Epidermolysis Bullosa Patients' Perception of Surgical Wound and Scar Healing

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. Address correspondence and reprint requests to: Dedee F. Murrell, MA, BMBCh, FAAD, MD, FACD, FRCP(Edin), Department of Dermatology, Ground floor James Laws House, St. George Hospital, Gray Street, Sydney, NSW 2217, Australia, or e-mail: d.murrell@unsw.edu.au The Australasian Blistering Diseases Foundation funded the ethics application for this study. The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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