Many clinicians expect complete healing after the removal of temporary anchorage devices, but clinical examination may reveal scar-like tissue. This report presents the typical features of scarring detected after the removal of miniscrews, and the clinical outcome of scar revision along with its pathologic features.
Cicatrix* ; Wound Healing

OBJECTIVES: To compare the efficacy, safety and cost of locally-produced microcellulose dressing from Acetobacter xylinum in promoting healing of superficial partial thickness burn wounds to standard dressing using silver sulfadiazine (SSD) cream and gauze in terms of the following: time to healing, morbidity/infection rate, pain score, scarring and cost of dressing

METHODS: Comparative controlled trial. Each patient served as his own control, that is, one area was randomized to the treatment group dressed with microcellulose dressing, while another was assigned to the control group dressing with SSD. Both areas were inspected regularly for signs of infection, as well as reepithelialization. The patients were also asked for the pain score at rest, and during dressing using the visual analog scale. Once healed, the Vancouver scale was used to grade the resultant scars.

RESULTS: Ten patients were included from February to June 2008. All patients were males, with a mean age of 30.1 years (17-48 years, ± 12.05), and a mean total body surface involvement of 12.75% (4-22% TBSA,?± 7.0) superficial partial thickness burns. The time in days to complete reepithelialization was significantly lower in MCD dressings (p-value=0.05760). The mean times (in days) to complete reepithelialization for MCD and SSD were 11.4 (90 percent CI: 9.80-13.0) and 13.8 (90 percent CI: 12.33-15.27) days, respectively. Statistical analysis of differences of VAS scores during dressing changes were significantly lower in MCD dressing on days 2,6,9 and 12 post burn. Background VAS scores were also lower in those patients with MCD dressing on days 6, 9 and 12 post burn. None of the wounds in either treatment arm had signs of infection. Scarring of wounds dressed with MCD were better, based on the Vancouver scar score than those dressed with SSD (p = 0.0299). The means for the Vancouver score for MCD and SSD were 2.65 (90 percent CI: 2.25-3.05) and 4.05 (90 percent CI: 3.32-4.78), respectively.

CONCLUSION: Microcellulose dressing is significantly more effective than silver sulfadiazine in treatment of second degree burn wounds in terms of number of days to full reepithelialization and quality of scarring. Dressing with MCD was less painful on days 2, 6, 9 and 12 post burn. Background VAS scores were also lower on days 6, 9 and 12 post burn. None ofthe wounds in both treatment arms had signs of infection throughout the treatment period. Human ; Male ; Silver Sulfadiazine ; Cicatrix ; Gluconacetobacter Xylinus ; Burns ; Re-epithelialization ; Bandages ; Wound Healing ; Pain

Recently, more and more clinical and basic studies have shown that early intervention of scars after wound healing can shorten the immature period of scars, improve the final outcome of scars, effectively prevent and control the occurrence and development of pathological scars. However, there are many methods for early management of scars with varying quality, and there is a lack of expert consensus on early scar management. Based on the existing clinical evidence of each intervention method and clinical experience of experts, more than 40 domestic experts from Standing Committee of Chinese Association of Plastics and Aesthetics Scar Medicine Branch have reached a consensus on definition, therapeutic principles, therapeutic methods, and other aspects of early scars after multiple discussions and revisions, providing reference for clinical treatment.
Cicatrix/therapy* ; Consensus ; Humans ; Wound Healing

No abstract available.
Wound Healing

In recent years, there is a growing enthusiasm in honey which has potential health benefits, disease prevention and serves as substitution of modern medicine. Honey is a natural sweet product which is produced by honey bees from floral nectar and has been traditionally used to treat several diseases such as cardiovascular disease, diabetes mellitus, cancer and Alzheimer’s disease since ancient times. Gelam honey (GH) is one of the Malaysian wild monofloral honey which is widely used as traditional medicine by the local population. GH is enriched with several therapeutic properties namely, antioxidative, antiinflammatory, anticancer and accelerated wound healing activities. However, there is lack of literature focusing on the overall effects of GH and its medicinal value. This review paper summarises the phytochemistry characteristics of GH along with its therapeutic values which lead to a broad spectrum idea on several diseases. A concise clarification on the therapeutic properties of GH is expected to provide new knowledge to thescientific society in these modern globalization eras.
Wound Healing

Objective: To evaluate the association of glycated haemoglobin (HbA1c) reduction and wound healing in patients with diabetic foot ulcer (DFU). Methodology: A 12-week prospective, non-controlled, interventional study in suboptimal-controlled T2DM patients with DFU was conducted. Antidiabetic medications were adjusted with the aim of at least 1% in relation to patient’s individualised HbA1c target. The wound area was determined by using specific wound tracing. The daily wound area healing rate in cm2 per day was calculated as the difference between wound area at first visit and the subsequent visit divided by the number of days between the two visits. Results: 19 patients were included in the study. There was a significant HbA1c reduction from 10.33 %+1.83% to 6.89%+1.4% (p<0.001) with no severe hypoglycaemia. The median daily wound area healing rate was 0.234 (0.025,0.453) cm2/day. There was a strong positive correlation between these two variables (r=0.752,p=0.01). After dividing the patients into four quartiles based on final HbA1c and comparing the first quartile vs fourth quartile, there was a significant difference in daily wound area healing rates (0.597 vs 0.044 cm2/day,p=0.012). Conclusion There was a positive correlation between HbA1c reduction and wound healing rate in patients with DFU. Although this is an association study, the study postulated the benefits of achieving lower HbA1c on wound healing rate in DFU which require evidence from future randomised controlled studies.
Wound Healing

BACKGROUND: The degree of scar formation varies according to the sites. Oral mucosa heals faster with lesser scar formation than skin and it is very rare for oral mucosa to develop hypertrophic scars. Collagen gel seeded with fibroblasts is considered as a valuable model for studying wound healing in vitro. OBJECTIVE: The purpose of this study was to find out whether there are any differences in contractiliy of collagen gel by fibroblasts derived from different sites. METHODS: Fibroblasts were cultured from normal skin, oral mucosa, and hypertrophic scar. They were seeded into collagen gel with or without serum, and the degree of contraction of the collagen gel was measured for 5 days. RESULTS: Hypertrophic scar fibroblasts in collagen gel possessed the greatest contraction potency followed by normal skin fibroblasts and oral mucosal fibroblasts. Serum significantly increased the contractility of each of the fibroblasts. The differences of contractility of collagen gel between oral mucosal fibroblasts and others became more obvious in the presence of serum, however, those between normal skin fibroblasts and hypertrophic scar fibroblasts became less obvious. CONCLUSION: The degree of contraction of collagen gel by fibroblasts correlated with the degree of scar formation. Addition of serum modified the degree of contractile potency which may reflect the differences in the fibroblasts with phenotypic alteration and the subtype of fibroblasts.
Cicatrix ; Cicatrix, Hypertrophic* ; Collagen* ; Fibroblasts* ; Mouth Mucosa* ; Skin* ; Wound Healing

PURPOSE: The mechanism of scar formation is not fully understood. Fibroblast is an important cell in wound healing process. We experienced a patient who was taking progesterone orally. Upper blepharoplasty was performed on her but, wound healing was delayed. We hypothesized that progesterone was the cause of delayed wound healing and fibroblast proliferation inhibition. We investigated the effect of progesterone in vitro on human dermal fibroblasts to study the effects on fibroblast proliferation. METHODS: Human dermal fibroblasts from four persons were cultured initially. Progesterone is mixed to them at various concentrations, and fibroblast cell count was measured by MTT assay method at 570nm. We confirmed that progesterone has some inhibitory effect on fibroblast proliferation and maximal inhibitory concentration of progesterone was determined. Then fibroblasts from a total of nineteen persons were cultured and the effects of progesterone were studied. RESULTS: The initial study showed the maximal inhibitory concentration of progesterone to be 50 microgram/ml. The main study showed that progesterone had 70.9% inhibitory effect on human dermal fibroblast in vitro. CONCLUSION: Progesterone has inhibitory effect on cultured human dermal fibroblast proliferation in vitro.
Blepharoplasty ; Cell Count ; Cicatrix ; Fibroblasts* ; Humans* ; Progesterone* ; Wound Healing

Dermal defection and the degree of its loss determine the natural process of wound healing, which is the key reason leading to excess scar hyperplasia. The function of tri-dimensional structure in dermis acts as a template to regulate the properties of reparative cells. The template structure induces the reparative cells to grow into the structure which changes the skin mechanic status on wound area. Also, the component of extracellular matrix can affect behaviours of fibroblasts negatively or positively, for the reason that the structure of dermal tissue has a permissive effect on the dermal components in regulating behaviours of reparative cells. Therefore, the behaviors of cells depend on the structure of the template. The suitable tri-dimensional structure of dermis facilitates normal cell cycling. The more the structure of dermis closed to its physiological status, the better the biological behaviors of cells act. Moreover, the integrity as well as the continuity of dermal tissue is the prerequisite for serving as a template. The damage to the integrity and the continuity of dermal tissue may be one of the key reasons to lead abnormal tissue repair and scar formation. Thus, we hypothesize that the loss of dermal template may be one of the mechanism of abnormal scar formation and propose the theory of extracellular matrix framework deficiency or destruction.
Cicatrix ; pathology ; Dermis ; pathology ; Epidermis ; pathology ; Humans ; Wound Healing

OBJECTIVETo establish an animal model of hypertrophic scar on the rabbit ears and to observe the dynamic process of scar formation on the ventral side of the rabbit ears.

METHODSFull skin defect (2 cm x 5 cm in diameter) was created on the ventral side of 60 ears in 32 New Zealand white rabbits. 1% silver sulfadiazine cream was applied to the wounds, and the dressing was changed once a week till wound healing. Four ears without operation were taken as control. Wound healing under natural condition was observed continuously for 12 months after the operation. The scar proliferation on the rabbit ears was observed by light microscope and transmission electron microscope, and the scar index was determined by computer image analyzing system.

RESULTSThe color, thickness and texture of the wounds on the rabbit ears after epithelization underwent a process of scar overgrowth, maturation and degeneration. The change in scar index was in accordance with the wax and wane of scar proliferation.

CONCLUSIONThe hypertrophic scar formed on the ventral side of rabbit ears after natural healing of full thickness skin wounds was similar to that in humans. The results indicated that this animal model was ideal for the study of the developmental mechanism of hypertrophic scars and for the evaluation of the efficacy of the prevention and treatment of hypertrophic scars.