Influence of Preoperative Pro-Inflammatory Cytokines and Nutritional Status on Skin Scar Hyperplasia

Abstract

Abstract Skin scar hyperplasia is a common complication following surgical procedures. We aimed to investigate certain sensitive indicators of hypertrophic scars formation and search potential strategies for reducing scar formation. Therefore, our objective was to collecte nutritional status, blood samples, and scar tissue samples from 123 patients undergoing internal fixation surgery between 2019 and 2022. Patients were classified into the hypertrophic scar (HS) group (n=33) and the non-hypertrophic scar (NHS) group (n=90) based on the degree of skin scar hyperplasia one year after surgery. Preoperative inflammatory factor (CRP, white blood cell, lymphocyte%, neutrophil%, monocyte%, IL-5, IL-6, IL-12p70, INF-γ) levels and nutritional status (ideal body weight (%), weight loss, lymphocyte, blood albumin, transferrin, pre-albumin) were measured by the blood test. RNA sequencing was used to test the tissue samples to explore related signaling pathways involving hypertrophic scars formation. In this study, we demonstrated the higher pro-inflammatory cytokine levels (CRP, neutrophil%, monocyte%, and IL-12p70)and worse nutritional status（ideal body weight, Lymphocyte, and Blood Albumin） occur in the HS group, with statistically significant difference (p < 0.05). In addition, Differential gene analysis found higher gene expression levels of inflammatory response, cell proliferation, and angiogenesis pathways in the HS group. Elevated preoperative inflammatory levels and poor nutritional status have significant effects on skin scar formation after surgery due to the role of pro-inflammatory cytokines in scar formation. Therefore, improving nutritional levels and controlling preoperative inflammation might be potential strategies for reducing scar formation. Trial registration number: ChiCTR2300069087 Date of registration: 2023-03-06