Scar Management - ECAB

Author: Khunger> Niti  

Publisher: Elsevier Health Sciences APAC‎

Publication year: 2013

E-ISBN: 9788131231715

P-ISBN(Paperback): 9788131225059

Subject: R751.05 dermiatrics

Keyword: 皮肤病学与性病学

Language: ENG

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Description

A number of scar revision techniques can be utilized to treat specific types of scars, in combination with each other or with adjunctive therapies to achieve optimal results. Pathological conditions like hypertrophic scars and keloids are still challenging. Though a number of therapies exist to treat keloids, such as intralesional steroids and anti-metabolites, cryosurgery, to name a few, none are definitive in treatment. Understanding the molecular basis of keloids may lead to development of new therapies. Striae, also known as 'stretch marks', are extremely common, disfiguring and a real challenge to treat. Management of striae is a neglected field of research. Except for topical retinoids, the efficacy satisfactorily. Current treatment options include chemical peels, lasers and collagen induction therapy, with a tendency towards active intervention. However, studies are necessary to determine treatment strategies which produce results that are effective with minimal adverse effects. Post-acne scarring is one of the most common causes of facial scars, causing considerable cosmetic disability. Acne is a common skin disorder, unfortunately affecting a large number of teenagers. Usually patients have a combination of different types of scars; hence no single modality is useful. A combination of procedures is generally required for a satisfactory cosmetic outcome. The use of fractional lasers is gaining importance, as it is a minimally invasive procedure as compared to aggress

Chapter

Wound Healing

Pathophysiology of Wound Healing1

Inflammatory Phase

Proliferative Phase

Remodeling Phase

Factors Affecting Wound Healing

Scars: Prevention and Care

What Can be Labeled as a Satisfactory or Unsatisfactory Scar? (Figures 1 and 2)

Classification of Scars

Preventive Steps for Better Scar Outcome

Wounds and Their Management

Planning of Surgical Incisions

Physical Properties of Skin and Planning of Incision

Technique of Wound Closure

Suture Material and Suturing Technique

Care and Management of Unfavorable Scar

Non-Surgical

Surgical

Pressure Therapy

Occlusive Dressings (Figure 14)

Scar Massage and Splintage

Corticosteroids

Onion Extract Gels

Laser Therapy

Radiotherapy

Cryotherapy

Inhibitors of Gene Transfer

Anti-Inflammatory Agents

Antihistamines

Calcium Antagonists

Skin Fillers

Tattooing

Surgery for Scar Improvement

Technique of Z-plasty

Trap Door Scar

Dermabrasion

Tissue Expansion (Figures 19a-c and 20a-c)

Scar Management Guidelines in Indian Context

Global Update in Wound Healing and Scar Management

Fetal Wound Healing

New Research Products for Scar Management

Altering Physical Properties of Collagen and its Effect on Hypertrophic Scar and Keloid Formation

Summary

Multimodality Scar Management Program-An Approach

Introduction

Objective of Scar Management

Patient Information and Evaluation

Does the Patient Really Need Scar Revision?

Is the Anxiety of the Patient Disproportionate to the Appearance of the Scar?

Is the Presence of the Scar Causing Professional or Social Impairment?

Scar Assessment

Update on Current Treatment Options

Conservative Techniques/Non-Surgical Techniques

Topical Therapy

Allium Cepa or Onion Extract

Topical Steroids

Topical Hypopigmenting Agents

Topical Psoralens

Topical Vitamin E

Topical Retinoids

Topical Imiquimod

Polyurethane Dressing

Silicone Gels and Sheets

Intralesional Therapies

Intralesional Steroids

Alternative Intralesional Therapies

Pressure Therapy

Resurfacing Techniques

Chemical Peels

Cryotherapy

Dermabrasion and Microdermabrasion

Lasers for Scar Revision

Ablative Laser Resurfacing

Non-Ablative Lasers

Elevation Techniques

Scar Augmentation by Fillers, Fat or Dermal Matrix

Subcision

Punch Excision and Grafting Techniques

Excisional Techniques

Scar Excision and Suturing, Serial Excision

Scar Irregularization Techniques

Broken Line Scar Revision Techniques-Z-Plasty, W-Plasty, Geometric Broken Line

Multimodality Approach to Management

Elevated Scars

Depressed Scars

Hyperpigmented Scars

Depigmented Scars

Hypertrophic Scars and Keloids

Wide Scars

Contracted Scars

Newer Options

Collagen Induction Therapy (Microneedling, Dermaroller)

Systemic Topiramide

Summary

Striae Distensae

Synonyms

Introduction

Etiology

Pregnancy

Puberty

Hereditary

Obesity

Cushing's Syndrome

Body-building

Anorexia Nervosa

Systemic Corticosteroids

Potent Topical Corticosteroids

Disorders of Connective Tissue

Following Augmentation Surgeries

Others

Risk Factors

Pathophysiology

Histopathology

Clinical Features

Grading

Differential Diagnosis

Investigations

Update on Current Treatment Options

Fresh Striae

Topical Creams and Emollients

Peels

Injections

Electrophonophoresis

Alternative Medicine

Home Remedies

Anecdotal

Mature Striae

Microdermabrasion

Collagen Induction Therapy (Dermarollers)

Laser Surgery

Plastic Surgery

Prognosis

Update in Indian Context

Personal Clinical Experience

Summary

Acne Scar Management-A Review of Current Trends

Pre-Operative Work-Up

Punch Elevation10

Punch Excision11

Punch Grafting

Subcision12

TCA Chemical Reconstruction13-15

Resurfacing

Fractional Lasers

Intralesional Triamcinolone Acetonide

Silicone Gel Dressings

Fillers

Chemical Peels4

Adjunctive Treatment

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