The Review of Most Current Therapy for Large Area of Hypertrophic Scar and Keloid
DOI:
https://doi.org/10.31907/2414-2093.2015.01.7Keywords:
Hypertrophic scar, Keloid, Scar treatment, Large area scar.Abstract
For the large area scar or keloid, the treatment is still posing a great challenge. Because the invasive therapy has an unbearable pain and increased risk of side effect, like the steroid injection and cryotherapy, so the non-invasive therapy is actually the optimal choice for large area scar and children patients. Here we introduce the major modalities for the treatment of large area scar, like pressure therapy, Silicone, Onion extract, and scar massage. In addition, three aspects are recommended for the scar therapy: early use, combination use and persistent use, which is essential for a successful scar treatment.
References
Steinstraesser L, Flak E, Witte B, Ring A, Tilkorn D, Hauser J, et al. Pressure garment therapy alone and in combination with silicone for the prevention of hypertrophic scarring: randomized controlled trial with intraindividual comparison. Plast Reconstr Surg. 2011; 128: e306e-13.
Bloemen MC, van der Veer WM, Ulrich MM, van Zuijlen PP, Niessen FB, Middelkoop E. Prevention and curative management of hypertrophic scar formation. Burns 2009; 35: 463-75. http://dx.doi.org/10.1016/j.burns.2008.07.016
Macintyre L. New calibration method for I-scan sensors to enable the precise measurement of pressures delivered by 'pressure garments'. Burns 2011; 37: 1174-1181. http://dx.doi.org/10.1016/j.burns.2011.06.008
Anzarut A, Olson J, Singh P, Rowe BH, Tredget EE. The effectiveness of pressure garment therapy for the prevention of abnormal scarring after burn injury: A meta-analysis. J Plast Reconstr Aesthet Surg. 2009; 62: 77-84. http://dx.doi.org/10.1016/j.bjps.2007.10.052
Steinstraesser L, Flak E, Witte B, Ring A, Tilkorn D, Hauser J, et al. Pressure garment therapy alone and in combination with silicone for the prevention of hypertrophic scarring: Randomized controlled trial with intraindividual comparison. Plast Reconstr Surg. 2011; 128: 306-13. http://dx.doi.org/10.1097/PRS.0b013e3182268c69
Berman B, Viera MH, Amini S, Huo R, Jones IS. Prevention and management of hypertrophic scars and keloids after burns in children. J Craniofac Surg. 2008; 19: 989-1006. http://dx.doi.org/10.1097/SCS.0b013e318175f3a7
Candy LH, Cecilia LT, Ping ZY. Effect of different pressure magnitudes on hypertrophic scar in a Chinese population. Burns 2010; 36: 1234-41. http://dx.doi.org/10.1016/j.burns.2010.05.008
Ward RS. Pressure therapy for the control of hypertrophic scar formation after burn injury: A history and review. J Burn Care Rehabil. 1991; 12: 257-262. http://dx.doi.org/10.1097/00004630-199105000-00011
Li-Tsang CW, Zheng YP, Lau JC. A randomized clinical trial to study the effect of silicone gel dressing and pressure therapy on posttraumatic hypertrophic scars. J Burn Care Res. 2010; 31: 448-57. http://dx.doi.org/10.1097/BCR.0b013e3181db52a7
Lynam EC, Xie Y, Dawson R, Mcgovern J, Upton Z, Wang X. Severe hypoxia and malnutrition collectively contribute to scar fibroblast inhibition and cell apoptosis. Wound Repair Regen. 2015; 23(5): 664-71. http://dx.doi.org/10.1111/wrr.12343
Perkins K, Davey RB, Wallis KA. Silicone gel: a new treatment for burn scars and contractures. Burns Incl Therm Inj. 1983; 9: 201-204. http://dx.doi.org/10.1016/0305-4179(83)90039-6
Berman B, Flores F. Comparison of a silicone gel-filled cushion and silicon gel sheeting for the treatment of hypertrophic or keloid scars. Dermatol Surg. 1999; 25: 484- 486. http://dx.doi.org/10.1046/j.1524-4725.1999.08292.x
Eishi K, Bae SJ, Ogawa F, Hamasaki Y, Shimizu K, Katayama I. Silicone gel sheets relieve pain and pruritus with clinical improvement of keloid: possible target of mast cells. J Dermatolog Treat. 2003; 14: 248-252. http://dx.doi.org/10.1080/09546630310016808
Ahn ST, Monafo WW, Mustoe TA. Topical silicone gel: a new treatment for hypertrophic scars. Surgery 1989; 106:781-786; discussion 786-787.
Quinn KJ, Evans JH, Courtney JM, Gaylor JD, Reid WH. Nonpressure treatment of hypertrophic scars. Burns Incl Therm Inj. 1985; 12: 102-108. http://dx.doi.org/10.1016/0305-4179(85)90035-X 32 Journal of Advanced Plastic Surgery Research, 2015, Vol. 1 Feng and Xi-Qiao
Gold MH, Foster TD, Adair MA, Burlison K, Lewis T. Prevention of hypertrophic scars and keloids by the prophylactic use of topical silicone gel sheets following a surgical procedure in an office setting. Dermatol Surg. 2001; 27: 641-644.
Mustoe TA. Evolution of silicone therapy and mechanism of action in scar management. Aesthetic Plast Surg. 2008; 32: 82-92. http://dx.doi.org/10.1007/s00266-007-9030-9
Tandara AA, Mustoe TA. The role of the epidermis in the control of scarring: evidence for mechanism of action for silicone gel. J Plast Reconstr Aesthet Surg. 2008; 61: 1219-1225. http://dx.doi.org/10.1016/j.bjps.2008.03.022
O'Shaughnessy KD, De La Garza M, Roy NK, Mustoe TA. Homeostasis of the epidermal barrier layer: a theory of how occlusion reduces hypertrophic scarring. Wound Repair Regen. 2009; 17: 700-708. http://dx.doi.org/10.1111/j.1524-475X.2009.00534.x
Saulis AS, Mogford JH, Mustoe TA, Tredget EE, Anzarut A. Effect of Mederma on hypertrophic scarring in the rabbit ear model. Plast Reconstr Surg. 2002; 110: 177-183. http://dx.doi.org/10.1097/00006534-200207000-00029
Tollefson TT, Kamangar F, Aminpour S, Lee A, DurbinJohnson B, Tinling S. Comparison of effectiveness of silicone gel sheeting with microporous paper tape in the prevention of hypertrophic scarring in a rabbit model. Arch Facial Plast Surg. 2012; 14: 45-51. http://dx.doi.org/10.1001/archfacial.2011.62
Eishi K, Bae SJ, Ogawa F, Hamasaki Y, Shimizu K, Katayama I. Silicone gel sheets relieve pain and pruritus with clinical improvement of keloid: possible target of mast cells. J Dermatolog Treat. 2003; 14: 248-252. http://dx.doi.org/10.1080/09546630310016808
Maher SF, Dorko L, Saliga S. Linear scar reduction using silicone gel sheets in individuals with normal healing. J Wound Care 2012; 21: 602-609. http://dx.doi.org/10.12968/jowc.2012.21.12.602
Ahn ST, Monafo WW, Mustoe TA. Topical silicone gel: a new treatment for hypertrophic scars. Surgery 1989; 106: 781- 786.
Li-Tsang CW, Lau J, Choi J, Chan CC, Jianan L. A prospective randomized clinical trial to investigate the effect of silicone gel sheeting (Cica-Care) on post-traumatic hypertrophic scar among the Chinese population. Burns 2006; 32: 678- 683. http://dx.doi.org/10.1016/j.burns.2006.01.016
O'Brien L, Jones DJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database Syst Rev. 2013; 9: CD003826. http://dx.doi.org/10.1002/14651858.cd003826.pub3
Sandhofer M, Schauer P. The safety, efficacy, and tolerability of a novel silicone gel dressing following dermatological surgery. Skinmed 2011; 10: S1-S7.
Puri N, Talwar A. The efficacy of silicone gel for the treatment of hypertrophic scars and keloids. J Cutan Aesthet Surg. 2009; 2: 104-106. http://dx.doi.org/10.4103/0974-2077.58527
Mustoe TA, Cooter RD, Gold MH, Hobbs FD, Ramelet AA, Shakespeare PG, et al. International Advisory Panel on Scar Management. International clinical recommendations on scar management. Plast Reconstr Surg. 2002; 110: 560- 571. http://dx.doi.org/10.1097/00006534-200208000-00031
Kelemen O1, Hegedus G, Kollár L, Menyhei G, Seress L. Morphological analysis of the connective tissue reaction in linear hypertrophic scars treated with intralesional steroid or silicone-gel sheeting. A light and electron microscopic study. Acta Biol Hung. 2008; 59: 129-145. http://dx.doi.org/10.1556/ABiol.59.2008.2.1
Hanasono MM, Lum J, Carroll LA, Mikulec AA, Koch RJ. The effect of silicone gel on basic fibroblast growth factor levels in fibroblast cell culture. Arch Facial Plast Surg. 2004; 6: 88-93. http://dx.doi.org/10.1001/archfaci.6.2.88
Kuhn MA, Moffit MR, Smith PD, Lyle WG, Ko F, Meltzer DD, et al. Silicone sheeting decreases fibroblast activity and downregulates TGFbeta2 in hypertrophic scar model. Int J Surg Investig. 2000; 2: 467-474.
Van den Kerckhove E, Stappaerts K, Boeckx W, Van den Hof B, Monstrey S, Van der Kelen A, et al. Silicones in the rehabilitation of burns: a review and overview. Burns 2001; 27: 205- 214. http://dx.doi.org/10.1016/S0305-4179(00)00102-9
Lynam EC1, Xie Y, Loli B, Dargaville TR, Leavesley DI, George GA, et al. The effect of amphiphilic siloxane oligomers on fibroblast and keratinocyte proliferation andapoptosis. J Biomed Mater Res A. 2010; 95(2): 620-31.
Ho WS1, Ying SY, Chan PC, Chan HH. Use of onion extract, heparin, allantoin gel in prevention of scarring in chinese patients having laser removal of tattoos: a prospective randomized controlled trial. Dermatol Surg. 2006; 32(7): 891-6.
Willital GH1, Heine H. Efficacy of Contractubex gel in the treatment of fresh scars after thoracic surgery in children and adolescents. Int J Clin Pharmacol Res. 1994; 14(5-6): 193- 202.
Sahin MT1, Inan S, Ozturkcan S, Guzel E, Bilac C, Giray G, et al. Comparison of the effects of Contractubex® gel in an experimental model of scar formation in rats: an immunohistochemical and ultrastructural study. J Drugs Dermatol. 2012; 11(1): 74-81.
Chanprapaph K, Tanrattanakorn S, Wattanakrai P, Wongkitisophon P, Vachiramon V. Effectiveness of onion extract gel on surgical scars in Asians. Dermatol Res Pract. 2012; 2012: 212945. http://dx.doi.org/10.1155/2012/212945
Hosnuter M, Payasli C, Isikdemir A, Tekerekoglu B. The effects of onion extract on hypertrophic and keloid scars. J Wound Care 2007; 16(6): 251-4. http://dx.doi.org/10.12968/jowc.2007.16.6.27070
Cho JW, Cho SY, Lee SR, Lee KS. Onion extract and quercetin induce matrix metalloproteinase-1 in vitro and in vivo. Int J of Mol Med. 2010; 25(3): 347-52.
Ho WS, Ying SY, Chan PC, Chan HH. Use of onion extract, heparin, allantoin gel in prevention of scarring in Chinese patients having laser removal of tattoos: A prospective randomized controlled trial. Dermatol Surg. 2006; 32(7): 891- 6. http://dx.doi.org/10.1097/00042728-200607000-00004
Morien A, Garrison D, Smith NK. Range of motion improves after massage in children with burns: a pilot study. J Bodyw Mov Ther. 2008; 12(1): 67-71. http://dx.doi.org/10.1016/j.jbmt.2007.05.003
Roh YS, Cho H, Oh JO, Yoon CJ. Effects of skin rehabilitation massage therapy on pruritus, skin status, and depression inburn survivors. Taehan Kanho Hakhoe Chi. 2007; 37(2): 221-6.
Field T, Peck M, Hernandez-Reif M, Krugman S, Burman et al. Postburn itching, pain, and psychological symptoms are reduced with massage therapy. J Burn Care Rehabil. 2000; 21: 189-93. http://dx.doi.org/10.1097/00004630-200021030-00002
Cho YS, Jeon JH, Hong A, Yang HT, Yim H, Cho YS, et al. The effect of burn rehabilitation massagetherapy on hypertrophic scar after burn: a randomized controlled trial. Burns 2014; 40(8): 1513-20. http://dx.doi.org/10.1016/j.burns.2014.02.005 Most Current Therapy for Large Area of Hypertrophic Scar and Keloid Journal of Advanced Plastic Surgery Research, 2015, Vol. 1 33
Chan MW, Hinz B, McCulloch CA. Mechanical induction of gene expression in connective tissue cells. Methods Cell Biol. 2010; 98: 178-205. http://dx.doi.org/10.1016/S0091-679X(10)98008-4
Bhadal N, Wall IB, Porter SR, Broad S, Lindahl GE, Whawell S, et al. The effect of mechanical strain on protease production by keratinocytes. Br J Dermatol. 2008; 158: 396-8. http://dx.doi.org/10.1111/j.1365-2133.2007.08341.x
Kaada B, Torsteinbo O. Increase of plasma beta-endorphins in connective tissue massage. Gen Pharmacol. 1989; 20: 487-9. http://dx.doi.org/10.1016/0306-3623(89)90200-0
Rahmani N, Hashemi SA, Ehteshami S. Vitamin E and its clinical challenges in cosmetic and reconstructive medicine with focus on scars; a review. J Pak Med Assoc. 2013; 63(3): 380-2.
Hayashi T, Furukawa H, Oyama A, Funayama E, Saito A, Murao N, et al. A new uniform protocol of combined corticosteroid injections and ointmentapplication reduces recurrence rates after surgical keloid/hypertrophic scarexcision. Dermatol Surg. 2012; 38(6): 893-7. http://dx.doi.org/10.1111/j.1524-4725.2012.02345.x
Monstrey S, Middelkoop E, Vranckx JJ, Bassetto F, Ziegler UE, Meaume S, et al. Updated scar management practical guidelines: non-invasive and invasive measures. J Plast Reconstr Aesthet Surg. 2014; 67(8): 1017-25. http://dx.doi.org/10.1016/j.bjps.2014.04.011
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