Scars, burns & healing最新文献

{"title":"Concomitant therapy of surgical shave excision and intralesional injections for ear keloids: Early results from a retrospective cohort study","authors":"J. Tran, S. Lultschik, J. Ho, S. Sapra, Kevin Dong, Klaudija Gusic","doi":"10.1177/20595131221098531","DOIUrl":"https://doi.org/10.1177/20595131221098531","url":null,"abstract":"Introduction Keloids are hypertrophic scars that commonly arise in the ear region. The authors’ objectives were to (1) evaluate effectiveness of surgical shave excision followed by intralesional triamcinolone acetonide and onabotulinumtoxinA injections; and (2) evaluate safety and patient satisfaction. Methods and Materials This study was a retrospective chart review of patients who received treatment of extralesional surgical shave excision followed by intralesional triamcinolone acetonide and onabotulinumtoxinA injections to treat ear keloids at a single outpatient dermatology clinic. A prospective patient questionnaire was administered to the same patient population to collect recurrence and patient satisfaction. Results A total of 45 patients were included, consisting of 84.4% females (n = 38) and 15.6% males (n = 7) with a mean age of 25.5 years. Through retrospective chart review, early recurrence was seen in 6.7% of patients (n = 3), and via the prospective patient questionnaire, 11.1% of patients noted early keloid recurrence (n = 5). Of the patients who expressed their level of satisfaction in-clinic, 96.0% (n = 24) reported being satisfied or very satisfied and 4.0% (n = 1) were dissatisfied. Satisfaction was also assessed through the prospective patient questionnaire; of those who consented to the questionnaire, 100.0% (n = 24) were satisfied or very satisfied. Only 20.0% (n = 9) of all patients reported experiencing side effects, consisting of pruritus (11.1%; n = 5), tenderness (4.4%; n = 2), pain (2.2%; n = 1), and mild atrophy (2.2%; n = 1). Conclusion Extralesional surgical shave excision followed by intralesional triamcinolone acetonide and onabotulinumtoxinA injections may represent a promising treatment option for ear keloids. Evidence Level: 3 retrospective cohort study. Lay Summary Keloids are a type of raised scar, which can be painful and itchy for patients. Keloids can occur on various part of the body, including on the ear. They are challenging to treat and tend to come back. There are many treatment options, however, there is not one universal best treatment for keloids on the ear. We hoped to discover if shave excision followed by intralesional triamcinolone acetonide and onabotulinumtoxinA injections is effective at treating keloids on the ear. In order to answer this we completed a chart review of clinic patients, who have already completed the following combination treatment for keloids on the ear. The keloids were treated first by physically removing the bulk of the keloid with a scalpel, which is called shave excision. After the removal, triamcinolone acetonide and onabotulinumtoxinA were injected directly into the keloid. The rate of patient satisfaction and the rate of the keloid returning were collected during in-clinic visits and an optional post-clinic patient questionnaire. The treatment effectiveness and side effects experienced were reported during in-clinic visits. This indicated that with the low rate of ","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48871611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinesio taping to address post-sternotomy scars in pediatric patients: A case report","authors":"Elizabeth G Harvey","doi":"10.1177/20595131221095355","DOIUrl":"https://doi.org/10.1177/20595131221095355","url":null,"abstract":"Introduction The role of postoperative scar tissue adhesion and its impact on motor control in infants with congenital heart disease has not been explored in the literature. Elastic therapeutic tapes, such as Kinesio tape, are designed to affect the integumentary system. This case report aims to demonstrate the safety and present the observations following use of Kinesio tape to treat scar tissue in a pediatric patient after open-heart surgery in conjunction with standard rehabilitation. Method This retrospective case report presents observations of an infant's sternotomy scar adhesion and gross motor development after six applications of Kinesio tape. The sternotomy and drain tube scars were treated with Kinesio tape fascia applications in addition to standard physical therapy (PT). Discussion Several domains showed positive changes. The scar mobility and appearance improved. The patient's motor skills improved, possibly due to skin stretch's role in motor learning. The taping application did not cause discomfort, and there were no adverse reactions. Conclusion In this infant, the three-month-old sternotomy scar improved in adherence and appearance after six applications of Kinesio Fingerprint tape; motor skills also increased in the presence of standard PT. There were no adverse reactions noted with the protocol. Kinesio tape may provide a safe adjunct to treat scar tissue adhesion in infants with median sternotomy scars. Lay Summary Issue being explored Sternotomy scars can cause physical and psychological harm. Sensors (receptors) in the skin help with movement and balance responses. The impact of scar stiffness (adhesion) on developing motor control has not been reported in infants. Treating the scar in the remodelling phase with elastic tape may improve the scar's appearance and ability to move, thereby improving development.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48190801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The conservative management of self-inflicted chemical burns: Case report and literature review","authors":"Amenah Galo, M. Farid, R. Almasharqah","doi":"10.1177/20595131221080545","DOIUrl":"https://doi.org/10.1177/20595131221080545","url":null,"abstract":"Introduction Chemical burns, particularly injuries related to psychiatric illnesses, are underreported in the literature. We present two cases of self-inflicted alkali chemical burns managed conservatively. Frequent clinical review of the burn was aimed to ensure appropriate healing and compliance with the treatment plan based on regular dressing changes. Case 1 A 24-year-old woman presented during the first day of the initial injury with a minor self-inflicted chemical burn to the right forearm. The causative agent was an oven cleaner containing sodium hydroxide triggering an alkali-based burn. The surface area of the injury was 0.5% total body surface area (TBSA) full-thickness burn. The patient had a complex psychiatric history diagnosed with personality disorder, anxiety and depression. Case 2 A 55-year-old woman presented with a self-inflicted left forearm full-thickness burn (0.5% TBSA). This was five days after the initial injury from an oven cleaner containing sodium hydroxide. The patient had a psychiatric history of anxiety and depressive disorder. The mainstay of burn management was conservative with regular dressing changes and a topical agent. Telemedicine via a designated email address was given to the patient for virtual clinical burn review and any urgent issues. Photograph of the initial burn was taken, and clinic visits were scheduled to determine healing progress. Conclusion Self-inflicted chemical burns are to be managed within a multidisciplinary setting including early psychiatric involvement. We advocate a holistic approach to determine conservative or operative management, taking into account patient factors, burn complexity and clinician's judgement to streamline the treatment plan. Lay Summary Chemical burns due to self-harm are rare to see in clinical practice. A review of two cases secondary to intentional burns sustained using an oven cleaning material. Patients had psychiatric issues and were on medications to control symptoms. Close observation with regular dressings and topical cream would allow burns to heal without the need for an operation. Our recommendation would be to treat these burns with dressings and regular follow up in the clinic or virtually till healed.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46816439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introductory Chapter: Scars","authors":"A. Chiriac","doi":"10.5772/intechopen.86397","DOIUrl":"https://doi.org/10.5772/intechopen.86397","url":null,"abstract":"","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"133 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76401904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intralesional excision as a surgical strategy to manage keloid scars: what's the evidence?","authors":"Ioannis Goutos","doi":"10.1177/2059513119867297","DOIUrl":"https://doi.org/10.1177/2059513119867297","url":null,"abstract":"<p><strong>Introduction: </strong>Keloid scars are a particularly challenging clinical entity and a variety of management approaches have been described in the literature including intralesional surgery. The current literature lacks a summative review to ascertain the evidence base behind this surgical approach.</p><p><strong>Methods: </strong>A comprehensive English literature database search was performed using PubMed Medline, EMBASE and Web of Science from their individual dates of inception to March 2018. We present the different rationales proposed for the use of this technique, the clinical outcomes reported in the literature as well as the scientific basis for intralesional excision of keloid scars.</p><p><strong>Discussion: </strong>A number of arguments have been proposed to support intralesional excision including avoiding injury to neighbouring non-keloidal skin and the deep layer of the dermis, removal of the most proliferative fibroblastic group as well as debulking to facilitate the administration of injectable steroid. The most current literature does not provide sufficient support for the adoption of intralesional excisions based on data emerging from basic science as well as clinical outcome studies.</p><p><strong>Conclusion: </strong>Emerging evidence supports the extralesional excision of keloid scars based on current mechanobiological, histological as well as clinical outcome data. Further trials comparing extralesional and intralesional surgical practices are eagerly awaited to ascertain the role of intralesional excisions in the keloid management arena.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"5 ","pages":"2059513119867297"},"PeriodicalIF":0.0,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059513119867297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene expression analysis in scars treated with silicone cream: a case series.","authors":"Robin Kikuchi,&nbsp;Abdullah J Khalil,&nbsp;Christopher I Zoumalan","doi":"10.1177/2059513119868345","DOIUrl":"https://doi.org/10.1177/2059513119868345","url":null,"abstract":"<p><strong>Background: </strong>In contrast to fetal scar tissue, adult scar tissue presents with visible scarring. Topical silicone creams have been shown to improve the appearance of scars. This case series compares the genetic expression of post-surgical scar tissues that received topical scar treatment with silicone cream, SKN2017B, or no treatment. SKN2017B is a recently formulated silicone-based scar cream that contains selective synthetic recombinant human growth factors, hyaluronic acid, and vitamin C. We hypothesise that scars treated with silicone-based scar creams have a more favourable genetic expression resembling a well-healing scar.</p><p><strong>Methods: </strong>Women who had undergone an abdominoplasty were included in this investigation and randomly assigned to treat part of the scar with topical silicone, another part with SKN2017B, and to leave a third part untreated. After four weeks, punch biopsies were taken and the RNA sequenced. Healthy abdominal skin was biopsied as baseline data. Genes of interest were identified and median values were calculated for the samples.</p><p><strong>Results: </strong>SKN2107B-treated scars demonstrated the lowest collagen type I to collagen type III ratio. Other key genes of interest in wound healing showed the lowest (favourable) expression of fibroblast activation protein alpha, lysyl oxidase and cartilage oligomeric matrix protein; the highest (favourable) expression of fibronectin type III domain containing 1 and matrix metallopeptidase 9 were found in scars treated with SKN2017B.</p><p><strong>Conclusion: </strong>The results of this small case series demonstrate a trend that those scars treated with topical silicone cream, notably SKN2017B, display the most favourable gene expression for wound healing.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"5 ","pages":"2059513119868345"},"PeriodicalIF":0.0,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059513119868345","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keloid research: current status and future directions.","authors":"Chia-Hsuan Tsai,&nbsp;Rei Ogawa","doi":"10.1177/2059513119868659","DOIUrl":"https://doi.org/10.1177/2059513119868659","url":null,"abstract":"<p><strong>Introduction: </strong>Keloids and hypertrophic scars are fibroproliferative disorders of the skin that result from abnormal healing of injured or irritated skin. Multiple studies suggest that genetic, systemic and local factors may contribute to the development and/or growth of keloids and hypertrophic scars. A key local factor may be mechanical stimuli. Here, we provide an up-to-date review of the studies on the roles that genetic variation, epigenetic modifications and mechanotransduction play in keloidogenesis.</p><p><strong>Methods: </strong>An English literature review was performed by searching the PubMed, Embase and Web of Science databases with the following keywords: genome-wide association study; epigenetics; non-coding RNA; microRNA; long non-coding RNA (lncRNA); DNA methylation; mechanobiology; and keloid. The searches targeted the time period between the date of database inception and July 2018.</p><p><strong>Results: </strong>Genetic studies identified several single-nucleotide polymorphisms and gene linkages that may contribute to keloid pathogenesis. Epigenetic modifications caused by non-coding RNAs (e.g. microRNAs and lncRNAs) and DNA methylation may also play important roles by inducing the persistent activation of keloidal fibroblasts. Mechanical forces and the ensuing cellular mechanotransduction may also influence the degree of scar formation, scar contracture and the formation/progression of keloids and hypertrophic scars.</p><p><strong>Conclusions: </strong>Recent research indicates that the formation/growth of keloids and hypertrophic scars associate clearly with genetic, epigenetic, systemic and local risk factors, particularly skin tension around scars. Further research into scar-related genetics, epigenetics and mechanobiology may reveal molecular, cellular or tissue-level targets that could lead to the development of more effective prophylactic and therapeutic strategies for wounds/scars in the future.</p>","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"5 ","pages":"2059513119868659"},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2059513119868659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometriosis of Postoperative Scar","authors":"A. Plotski","doi":"10.5772/INTECHOPEN.88246","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.88246","url":null,"abstract":"Endometriosis in a postoperative scar is a secondary process in scars after surgical procedures affecting endometrium: cesarean section, hysterectomy, amniocentesis \u0000etc. Nevertheless scar endometriosis occurs also after general surgery – appendectomy, cholecystectomy, correction of hernias. The cause of surgical scar \u0000endometriosis is believed to be iatrogenic transplantation of endometrium to the surgical wound. Despite the ectopic location, endometrial tissue is able to respond to \u0000hormonal effects, thereby causing clinical signs of disease. Endometriosis of postoperative scar is a typical example of extragenital endometriosis. The most common \u0000presenting symptom of endometrioma in a scar is a palpable mass associated with cyclic pain and swelling during menses. When the patient complains are not cyclical \u0000(25-45% of patients with scar endometriosis) clinical diagnosis is impaired. The typical sonographic pattern of endometriomas is presence of subcutaneous nodule, \u0000hypoechoic with hyperechoic strands and irregular margins. Different types of hormonal therapy has been tried with minimal effects. That’s why for endometriosis of \u0000postoperative scar total surgical excision is considered to be golden standard for both diagnosis and treatment. In order to prevent scar endometriosis some measures \u0000have been proposed. But no measures of prevention have proved its efficiency and all these measures were suggested without any evident scientific corroboration.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75875964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Specificities of Electrical Burn Healing","authors":"I. Ghorbel, S. Moalla, A. Abid, Amir Karra, K. Ennouri","doi":"10.5772/INTECHOPEN.83582","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.83582","url":null,"abstract":"Electrical burns are a major cause of bodily harm due to the mechanism and effect of the lesions. This prompts us to study these lesions and their management in order to reduce the morbidity caused by this type of accident. In the event of an electric chock accident, the treatment is medico-surgical and is composed of two main phases: acute phase when general treatment is essential and subacute phase when local treatment is implemented. The study shows that conventional emergency decompression does not appear to reduce the amputation rate, the use of local and locoregional flaps in the initial phase (<21 days) carries a significant risk of suffering and necrosis, and also antithrom-botic prevention or the use of flaps does not seem to have an impact on healing delays.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77951686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scarring After Burn Injury","authors":"L. Damkat-Thomas, J. Greenwood","doi":"10.5772/INTECHOPEN.85411","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85411","url":null,"abstract":"Burn injury is a trauma that has variable scarring outcomes dependent on both the size and the depth of the burn. This chapter will discuss the pathophysiology of wound healing by both primary and secondary intention and its applicability to burn wounds. The importance of accurate assessment of burn depth and its impact on the primary treatment and subsequent scar outcome will be explored. Special anatomic areas such as the face, hands and neck will be highlighted. Skin grafting and skin substitutes as treatment options will be reviewed. Improvements in burn care have enabled people to survive larger burns that may once have proved fatal. The emphasis of treatment, once healing has been achieved, is now focused upon rehabilitation and scar management. Scar management strategies including pressure garments and silicone therapy are highlighted along with secondary scar revision strategies.","PeriodicalId":94205,"journal":{"name":"Scars, burns & healing","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74361243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}