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

OBJECTIVETo introduce a modification of Lejour reduction mammaplasty.

METHODSWith the upper pedical flap as the base of mammaplasty, the lower part of breast was resected while excess skin was pushed to lateral and formed "L"-shaped scar after it was resected.

RESULTSFrom October 2005 to April 2006, the modified Lejour reduction mammaplasty was applied to 10 mammahypertrophic patients with 20 breasts in sum. The result of operation was good and only "L"-shape scar was left in the lower lateral part of the breast.

CONCLUSIONSThis method is easy to perform and could avoid inverted T scar caused by routine mammaplasty technique. This method is worth introducing widely.

Adult ; Cicatrix ; prevention & control ; Female ; Humans ; Mammaplasty ; methods ; Young Adult

In the wound healing process after a deep burn injury, improper treatment in the early stage and lack of functional rehabilitation measures in the late stage usually lead to hyperplastic scar, joint contracture, synarthrophysis, and other deformities. All of them may result in cosmetic and functional impairments, loss of work ability, poor life quality, and even psychopathy of the patients. Thus, the improvement in rehabilitation methods and the maximal recovery of appearance and functions have drawn intense attention. This article mainly discusses the prevention, systematic treatment principles and methods for the hyperplastic scar and scar contracture, as well as the problems need to be solved in burn rehabilitation, based on the introduction of the new advancement in the rehabilitation techniques.
Burns ; rehabilitation ; surgery ; Cicatrix ; prevention & control ; Humans ; Wound Healing

Cutaneous wounding in adult humans and higher vertebrate animals results in scar formation. In contrast, both human and animal fetuses, at early gestational ages, exhibit skin wound healing without scarring. This distinction suggests that the repair of adult wounds by skin regeneration, rather than by fibrosis, may be achieved if adult wounds can be modified to mimic the healing process of fetal wounds. The development of gene therapy offers the possibility to specifically enhance or block the gene expression of cytokines and extracellular molecules, and thus convert adult wound healing into a healing process more similar to tissue regeneration. This article reviews the characteristics of fetal wound repair focusing on cytokine profiles and the inflammatory response to dermal injury. Also included are new developments in gene transfer techniques as well as their application in wound healing. Finally, the authors propose possible strategies of wound gene therapy, to reduce wound scarring and to promote tissue regeneration.
Animal ; Cicatrix/*prevention & control ; Fetus/physiology ; *Gene Therapy ; Human ; Wound Healing/physiology

Scarless healing is considered as the most ideal mode of wound repair. This ability generally exists in the early period of mammalian embryos, however it gradually turns to scar healing with the development of the embryos. This phenomenon is the result of the interaction of multiple biological functions, and the mechanism is still uncertain. This article deals with a systematical review of literature concerning the mechanism of scarless healing based on the recent experimental studies, hoping to provide evidence for the treatment of wounds to realize scarless healing in adult.
Adult ; Animals ; Cicatrix ; prevention & control ; Fetus ; physiology ; Humans ; Wound Healing ; physiology

OBJECTIVETo find a new method to perform medial canthoplasty and upper eyelid fold formation at one stage.

METHODSBased on the principle to release the skin tension and minimize incision scarring around the medial canthus, an operation was designed for medial canthoplasty together with upper eyelid fold formation. 136 patients with mild or moderate epicanthus underwent this procedure. Postoperative follow-up was as long as 34 months.

RESULTSBased on the follow-up of 67 cases, the appearances of the upper eyelid fold and medial canthus were evaluated. The upper eyelid fold was the parallel type. The epicanthus was corrected completely or mostly.

CONCLUSIONThis new method for medial canthoplasty together with upper eyelid fold formation is suitable to all the simple epicanthus except the reverse epicanthus. The operative results were effective and satisfactory.

Blepharoplasty ; methods ; Cicatrix ; prevention & control ; Eyelids ; surgery ; Humans ; Postoperative Period ; Skin

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

PURPOSE: Hypertrophic scarring and depression are the principal problems of burn rehabilitation. This study was done to verify the effects of skin rehabilitation massage therapy (SRMT) on pruritus, skin status, and depression for Korean burn survivors. METHODS: A pretest-posttest design using a nonequivalent control group was applied to examine the effects of SRMT for 3 months in a group of 18 burn survivors. The major dependent variables-including pruritus, objective and subjective scar status, and depression-were measured at the beginning and at the end of the therapy to examine the effects of SRMT. RESULTS: Burn survivors receiving SRMT showed reduced pruritus, improved skin status, and depression. The remaining scar also showed improvement in skin pigmentation, pliability, vascularity, and height (compared to the surrounding skin) as measured on the Vancouver Scar Scale (VSS). CONCLUSIONS: The findings demonstrate that SRMT for burn survivors may improve their scars both objectively and subjectively, and also reduce pruritus and depression.
Adult ; Burns/complications/*rehabilitation ; Cicatrix, Hypertrophic/etiology/*prevention & control ; Depressive Disorder/etiology/*prevention & control ; Female ; Humans ; Male ; *Massage ; Pruritus/etiology/*prevention & control

OBJECTIVETo determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits.

METHODSTwenty-four Japanese white rabbits underwent laminectomy (including the attached ligaments) at L(2 ) and L(5). After laminectomy at L(5), polylactic acid glue was sprayed on the dura and nerve roots and this segment was taken as the experimental group. After laminectomy at L(2), nothing was used and this segment was enrolled as the self control group. Four rabbits were killed every two weeks postoperatively till the end of the experiment at 12 weeks. Then the operated spine was observed grossly, histologically and ultrastructurally to check the degree of scar formation, the status of epidural scar adhesion, the absorption of the glue, and the intracellular structure of fibroblasts.

RESULTSThe glue coagulated immediately after spraying and showed excellent hemostatic effect. The glue membrane was easy to be taken away from the dura mater of the samples for 2 weeks and there were no cells in the epidural space in the experimental group. But the dura mater was covered by hematoma in the control group, which formed mild adhesion, with fibroblasts proliferating actively. In the 4th week, some glue shivers remained in the epidural space with fibroblasts increasing a little, and the dura mater was smooth in the experimental group. However, in the control group, the formed scar was fragile and conglutinated with the dura mater diffusely and fibroblasts were much more than those in the experimental group. In the 6th-12th weeks, there was a potential interspace between the scar and the dura mater, and the polylactic acid glue was absorbed completely in the experimental group. Much tough scar was found in the control group, which was very difficult to dissect from the dura mater and the surrounding tissues. From the ultrastructural observation of the fibroblasts, the nucleus became much bigger and the rough endoplasmic reticulum was much more plentiful in the control group than that in the experimental group.

CONCLUSIONSPolylactic acid glue can effectively reduce epidural cicatrization and adhesion.

Animals ; Biocompatible Materials ; Cicatrix ; prevention & control ; Lactic Acid ; administration & dosage ; pharmacology ; Laminectomy ; Membranes, Artificial ; Polyesters ; Polymers ; administration & dosage ; pharmacology ; Postoperative Complications ; prevention & control ; Rabbits ; Tissue Adhesions ; prevention & control