe te bao gdc Juvian.
+ Nhdm 2: gdm 30 benh nhan den khdm va dieu trj vao ngay chan, dUpc dieu trj bang acid trichloracetic 100% don thuan.
2.2.2. Cdch thWe dieu trf
* Nhdm 1
Sdt trung tdn thUOng, dijng dau tam vdt nhpn da tiet trung nhung vao acid trichloracetic
100%, sau dd cham vao gifla ddy seo, an nhe tam de dat dp sau khodng 1 mm, de khd t u nhien.
- Bdi Juvian ngay mdt lan vao budi tdi trong vdng 24 gid sau khi cham acid. Bdi lien tuc trong vdng mdt thang va den khdm lai.
- Cham nhae lai TCA tren moi thdng mdt lan, neu seo ehUa day, cham tiep acid va bdi Juvian lien tue eho tdi 3 thdng.
4 0 I D A LlEU H O C S6 04 (Thang 06/2011)
* Nhdm 2
Cham TCA 100% va theo ddi nhU nhdm 1 nhung khdng bdi Juvian phdi hpp.
2.2.3. Cae ehi so danh gia
Tieu chuan khdi benh: seo phang vdi mat da xung quanh va cd mau sac blnh thudng hodc gan nhu da blnh thudng.
- Ddnh gid ket qud dieu trj theo 3 mflc dp:
+ Tdt: seo phang vdi mat da xung quanh, mau sac blnh thudng hoac gan nhU da blnh thudng.
+ Khd: seo day gan bang mat da xung quanh, mau sac binh thudng hoac dd hdng hode tham hon mau da xung quanh.
-I- Kem: seo khdng day hon len so vdi mat
4 - 4 ~ 4 * ^ NGHliN OdU KHOA HOC
da xung quanh, mau sac blnh thudng hoac dd hdng hode tham hon mau da xung quanh.
- Ddnh gid tdc dung phu eua thude: dau, rdt bdng, ngfla, loet, ban dd; nhiim trung: sUng dd, ehdy djch mu, loet...
2.3. Dja diem va thcri gian nghien eflu - Dja diem: khoa Khdm benh- Benh vien Da lilu Trung UOng.
-Thdi gian: tfl thdng 1/2009-8/2009.
2.4. Phuong phap x f l li sd lieu
Cdc sd lieu thu thap duac xfl If bang phan mem SPSS 16.0, sfl dung ede thuat todn thdng ke y hpe.
3. K£T QUA VA BAN LUAN
3.1. Ti le benh nhan bj seo Idm do trflng ea
BAng I.Tili binh nhan biseo 16m do trWng ed
Sdbenh nhan Ti le (%)
So benh nhanbi seo Idm 457
0,3
So benh nhan bi trflng ea den kham 158.500
100
Tfl thdng 8/2008 - 8/2009, sd benh nhan seo Idm den khdm va dieu trj tai benh vien la 457 benh nhan ehiem 0,3% trong tdng sd benh nhan bj benh da. Tuy nhien, sd lieu nay ehUa phdn dnh chfnh xdc ti le seo Idm do trflng ed gay nen vl bao gdm ed benh nhan bj seo Idm do thuy dau. Mdt phan Idn sd benh nhan khde bj benh trflng ed ed kem theo seo Idm nhUng chi dUpc chan dodn la trflng ed nen da bd sdt nhflng ddi tupng BN nay.
Poli va CS cho thay: ed tdi 49% benh nhan trflng ed bj seo Idm [13], cdn Layton A.M va CS thdng bdo cd tdi 95% ede tdn thuong do mun trflng ed gay ra deu ed the de lai hau qud Id nhflng vet seo [9].
3.2. So sanh ket quk dieu trj gifla 2 phae do sau 12 tuan
BAng 2. Mau sdc eua ede loai seo givfa 2 phae do
~~~~~~^ Phae do
Mau sac —-____
Mau da blnh thudng Dd
Tham Tdng
Phae d d i So luat
70 5 0 75
% 93,3
6,7 0 100,0
Phae do 2 So luat
4 47
9 60
% 5,3 62,7 12,0 100,0
P
<0,01
<0,01
So 04 (Thang 06/2011) DA L I § U H O C I 4 - |
NGHIEN CUU KHOA HOC ^ ^ ^ ^
Sau 12 tuan dieu trj, sd lUpt benh nhan ed mau sac seo trd ve mau da blnh thudng d phdc dd 1 eao gap 17,5 lan so vdi phae dd 2. SU khde biet ed y nghTa thdng ke vdi p < 0,01. Sd lupt benh nhan ed seo edn mau dd sau dieu trj phae 36 2 cao gap 9,4 lan so vdi phdc dd 1. SU khde biet ed y nghTa thdng ke vdi p < 0,01
Nhin ehung, benh trflng ed sau khi dieu trj gidm het viem thudng de lai seo tham mdt thdi gian dai [6] va phdi dieu trj bang mdt sd loai
thude nhu hydrroquinone hoac azelaie acit [7]
... Nhieu trudng hpp khac bj dd tai tdn thuong nhieu thang sau dieu trj. Trong nghien cflu nay, chung tdi ehi dieu trj nhflng ngUdi ed seo da trd ve mau da blnh thudng. Sau cham TCA seo lai bj dd trd lai va nhflng ngudi d\jgc bdi them Juvian d phdc dd 1 da ed tien trien tdt ve mau sac, nhanh hon phdc dd 2 do da dugc eung cap them dudng chat nen vet thUOng dUpc tdi tao nhanh hon.
Bang 3. Tien trien eua ede loai seo giWa 2 phae do
~~~~~~~ ~ - - ^ _ _ ^ Phae d o
Tien trien —-—____^
Seo bang phang mat da Seo day len so vdi trUde Khdng thay ddi
Tdng
Phac do 1 So luat
27 47 1 75
% 36,0 62,7 1,3 100,0
Phae do 2 So luat
16 42 2 60
% 21,3 56,0 2,7 100,0
P
>0,05
>0,05
>0,05
Mae du sd benh nhan ed seo day len bang mat da d phdc do 1 eao gap 1,7 lan so vdi phdc dd 2 nhUng sU khde biet gifla hai phdc 66 chUa du mflc ed y nghTa thdng ke. Ngoai ra, sd benh nhan ed seo day len so vdi trUde d cd 2 phdc dd la tuong dUOng nhau.
Nhflng benh nhan den vdi chung tdi thudng cd sU phdi hpp nhieu loai seo khde nhau nhU seo hlnh phiu, Idng ehao va ddy phang. Lfla tudi eua ede loai seo nay khdng ddng deu, nhieu seo bj XO hod tfl lau can phd bd nhflng spi xo d ddy seo thi mdi kfch thfeh lam day seo nhanh. Tuy nhien, trong nghien eflu nay, ehung tdi khdng phd bd spi XO day seo de danh gia chfnh xdc, khdeh quan tdc dung don thuan eua TCA trong viec tao ra tdn thuong mdi, kfch thfch lam day seo va tdc dung ho trp lanh vet thuong lam day seo eua Juvian.
Khi cham TCA, phdn flng tU nhien eua eo the se lam lien vet thUong cap tfnh tren da [12]. Vai
phut sau khi da bj tdn thuong, ede tieu cau se tao nut fibrin ehdng chdy mdu. Tiep den la giai doan han gan vet thuong vdi sU tang sinh eua ede td chflc hat, spi collagen, tang sinh bieu md, thu nhd vet thuong [11]. Cdc mach mdu tan sinh dugc hlnh thanh tfl cdc te bao ndi mach [2]. Khi td chflc hat dUpc hlnh thanh, ede nguyen bao spi tang sinh va phdt trien, tao ra mdt mang ludi gian bao vdi sU tham gia cua collagen va fibroneetin [11]. Qud trinh tai tao bieu md eua thupng bl dUgc hlnh thanh do tang sinh rat nhanh ede te bao thupng bl va ehung phdt trien tfl ddy len lam day dan vet thUOng [4]. Ben canh dd, vet thuong cdn nhd lai nhd cdc nguyen bao CO lam co keo hai bd gan lai nhau va thu nhd nhu te bao eo tron [11]. Neu vet thUOng man tfnh, XO hod thi se lam dnh hUdng den qua trinh han gan vet thuong [3].
Ket qud nghien eflu eho thay, tien trien eua cae loai seo ed khde nhau do tfnh chat, dac diem eua
4 2 I DA LIEU HOC S6 04 (Thang 06/2011)
^ ^ ^ ^ N G H I I N cufU KHOA HOC
tflng loai seo. Juvian da nhanh ehdng bd sung cac thanh phan dudng chat cho vet thuong, dac biet collagen type 1 trong Juvian hd trp tdt cho qua trinh lien cdc vet seo trong thdi gian dau. Hon the nfla Juvian edn "ddnh thflc" cdc te bao gdc d da nam tai Idp te bao day, tuyen bd nhdn va phinh nang Idng lam gia tang qud trinh biet hod ede te bao bleu md, sdn sinh collagen, fibroneetin va cdc yeu td ngoai bao khde, gdp phan thuc day qud
BAng 4. KetquA
trinh tdi tao td ehfle vung seo Idm, lam day seo nhanh do edi thien chat lUpng lien seo, han che seo tham hoac dd sau dieu trj. Hien tai, ehUa ed nghien cflu nao ve sU phdi hpp gifla 2 loai thudc nay trong dieu trj seo Idm do trflng ca nen ehung tdi ehUa so sdnh dupe ket qud vdi ede tde gia khde Tuy nhien, vdi sd lupng benh nhan ft, thdi gian theo ddi ngan nen sU khde biet ve tien trien eua ede loai seo gifla hai phdc dd ehUa ed y nghTa thdng ke.
dfeu trj d 2 phdc do
^^^-—-.Phae dd
KetquS ^^^~~~---,__^^
Tdt Khd Kem Tdng
Phae do 1 SdlUpt
27 47 1 75
% 36 62,7
1,3 100,0
Phac do 2 So luat
4 54
2 60
% 6,7 90 3,3 100,0
P
<0,05
>0,05
>0,05
Sd lupt benh nhan ed seo dat loai tdt d phdc do 1 cao gap 7 lan so vdi phdc dd 2. SU khde biet gifla hai phdc do ed y nghTa thdng ke vdi p < 0,05.
Sd lupt benh nhan ed seo dat loai khd d hai phae do dat ti le tfl 62,7%-90%, van ed 1 benh nhan d phdc do 1 va 2 benh nhan d phae do 2 ed seo khdng thay ddi so vdi trude dieu trj. SU khde biet gifla hai phdc dd khdng cd y nghTa thdng ke vdi p > 0,05.
Mpt sd nghien cflu nUde ngoai sfl dung TCA dieu trj seo Idm eho thay Jung Bock Lee M.D va CS (2002) dieu trj 2 nhdm benh nhan. Nhdm 1: 33 benh nhan dupe cham TCA 65% trong 5-6 lan, ket qud la 27/33 benh nhan (82) ed seo dupe edi thien. Nhdm 2: 33 benh nhdn dieu tri TCA 100%, ed 32/33 benh nhan (93,7%) dat ket qud tdt [8].
Theo Makram M. Al- Waiz va CS (2002), theo
ddi dieu trj eho 15 benh nhan bj seo Idm gdm 14 nfl va 1 nam bang TCA 35%. Ket qudsau2-3lan dieu trj ed 13 benh nhan dat ket qud tdt (ehiem 86,7%), 1 benh nhan dat loai khd (6,7) va 1 benh nhan edi thien ft (6,7%) [10].
Chung tdi khdng rd tieu ehuan ddnh gid eua ede nghien eflu tren nhuthe nao nen khdng so sdnh dupe. Hien tai, ehung tdi ehUa tham khdo dugc tai lieu nao nghien eflu ve sU phdi hpp gifla TCA vd Juvian trong dieu trj seo Idm.
BAng S. Cae tac dung khong mong muon
^"^--.^^ Phae do Trieu chUn^-^^
Dau rat Ngfla Ban dd Nhiim trung Khde
Phac d d i n=30
25 18 0 0 0
Phae do 2 n=30 29 22 0 0 0
P
>0,05
>0,05
So 04 (Thang 06/2011) DA L I § U HOC I 4 3
NGHIEN CUU KHOA HOC
Nhieu benh nhan d cd hai phdc dd deu bj dau rdt ngay sau khi cham TCA va bj ngfla nhe sau 2-3 ngay. Dau rdt la do phdn flng kfch flng tai eho khi da tiep xuc vdi acid dam dae va do ehung tdi edn an nhe dau tam vao ddy seo khi cham TCA. Tuy nhien, cdm gidc dau rdt se mat nhanh trong khodng 15 30 phut. Cdm gidc ngfla nhe sau 2-3 ngay thudng gap trong qud trinh lien vet thuong, chi thodng qua, khdng gay khd chju eho benh nhan.
BAng 6. MWe dp hai long eua binh nhdn sau 12 tudn dieu tri theo 2 phae do
^ \ P h a e d d Ket qua ^ ^ ^ Hai Idng
Khdng hai Idng
P
Phae do 1 (n=30) n
29 1
% 96,7
3,3
Phae do 2 (n=30) n
22 8
% 73,3 26,7 p < 0,05
Sd benh nhan hai Idng vdi ket qud dieu trj d phae dd 1 eao gap 1,3 lan so vdi phdc dd 2. Trong khi dd, sd benh nhan khdng hai Idng d phdc 66 2 eao gap 8 lan so vdi phdc do 1. d cd hai phdc do ed 9 benh nhan (15%) khdng hai Idng, dieu nay la ddng lUe giup ehung tdi ed gang tim tdi tim gidi phdp hflu hieu hOn de dieu trj seo do trflng cd.
e j ^ ^ D Hal long
I Eliong bai long
Bieu do 1. MWe dp hai long eua binh nhan cA hai nhom sau 12 tudn dieu trj
4. K^T L U A N
- Ve mau sac: 93,3% sd benh nhan ed seo d phae dd 1 trd ve mau da blnh thudng, eao gap 17,5 lan so vdi phac dd 2. SU khde biet ed y nghTa thdng ke vdi p < 0,01.
- Ve tien trien: phae 66 1 so vdi phdc 66 2 eho thay, sd benh nhan ed seo day len bang vdi mat da va seo day len so vdi trUde lan lUpt la 36% vs 21,3% va 62,7% vs 56%. Tuy nhien, sU khac biet khdng cd y nghTa thdng ke.
- Ve ket qud dieu trj ehung: sd lUpt benh nhan ed seo dat loai tdt d phdc do 1 eao gap 7 lan so vdi phdc dd 2. SU khde biet cd y nghTa thdng ke vdi p < 0,05.
- Sd benh nhan khdng hai Idng vdi ket qud dieu trj d phdc do 2 cao gap 8 lan so vdi phdc d d i .
TAILI£UTHAMKHAO
1. Pham Van Son (2004), "Diiu trj seo mun trdng cd", cap nhat Da lilu, tap 3 sd 3, tr. 16-19.
2. Chang H.Y, Sneddon J.B, Alizadeh A.A.
(2004), "Gene Expression Signature of Fibroblats Serum Response Predicts Human Cancer Progression: Similarities between Tumors and Wounds", Public Library of Science 2.
3. Enoch, S. Price, P. (2004), "Cellulat, molecular and biochemical differences in the
pathophysiology of healing between acute wounds, chronic wounds and wounds in the eWer/y", Worldwidewidewounds.eom.
4. Gaig, H.G. (2000), "Searless Wound Healing", New York Marcel Dekker, Inc. Electronic book
S.Goodman GJ, Baron JA. (2007),
"The management of post- acne scarring"
Dermatologie Sugerey, 33(10), pp 1175 -1188.
e.Googman GJ. (2000), "Management of
4 4 I DA LIEU H O C S6 04 (Thang 06 / 2011)
^ 4 -
NGHIEN CUlU KHOA HOCpost acne scarring: What are the options for treatment ?" A m J Clin Dermatol 1:3-17.
7. Haider RM, Richards GM. (2004),
"Topical agents used in the management of hyperpigmentation". Skin Therapy Letter, 9(6): 1-3.
8. Jung Boek Lee M D , Woo Gil Chung MD. (2002), "Focal treatment of acne sear with Trichloracetic acid: Chemical reconstruction of skin scar method", Dermatologie Sugerey, 28(11),pp: 1017-1021.
9. Layton A M , Henderson CA, Cunliffe WJ.
(1994), "A elinieal evaluation of acne scarring and its incidence", Clin Exp Dermatol, 19(4), pp: 303-308.
10. Makram M. Al- Waiz, MBChB. (2002),
"Medium - Depth Chemical Peels in the Treatment of Acne Scar in Dark - Skinned Individuals", Dermatol
Sugery, 28,383-387.
1 1 . Midwood K.S, Williams L.V, and Sehwarzbauer J.E. (2004), "Tissue repair and the dynamics of the extracellular matrix". The International Journal of Biochemistry & Cell Biology 36(6): 1031-W37.
12. Nguyen DT, Orgill DP, Murphy GF. (2009), "The pathophysiologic basiss for w o u n d healing and cutaneous regeneration.
Biomaterials For Treating Skin Loss", CRC Press (US) & Woodhead Publishing (UK), Boca Raton/
Cambridge, p. 25-57.
13. Poli F, Dreno B, Verehoore M. (2001),
"An epidemiological study of acne in female adults: Results of a survey conducted in France, J Eur Acad Dermatol Venereol 15:541-5.
SUMMARY
THE USE OF 100% TRICHLORACETIC ACID AND JUVIAN STEM CELL SOLUTION IN TREATMENT OF DEEP ACNE SCARS
Acne is a skin disease commonly found in youth and adolescents. The disease could result in several consequences such as hyperpigmentation/redness, hypertrophic scars, keloids and deep scars... Acne scarring is the most common, occurring in 95% acne patients, of which deep scars accounts for 3%.
Between August 2008 and August 2009, patients seeking treatment for deep aene sear made up to 0.3% of total patients in National Hospital of Dermatology and Venereology of Vietnam. 60 patients with uncomplicated deep aene sears were randomly assigned to receive either combination treatment of 100%
trichloroacetic acid (TCA) and Juvian stem cell solution (group 1, n=30), or treatment with 100% TCA alone (group 2, n=30).
After 12-month of treatment, the number of patients having redness/hyperpigmentation returned back to normal in group 1 was 17.5 times higher than that in group 2(p<0.01). Reduction in scar depth was also observed 1.7 times more in group 1 patients in eomparision of group 2. Moreover, the number of patients achieving good sear appearance and quality is 7 times higher in group 1, compared to group 2 (p
< 0.05). In conclusion, the use of 100% TCA and Juvian stem cell solution gives better therapeutic results than 100% TCA alone in treatment of deep aene sears.
So 04 (Thang 06 / 2011) D A L l i U H O C I 4 5