1
|
Flores R, Valenzuela F. Cicatrices de quemaduras y la utilidad de la terapia láser en su manejo. REVISTA MÉDICA CLÍNICA LAS CONDES 2023. [DOI: 10.1016/j.rmclc.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
2
|
Lubczyńska A, Garncarczyk A, Wcisło‐Dziadecka D. Effectiveness of various methods of manual scar therapy. Skin Res Technol 2023; 29:e13272. [PMID: 36973982 PMCID: PMC10155853 DOI: 10.1111/srt.13272] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/30/2022] [Indexed: 03/05/2023]
Abstract
BACKGROUND The skin is a protective barrier of the body against external factors, and its damage leads to a loss of integrity. Normal wound healing results in a correct, flat, bright, and flexible scar. Initial skin damage and patient specific factors in wound healing contribute that many of these scars may progress into widespread or pathologic hypertrophic and keloid scars. The changes in cosmetic appearance, continuing pain, and loss of movement due to contracture or adhesion and persistent pruritis can significantly affect an individual's quality of life and psychological recovery post injury. Many different treatment methods can reduce the trauma and surgical scars. Manual scar treatment includes various techniques of therapy. The most effectiveness is a combined therapy, which has a multidirectional impact. Clinical observations show an effectiveness of manual scar therapy. MATERIAL AND METHODS The aim of this work was to evaluate effectiveness of the scar manual therapy combined with complementary methods on the postoperative scars. Treatment protocol included two therapies during 30 min per week for 8 weeks. Therapy included manual scar manipulation, massage, cupping, dry needling, and taping. RESULTS Treatment had a significant positive effect to influence pain, pigmentation, pliability, pruritus, surface area, and scar stiffness. Improvement of skin parameters (scar elasticity, thickness, regularity, color) was also noticed. CONCLUSION To investigate the most effective manual therapy strategy, further studies are needed, evaluating comparisons of different individual and combined scar therapy modalities.
Collapse
Affiliation(s)
- Agnieszka Lubczyńska
- Department of Cosmetology, School of Pharmaceutical Science in SosnowiecMedical University of SilesiaKatowicePoland
| | - Agnieszka Garncarczyk
- Department of Cosmetology, School of Pharmaceutical Science in SosnowiecMedical University of SilesiaKatowicePoland
| | - Dominika Wcisło‐Dziadecka
- Department of Cosmetology, School of Pharmaceutical Science in SosnowiecMedical University of SilesiaKatowicePoland
| |
Collapse
|
3
|
Combination of W-plasty and Botulinum Neurotoxin Type A Injection for Preventing Rhytidectomy Scar in Asians. Aesthetic Plast Surg 2023; 47:181-188. [PMID: 35697816 DOI: 10.1007/s00266-022-02970-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/21/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND This study was conducted to see if better scar results could be obtained by administering botulinum neurotoxin type A (BoNTA) injection and W-plasty incision for preventing rhytidectomy scar. METHODS All patients underwent extended deep-plane rhytidectomy in two groups. Group 1 had a straight incision line, and BoNTA was not given. Group 2 was injected with W-plasty and BoNTA. Photos were taken before surgery and twelve months after surgery. Two aesthetic surgeons analyzed the results using MSS, MSRS, and SBSES. Interrater reliability was measured using the intraclass correlation coefficient (ICC). RESULTS Forty-nine patients were included in the study. Group 1 (Straight incision, No BoNTA) had 26, and Group 2 (W-plasty, BoNTA) had 23 patients. The interrater reliability in Group 1 was excellent for MSS (ICC, 0.957 [0.904-0.981]), and good in two of the interrater reliability measures (ICCs, 0.897 [0.769-0.954] for MSRS, and 0.821 [0.605-0.919] for SBSES). Interrater reliability in Group 2 was good in two out of three measures (ICCs, 0.760 [0.423-0.899] for MSS, 0.746 [0.392-0.893] for MSRS, and 0.851 [0.654-0.937] for SBSES). There was a significant statistical difference between Group 1 and Group 2, showing that Group 2 has superior outcomes (MSS, 6.596 ± 1.569 vs. 5.435 ± 0.590, P = 0.001; MSRS, 4.346 ± 0.967 vs. 3.652 ± 0.510, P = 0.003; SBSES, 3.788 ± 0.695 vs. 4.261 ± 0.541, P = 0.012). CONCLUSIONS Analyzed by three dedicated scar assessments, better results were obtained through combining W-plasty and BoNTA injections, so it is expected to be a useful method for improving scars. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
|
4
|
Behrangi E, Moradi S, Ghassemi M, Goodarzi A, Hanifnia A, Zare S, Nouri M, Dehghani A, Seifadini A, Nilforoushzadeh MA, Roohaninasab M. The investigation of the efficacy and safety of stromal vascular fraction in the treatment of nanofat-treated acne scar: a randomized blinded controlled clinical trial. Stem Cell Res Ther 2022; 13:298. [PMID: 35841057 PMCID: PMC9284502 DOI: 10.1186/s13287-022-02957-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 05/06/2022] [Indexed: 01/16/2023] Open
Abstract
Background Acne is the most common skin disorder which is known as a chronic inflammatory disease with psychological burden and reduced quality of life. Adipose tissue-derived stromal vascular fraction (SVF) is recognized as a source of regenerative cells and improves the quality of skin by increasing collagen content. To date, a few studies have been performed on the therapeutic role of SVF in the treatment of acne scars. Methods This randomized, single-blinded clinical trial was performed on 7 patients with acne scars. In all patients, the initial grade of acne (volume, area and depth) was evaluated and ultrasound of the relevant scar was performed to evaluate neocollagenesis. As a spilt face study, for treating the scars, we used nanofat subcutaneously on one side of the face (control group) and combination of nanofat subcutaneously and SVF intradermally on the opposite side (intervention group). The patients were evaluated for severity of acne by visioface after one month, also for thickness of epidermis and dermis by ultrasound after one month and three months. Results All of the apparent findings of scars improved in two groups after one month, but these changes were significant just for the group treated with SVF (p value < 0.05). Epidermal, dermal and complete thicknesses during the first month in both control and intervention groups were significantly increased (p value < 0.05) but between the first and third months, there was no significant difference in the variables (p value > 0.05). The findings showed that dermal and complete thicknesses of the skin in the first month were different between two groups significantly (p value: 0.042 and 0.040, respectively). Conclusion The use of SVF in the treatment of patients with acne scars accelerates the improvement of volume, area and depth of the scar by increasing collagen content and the dermal thickness, so it can be used as a potentially effective treatment for these patients.
Collapse
Affiliation(s)
- Elham Behrangi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Moradi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Ghassemi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirreza Hanifnia
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sona Zare
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Nouri
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Dehghani
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Seifadini
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Nilforoushzadeh
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. .,Skin Repair Research Center, Jordan Dermatology and Hair Transplantation Center, Tehran, Iran.
| | - Masoumeh Roohaninasab
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran. .,Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
5
|
Monteiro R, Bhat R, Martis J, Kamath HG. A comparative study of the efficacy of intralesional 5 fluorouracil vs combination of 5 fluorouracil with triamcinolone acetonide in keloids. Indian J Dermatol 2022; 67:211-215. [DOI: 10.4103/ijd.ijd_485_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
6
|
Nonsurgical Management of Hypertrophic Scars: Evidence-Based Therapies, Standard Practices, and Emerging Methods. Aesthetic Plast Surg 2020; 44:1320-1344. [PMID: 32766921 DOI: 10.1007/s00266-020-01820-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Accepted: 01/05/2007] [Indexed: 12/12/2022]
Abstract
Hypertrophic scars, resulting from alterations in the normal processes of cutaneous wound healing, are characterized by proliferation of dermal tissue with excessive deposition of fibroblast-derived extracellular matrix proteins, especially collagen, over long periods, and by persistent inflammation and fibrosis. Hypertrophic scars are among the most common and frustrating problems after injury. As current aesthetic surgical techniques become more standardized and results more predictable, a fine scar may be the demarcating line between acceptable and unacceptable aesthetic results. However, hypertrophic scars remain notoriously difficult to eradicate because of the high recurrence rates and the incidence of side effects associated with available treatment methods. This review explores the various treatment methods for hypertrophic scarring described in the literature including evidence-based therapies, standard practices, and emerging methods, attempting to distinguish those with clearly proven efficiency from anecdotal reports about therapies of doubtful benefits while trying to differentiate between prophylactic measures and actual treatment methods. Unfortunately, the distinction between hypertrophic scar treatments and keloid treatments is not obvious in most reports, making it difficult to assess the efficacy of hypertrophic scar treatment.
Collapse
|
7
|
Rosenthal A, Kolli H, Israilevich R, Moy R. Lasers for the prevention and treatment of hypertrophic scars: a review of the literature. J COSMET LASER THER 2020; 22:115-125. [PMID: 32576064 DOI: 10.1080/14764172.2020.1783451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Despite the increasing knowledge about wound healing mechanisms and the advancements made in laser technology, hypertrophic scars remain difficult to manage. This review intends to discuss the laser devices studied in the prevention and treatment of HS, arising from trauma, surgery, and burns, detail their mechanisms of action, and emphasize those devices with the most promising effects. Most of the suggested mechanisms and explanations for the use of lasers in treating hypertrophic scars are based on selective photothermolysis, in which the light energy emitted from a laser is absorbed by its intended target, thereby disrupting existing collagen and altering the cycle of neocollagenesis. Through our literature review, we have determined that combination therapies, utilizing more than one laser target demonstrate enhanced clinical efficacy. Further, early use of laser devices has been shown to enhance the cosmetic result of sutured wounds and may play a role in preventing the development of hypertrophic scars.
Collapse
Affiliation(s)
- Amanda Rosenthal
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine , Miami, FL, USA.,Research Department, Moy-Fincher-Chipps Facial Plastics & Dermatology , Beverly Hills, CA, USA
| | - Hiren Kolli
- Research Department, Moy-Fincher-Chipps Facial Plastics & Dermatology , Beverly Hills, CA, USA
| | - Rachel Israilevich
- Research Department, Moy-Fincher-Chipps Facial Plastics & Dermatology , Beverly Hills, CA, USA
| | - Ronald Moy
- Research Department, Moy-Fincher-Chipps Facial Plastics & Dermatology , Beverly Hills, CA, USA
| |
Collapse
|
8
|
Abe Y, Konno H, Yoshida S, Yamauchi T, Yamasaki K, Denda M, Nishizawa M. Red light-promoted skin barrier recovery: Spatiotemporal evaluation by transepidermal potential. PLoS One 2019; 14:e0219198. [PMID: 31291308 PMCID: PMC6620005 DOI: 10.1371/journal.pone.0219198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/18/2019] [Indexed: 11/25/2022] Open
Abstract
The light-promoted recovery of epidermal barrier of skin was evaluated by the associated recovery of transepidermal potential (TEP), the potential difference between the surface and dermis of skin, by using porcine skin samples. An accelerated recovery of TEP was observed by irradiation of red light with the irradiance of 40 mW/cm2 and a duration of > 10 min. The influence of the light stimulation to the surroundings (~ 20 mm) was also observed. The irradiations of blue and purple lights were ineffective in accelerating the barrier recovery. These characteristics of the light stimulation would be useful for the design of effective and safe phototherapy devices for skin. The present study proves that the TEP can serve as a spatiotemporal indicator of the epidermal barrier function.
Collapse
Affiliation(s)
- Yuina Abe
- Department of Finemechanics, Graduate School of Engineering, Tohoku University, Aramaki Aoba, Sendai, Japan
| | - Hajime Konno
- Department of Finemechanics, Graduate School of Engineering, Tohoku University, Aramaki Aoba, Sendai, Japan
| | - Shotaro Yoshida
- Department of Finemechanics, Graduate School of Engineering, Tohoku University, Aramaki Aoba, Sendai, Japan
| | - Takeshi Yamauchi
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Seiryo-machi, Sendai, Japan
| | - Kenshi Yamasaki
- Department of Dermatology, Graduate School of Medicine, Tohoku University, Seiryo-machi, Sendai, Japan
| | - Mitsuhiro Denda
- Shiseido Research Center, Fukuura, Kanazawa-ku, Yokohama, Japan
| | - Matsuhiko Nishizawa
- Department of Finemechanics, Graduate School of Engineering, Tohoku University, Aramaki Aoba, Sendai, Japan
- * E-mail:
| |
Collapse
|
9
|
Srivastava S, Kumari H, Singh A. Comparison of Fractional CO 2 Laser, Verapamil, and Triamcinolone for the Treatment of Keloid. Adv Wound Care (New Rochelle) 2019; 8:7-13. [PMID: 30705785 DOI: 10.1089/wound.2018.0798] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022] Open
Abstract
Objective: Scar biology is a territory less understood. The search for ideal treatment of keloid continues. The aim of this study was to compare the role of CO2 laser, triamcinolone (TAC), and verapamil in the treatment of keloid. Approach: A randomized parallel-group study was conducted in which 60 patients were randomly allocated to three groups from May 2017 to April 2018. First group received fractional CO2 laser therapy, second group received triamcinolone, and third group received intralesional verapamil. Outcomes were evaluated using Vancouver scar scale score at 3 weekly intervals for 6 months. Results: There was a reduction in scar height, vascularity, and pliability in all the three groups. However, pigmentation was not completely resolved by any of the three modalities. The response was fastest in case of triamcinolone followed by verapamil and laser, which was statistically significant. There was reduction in pain and pruritus in all the three groups and lesser injection site pain with verapamil. There was some amount of charring with CO2 laser. Innovation: Our study provides evidence that TAC has the fastest response in treating keloids when compared to other modalities. Scar pigmentation is the parameter that is not completely resolved by TAC, verapamil, or CO2 laser. Conclusion: The study revealed that fractional CO2 laser and verapamil are as efficient as triamcinolone acetonide (TAC) for treating keloids, except it takes longer for laser and verapamil to act compared to TAC. Verapamil can be used as an alternative treatment modality that is cost-effective with minimal adverse effects.
Collapse
Affiliation(s)
- Sunil Srivastava
- Department of Plastic Surgery, Sawai Man Singh Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India
| | - Hiranmayi Kumari
- Department of Plastic Surgery, Sawai Man Singh Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India
| | - Abhimanyu Singh
- Department of Plastic Surgery, Sawai Man Singh Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India
| |
Collapse
|
10
|
Morelli Coppola M, Salzillo R, Segreto F, Persichetti P. Triamcinolone acetonide intralesional injection for the treatment of keloid scars: patient selection and perspectives. Clin Cosmet Investig Dermatol 2018; 11:387-396. [PMID: 30087573 PMCID: PMC6063260 DOI: 10.2147/ccid.s133672] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Keloids are pathological scars presenting as nodular lesions that extend beyond the area of injury. They do not spontaneously regress, often continuing to grow over time. The abnormal wound-healing process underlying keloid formation results from the lack of control mechanisms self-regulating cell proliferation and tissue repair. Keloids may lead to cosmetic disfigurement and functional impairment and affect the quality of life. Although several treatments were reported in the literature, no universally effective therapy was found to date. The most common approach is intralesional corticosteroid injection alone or in combination with other treatment modalities. Triamcinolone acetonide (TAC) is the most commonly used intralesional corticosteroid. The aim of this article was to review the use of TAC, alone or in combination, in the treatment of keloid scars. The response to corticosteroid injection alone is variable with 50-100% regression and a recurrence rate of 33% and 50% after 1 and 5 years, respectively. Compared to verapamil, TAC showed a faster and more effective response even though with a higher complication rate. TAC combined with verapamil was proved to be effective with statistically significant overall improvements of scars over time and long-term stable results. TAC and 5-fluorouracil (5-FU) intralesional injections were found to achieve comparable outcomes when administered alone, although 5-FU was more frequently associated with side effects. Conversely, the combination of 5-FU and TAC was more effective and showed fewer undesirable effects compared to TAC or 5-FU alone. Several kinds of laser treatments were reported to address keloids; however, laser therapy alone was burdened with a high recurrence rate. Better results were described by combining CO2, pulsed-dye or Nd: YAG lasers with TAC intralesional injections. Further options such as needle-less intraepidermal drug delivery are being explored, but more studies are needed to establish safety, feasibility and effectiveness of this approach.
Collapse
Affiliation(s)
- Marco Morelli Coppola
- Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico" University of Rome, Rome, Italy,
| | - Rosa Salzillo
- Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico" University of Rome, Rome, Italy,
| | - Francesco Segreto
- Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico" University of Rome, Rome, Italy,
| | - Paolo Persichetti
- Department of Plastic, Reconstructive and Aesthetic Surgery, "Campus Bio-Medico" University of Rome, Rome, Italy,
| |
Collapse
|
11
|
|
12
|
Uyulmaz S, Sanchez Macedo N, Rezaeian F, Giovanoli P, Lindenblatt N. Nanofat Grafting for Scar Treatment and Skin Quality Improvement. Aesthet Surg J 2018; 38:421-428. [PMID: 29365061 DOI: 10.1093/asj/sjx183] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Fat grafting has been gaining attention in tissue augmentation over the past decade, not only for lipofilling, but also for its observed regenerative properties and overall skin texture improvement. OBJECTIVES The aim of this study was to analyze the effect of nanofat grafting on scars, wrinkles, and skin discolorations in our clinic. METHODS Nanofat was prepared by a standard emulsification and filtration protocol. The resulting liquid was injected intradermally or directly into the scar tissue. Skin quality was evaluated based on a scoring system, and patient satisfaction was documented. Three physicians compared and analyzed standardized pre- and posttreatment photographs in respect to general improvement of skin aesthetics. RESULTS Fifty-two patients were treated with nanofat from November 2013 to April 2016. The mean (± standard deviation) posttreatment follow up was 155 ± 49 days and average volume of harvested fat amounted to 165 cc. The primary harvesting areas were the abdomen and flanks, and the injected volume of nanofat ranged from 1 to 25 mL (mean, 4.6 mL). A total of 40 scars (76% of all patient defects) were effectively treated as well as 6 patients with wrinkles, and 6 patients with discoloration. Posttreatment clinical evaluations showed a marked improvement of scar quality and a high patient satisfaction. The results in our clinic showed that nanofat grafting softened the scars, made discolorations less pronounced, and wrinkles appeared less prominent. CONCLUSIONS Nanofat grafting has been shown to have beneficial effects in the treatment of scars, wrinkles, and skin discolorations. LEVEL OF EVIDENCE 4
Collapse
Affiliation(s)
- Semra Uyulmaz
- Division of Plastic and Hand Surgery, Department of Surgery, University Hospital Zurich, Zürich, Switzerland
| | - Nadia Sanchez Macedo
- Division of Plastic and Hand Surgery, Department of Surgery, University Hospital Zurich, Zürich, Switzerland
| | - Farid Rezaeian
- Division of Plastic and Hand Surgery, Department of Surgery, University Hospital Zurich, Zürich, Switzerland
| | - Pietro Giovanoli
- Division of Plastic and Hand Surgery, Department of Surgery, University Hospital Zurich, Zürich, Switzerland
| | - Nicole Lindenblatt
- Division of Plastic and Hand Surgery, Department of Surgery, University Hospital Zurich, Zürich, Switzerland
| |
Collapse
|
13
|
Geraghty LN, Rahman Z. Treatment of Surgical Scars with Laser Therapy. CURRENT DERMATOLOGY REPORTS 2016. [DOI: 10.1007/s13671-016-0152-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
14
|
Svolacchia F, De Francesco F, Trovato L, Graziano A, Ferraro GA. An innovative regenerative treatment of scars with dermal micrografts. J Cosmet Dermatol 2016; 15:245-53. [DOI: 10.1111/jocd.12212] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - Francesco De Francesco
- Multidisciplinary Department of Medical-Surgical and Dental Specialties; Second University of Naples; Naples Italy
| | | | - Antonio Graziano
- Human Brain Wave srl; Turin Italy
- SHRO - Temple University of Philadelphia; Philadelphia PA USA
| | - Giuseppe A. Ferraro
- Multidisciplinary Department of Medical-Surgical and Dental Specialties; Second University of Naples; Naples Italy
| |
Collapse
|
15
|
Shin JU, Park JH, Oh SH, Jeong JJ, Kang S, Nam K, Chung WY, Lee JH. Early intervention in thyroidectomy scars: demographics, symptoms, and prevention. J Wound Care 2015; 24:163-4, 166-8, 170-1. [PMID: 25853473 DOI: 10.12968/jowc.2015.24.4.163] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Although hypertrophic scars are cosmetically problematic for patients following thyroidectomy, the associated risk factors are not well defined. Our objective was to determine the factors associated with hypertrophic scar development following thyroidectomy. METHOD A retrospective chart review was performed collecting data on sex, age, body mass index (BMI), operation site, skin characteristics (pigmentation, erythema, elasticity, and hydration), and clinical scar characteristics (itching, tightening, induration, adhesion, and oedema). It was also noted if the patient had early scar intervention with intralesional steroid injection or non-ablative fractional laser irradiation, and preventive topical treatment agents. The effects of these factors were analysed using univariate and multivariate analyses. RESULTS Data from 1141 patients showed the incidence of hypertrophic scars was 13.9%. Significant variables in univariate analysis were combined for multivariate analysis. Young age, high BMI, itching, tightening, induration, and adhesion were associated with hypertrophic scar formation. Early scar intervention, as well as the use of preventive topical agents, were associated with decreased hypertrophic scar formation. CONCLUSION Based on our results, we suggest that dermatologists consider using non-ablative fractional laser, intralesional steroid injection, and topical preventive agents to lower the incidence of hypertrophic scars, especially in young patients or those with high BMI and/or clinical symptoms such as itching, tightening, induration, and adhesion.
Collapse
Affiliation(s)
- J U Shin
- Department of Dermatology and Cutaneous Biology Research Institute
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Efficacy and safety of fractional carbon dioxide laser for treatment of unwanted facial freckles in phototypes II-IV: a pilot study. Lasers Med Sci 2014; 29:1937-42. [PMID: 24917080 DOI: 10.1007/s10103-014-1610-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 06/03/2014] [Indexed: 10/25/2022]
Abstract
Facial freckles are a cosmetic concern to Egyptians, particularly young females. Several therapeutic lines exist with variable response rates and limitations. Fractional carbon dioxide (FCO2) laser provides minimal ablation and therefore less down time and less side effects. The efficacy and safety of this laser technology have still not been studied in freckles. The aim of this study is to assess the efficacy and safety of FCO2 laser in the treatment of unwanted facial freckles in Egyptians. Twenty patients undergone a single session of FCO2 laser and then were followed up clinically a month later. Photographs were taken before treatment and at follow-up visit and were assessed by three blinded investigators. Percent of global improvement was measured on a 4-point grading scale. Patient's satisfaction and adverse events were recorded. Two patients (10 %) showed grade 1 improvement, while eight patients (40 %) showed grade 2 improvement. Nine patients (45 %) showed grade 3 improvement, and only one patient (5 %) showed grade 4 improvement. FCO2 laser resurfacing is effective and safe in treatment of facial freckles in skin phototypes II-IV. It can offer a more practical alternative to topical treatments, and a cheaper alternative to Q-switched lasers.
Collapse
|
17
|
Freitas CP, Melo C, Alexandrino AM, Noites A. Efficacy of low-level laser therapy on scar tissue. J COSMET LASER THER 2013; 15:171-6. [DOI: 10.3109/14764172.2013.769272] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
18
|
Pulsed dye laser treatment with different onset times for new surgical scars: a single-blind randomized controlled trial. Lasers Med Sci 2012; 27:1095-8. [DOI: 10.1007/s10103-011-1044-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Accepted: 12/12/2011] [Indexed: 11/27/2022]
|
19
|
YUN JISUP, CHOI YOUNGJUN, KIM WONSERK, LEE GAYOUNG. Prevention of Thyroidectomy Scars in Asian Adults Using a 532-nm Potassium Titanyl Phosphate Laser. Dermatol Surg 2011; 37:1747-53. [DOI: 10.1111/j.1524-4725.2011.02128.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
20
|
Kassab AN, El Kharbotly A. Management of ear lobule keloids using 980-nm diode laser. Eur Arch Otorhinolaryngol 2011; 269:419-23. [PMID: 21630062 DOI: 10.1007/s00405-011-1632-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 05/09/2011] [Indexed: 11/28/2022]
Abstract
The objective of the study was to evaluate the 980-nm diode laser in conjunction with corticosteroids in the treatment of ear lobule keloids. Several methods have been described for the treatment of keloid scars, but none of them have been 100% successful. Advances in laser techniques have enabled surgeons to define the most appropriate lasers for use in the treatment of different scar types. The diode laser pulses are delivered interstitially in a single repeated mode in non-overlapping sites using a bare optical fiber, followed by intralesional triamcinolone acetonide injection. The number of sessions varies between two to five for the management of more than 75% of keloid size, with a total success rate of 75% and no recurrence in the follow-up of 12 months. The technique used proved to be effective in the treatment of ear lobule keloids.
Collapse
Affiliation(s)
- Ahmed Nazmi Kassab
- Otorhinolaryngology Unit, Department of Medical Laser Applications, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt.
| | | |
Collapse
|
21
|
A review of the effectiveness of antimitotic drug injections for hypertrophic scars and keloids. Ann Plast Surg 2010; 63:688-92. [PMID: 19887927 DOI: 10.1097/sap.0b013e3181978753] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hypertrophic scars and keloids are common problems after injury and cause functional and cosmetic deformities. A wide variety of treatments have been advocated for hypertrophic scars and keloids regression. Unfortunately, the reported efficacy has been variable. This article explores antimitotic drugs described in the literature such as steroid injection, 5-FU, mitomycin C, and bleomycin, which mainly target the fibroblasts in scar tissue, have been proposed as the effective modalities for scar treatment and scar prevention after surgery, but restricted due to possible side effects. The current accepted treatment for hypertrophic scar and keloid are combination therapy and the early treatment which could achieve better efficacy and less adverse effect.
Collapse
|
22
|
Vaccaro M, Borgia F, Guarneri B. Treatment of hypertrophic thyroidectomy scar using 532-nm potassium-titanyl-phosphate (KTP) laser. Int J Dermatol 2009; 48:1139-41. [DOI: 10.1111/j.1365-4632.2009.04092.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Chike-Obi CJ, Cole PD, Brissett AE. Keloids: pathogenesis, clinical features, and management. Semin Plast Surg 2009; 23:178-84. [PMID: 20676312 PMCID: PMC2884925 DOI: 10.1055/s-0029-1224797] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cutaneous wound healing is a complex response to skin injury. Deregulation of this process can lead to excessive scar formation, as seen in keloids. Keloids are common skin lesions that are difficult to treat and are associated with high recurrence rates despite the large number of available treatment options. With increased knowledge of the disease process and further scientific advancements, future approaches will hopefully improve keloid treatment. In this article, we review the epidemiology, genetic basis, etiology, clinical features, pathogenesis, and management of keloids.
Collapse
Affiliation(s)
| | - Patrick D. Cole
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
| | - Anthony E. Brissett
- Bobby R. Alford Department of Otorhinolaryngology, Baylor College of Medicine, Houston, Texas
| |
Collapse
|
24
|
Haedersdal M, Moreau KE, Beyer DM, Nymann P, Alsbjørn B. Fractional nonablative 1540 nm laser resurfacing for thermal burn scars: A randomized controlled trial. Lasers Surg Med 2009; 41:189-95. [DOI: 10.1002/lsm.20756] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
25
|
Atiyeh BS. Nonsurgical management of hypertrophic scars: evidence-based therapies, standard practices, and emerging methods. Aesthetic Plast Surg 2007; 31:468-92; discussion 493-4. [PMID: 17576505 DOI: 10.1007/s00266-006-0253-y] [Citation(s) in RCA: 166] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Accepted: 01/05/2007] [Indexed: 01/10/2023]
Abstract
Hypertrophic scars, resulting from alterations in the normal processes of cutaneous wound healing, are characterized by proliferation of dermal tissue with excessive deposition of fibroblast-derived extracellular matrix proteins, especially collagen, over long periods, and by persistent inflammation and fibrosis. Hypertrophic scars are among the most common and frustrating problems after injury. As current aesthetic surgical techniques become more standardized and results more predictable, a fine scar may be the demarcating line between acceptable and unacceptable aesthetic results. However, hypertrophic scars remain notoriously difficult to eradicate because of the high recurrence rates and the incidence of side effects associated with available treatment methods. This review explores the various treatment methods for hypertrophic scarring described in the literature including evidence-based therapies, standard practices, and emerging methods, attempting to distinguish those with clearly proven efficiency from anecdotal reports about therapies of doubtful benefits while trying to differentiate between prophylactic measures and actual treatment methods. Unfortunately, the distinction between hypertrophic scar treatments and keloid treatments is not obvious in most reports, making it difficult to assess the efficacy of hypertrophic scar treatment.
Collapse
Affiliation(s)
- Bishara S Atiyeh
- Division Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
| |
Collapse
|