This paper reviews the new progress in the research of fractional carbon dioxide laser in treating hypertrophic scar after burn injury, which remains a challenging problem for burn care surgeons. There have been many traditional therapeutic approaches, such as compression remedy, operation, and so on. However, a satisfactory method is lacking to date. In recent years, the newly developed fractional carbon dioxide laser has been employed to treat different kinds of scars, and it has been proved to be effective in terms of an improvement of scar color, texture, and rigidity. It seems to be a promising method for scar treatment in future.
Burns ; surgery ; Cicatrix ; surgery ; Cicatrix, Hypertrophic ; surgery ; Humans ; Lasers, Gas ; Treatment Outcome

BACKGROUND: Minimizing scarring has long been a challenge in plastic surgery. Factors affecting scar formation are well known, but the effect of some patient-specific factors such as dermal thickness remains unverified. Management of factors predictive of scarring can improve postoperative patient satisfaction and scar treatment. METHODS: For 3 years, we used ultrasonography to measure dermal thickness in female patients who had undergone thyroidectomy for cancer at our hospital. We confirmed the influence of dermal thickness on hypertrophic scar formation and the Patient and Observer Scar Assessment Scale scar score 6 months after surgery. RESULTS: There was a positive correlation between dermal thickness and scar score (p < 0.05), and dermal thickness appears to be a cause of hypertrophic scar formation (p < 0.05). CONCLUSION: Thick dermis was found to cause poor scar formation and hypertrophic scarring. Prediction of factors that can influence scar formation can be used to educate patients before surgery and can help in scar management and improvement in patient satisfaction.
Cicatrix* ; Cicatrix, Hypertrophic ; Dermis ; Female* ; Humans ; Patient Satisfaction ; Skinfold Thickness ; Surgery, Plastic ; Thyroidectomy* ; Ultrasonography

Wound repair is the critical issue in burn injury management. Optimal coverage or regeneration of skin tissue is still a great challenge. In this review, we summarize the current achievements in the fields of immune tolerance induction, skin tissue regeneration, and hypertrophic scar control, which might provide new viewpoints and research direction for diagnosis and treatment of burn wounds.
Burns ; surgery ; Cicatrix, Hypertrophic ; prevention & control ; surgery ; Humans ; Regeneration ; Skin Transplantation

The management of local wounds is one of the key steps in the treatment of trauma and burns. Based on the advance in wound management in recent years, we emphasize the importance of paying much attention to study on mechanisms, prevention and treatment in local chronic wounds and hypertrophic scar. Also, the application of some high-technique methods may help enhancing the wound healing velocity and quality after injury.
Burns ; surgery ; Cicatrix, Hypertrophic ; prevention & control ; Humans ; Wound Healing ; Wounds and Injuries ; surgery

Management of incisional scar is intimately connected to stages of wound healing. The management of an elective surgery patient begins with a thorough informed consent process in which the patient is made aware of personal and clinical circumstances that cannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. Traditional incisions most often follow relaxed skin tension lines, but no such lines exist in high surface tension areas. If such incisions are unavoidable, the patient must be informed of this ahead of time. The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. Patient participation is paramount in obtaining the optimal outcome. Postoperative visits should screen for signs of scar hypertrophy and has a dual purpose of continued patient education and reinforcement of proper care. Early intervention is a key to control hyperplastic response. Hypertrophic scars that do not improve by 6 months are keloids and should be managed aggressively with intralesional steroid injections and alternate modalities.
Cicatrix/*prevention & control/surgery ; Cicatrix, Hypertrophic/prevention & control ; Humans ; Keloid/prevention & control/radiotherapy ; Sebaceous Glands/physiology ; Skin/physiopathology ; Wound Healing

PURPOSE: The skin hyperpigmentation or hypermelanosis caused by burns results in social withdrawal due to cosmetic problem and depression as a psychiatric aspect. The treatment of the skin hyperpigmentation includes sunscreen, whitening material, skin massage, laser therapy and plastic surgery. Placenta extract can be used to reduce and inactivate the synthesis of the important enzyme (tyrosinase) that compose melanin. This study was performed to estimate the effect of intradermal injection of placenta extract (placenta hydrolysate) for the postburn hyperpigmentation. METHODS: Total 10 subjects who have postburn hyperpigmentation were selected. Two sites of skin area from each subject were randomly selected as possible as symmetrical body area, the one site was to be 'treated site' with placenta extract, the other site was untreated 'control site'. The injection was performed weekly for about 4 weeks only to the 'treated site', not to the control site. The both site were measured by pigment index using Mexameter. The index was also converted to the percentage that indicate a change of after-injection to before-injection. RESULTS: The pigment index of 'treated site' was 399.5+/-63.9 before treatment, and then it had decreased to 333.6+/-59.5 after 4 weeks of injection. The change after injection compared to before injection was significant statistically (p< 0.05). In the control sites which did not have placenta injection, the pigment index had changed from 284.5+/-67.8 to 290.7+/-52.3. But it was not significant statistically (p>0.05). CONCLUSION: As a result, in the posttburn hyperpigmentation scar, the intradermal injection of placenta extract may be helpful in the management of hyperpigmentation or rehabilitation process of the hypertrophic scar.
Burns ; Cicatrix ; Cicatrix, Hypertrophic ; Cosmetics ; Depression ; Hyperpigmentation ; Injections, Intradermal ; Laser Therapy ; Massage ; Melanins ; Placenta ; Skin ; Surgery, Plastic

BACKGROUND: In esthetic surgery, understanding the factors that influence patient satisfaction is important for successful practice. We hypothesize that the factors that influence patient satisfaction include not only aesthetic and functional outcomes, but also personal factors such as the level of familiarity with factors affecting wound healing and expectations regarding aesthetic outcome. METHODS: One hundred patients who underwent esthetic closure after thyroidectomy were included in this study. In order to evaluate the individual characteristics of the patients, a preoperative survey was administered to the patients. We estimated the patient satisfaction six months postoperatively and assessed the aesthetic and functional outcomes using the Patient and Observer Scar Assessment Scale. RESULTS: According to the results of correlation analysis, level of familiarity with wound healing factors had a positive correlation with satisfaction. High expectations, pain, itching, and high observer scale score had negative correlations with satisfaction. The factors that were correlated with satisfaction were included in the multiple regression analysis. Level of familiarity with wound healing factors was found to have a positive relationship with satisfaction, while itching and observer scale were found to have a negative relationship with satisfaction. After excluding 10 patients who had hypertrophic scars, only level of familiarity with wound healing factors and expectations affected satisfaction. CONCLUSIONS: The level of familiarity with factors affecting wound healing and expectations were found to independently affect satisfaction. Improving patients' level of familiarity with wound healing factors and reducing their expectations by providing suitable preoperative education has the potential to improve patient satisfaction.
Cicatrix ; Cicatrix, Hypertrophic ; Esthetics ; Female ; Humans ; Patient Satisfaction ; Personal Satisfaction ; Pruritus ; Recognition (Psychology) ; Surgery, Plastic ; Sutures ; Thyroidectomy ; Wound Healing

There is one problematic part of the facialplasty procedure that has been addressed with relative infrequency in the plastic surgery literature. Hypertrophic scar, deformed tragus and "pixie ear" deformity, the problems associated with the design and closure of the periauricular incisions, are still recognized. Prevention of these undesirable results of facialplasty is the surgical challenge about which this article is concerned. In facelift, pretragal incision leaves long scar formation on preauricular area and retrotragal incision occasionally makes the unnatural tragus. Since the marginal tragal incision consists of several short segments, it can prevent tragal deformity caused by scar contracture and preserve shape of the tragus. Putting 2 anchoring key sutures on just above the ear and at the mastoid area minimizes the tension on the incision line and minimizes postoperative ear deformity. We experienced 42 face lifting procedures in patients with aging face during the last 6 years(from Dec 1999 to May. 2005). Complications were hematoma in four cases(9.5%) and focal wound dehiscence in two cases(4.8%). The patients with the complications completely recovered 3 months later.
Aging ; Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Contracture ; Ear ; Hematoma ; Humans ; Mastoid ; Rhytidoplasty* ; Surgery, Plastic ; Sutures ; Wounds and Injuries

OBJECTIVES: To assess submental route intubation as an alternative technique to a tracheostomy in the management of the airway in cranio-maxillofacial trauma, along with an assessment of its morbidity and complications. MATERIALS AND METHODS: Submental intubation was performed in 17 patients who had maxillofacial panfacial trauma and management was done under general anesthesia during a period of one year from 2013 to 2014 at Departments of Oral and Maxillofacial Surgery and Dentistry, the Malankara Orthodox Syrian Church Medical College, Kochi, India. RESULTS: In all 17 cases, the technique of submental intubation was found to be simple and reliable. Hypertrophic scars were noted in three cases, orocutaneous fistula and mucocele in one case each. All these complications were managed comfortably without significant morbidity to the patient. CONCLUSION: Submental intubation is a good technique that can be used regularly in the management of the airway in cranio-maxillofacial trauma, but with some manageable complications.
Airway Management* ; Anesthesia, General ; Cicatrix, Hypertrophic ; Dentistry ; Fistula ; Humans ; India ; Intubation* ; Mucocele ; Surgery, Oral ; Tracheostomy

A 59-year-old male patient with local sinus tract formation due to residual foreign body was admitted to the Second Affiliated Hospital of Zhejiang University College of Medicine on December 17, 2018. The examination showed that the residual foreign body was the component of a sticky cloth implanted when the patient underwent appendectomy 27 years ago. Hypertrophic scar developed at the right-lower abdominal incision for appendectomy 23 years ago and the secondary infection after cicatrectomy resulted in non-healing of the wound. The chronic refractory wound healed completely after surgical treatment in our hospital after this admission. The postoperative pathological examination revealed local inflammatory granuloma. This case suggests that chronic refractory wound is likely to form when secondary infection occurs following the surgical procedure near the implant, and aggressive surgery is an effective way to solve this problem.
Abdomen ; Abdominal Cavity ; Cicatrix, Hypertrophic ; Coinfection ; Foreign Bodies/surgery* ; Humans ; Male ; Middle Aged