Monthly Archives: January 2013

Pressure Treatment in Scar Healing

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compression garment for torso When an imbalance occurs between the anabolic and catabolic phases of the healing process in a wound somtimes more collagen is produced than the is degradation of collagen in the healing process. This results in the scar growing in all directions. The scar is elevated above the skin and remains hyperemic. This is excessive scar tissue is medically classified either as a keloid or a hypertrophic scar.

There are several nonsurgical options that are utilized to treat of these abnormal type scars. Pressure is a treatment that has demonstrated a level of success in some patients. The use of pressure to treat scars is thought to decrease tissue metabolism and increase collagen breakdown within the wound. Pressue is sometimes used preventatively in patients who have a history of keloid or hypertrophic scarring.

There are various different methods for administering pressure to facilitate this type of treatment including:
• elastic bandages (eg, Ace wraps) for the extremities
• thromboembolic stockings for the feet
• Isotoner-type gloves for the hands.
• custom-fitted compression garments can be used for the more difficult areas ( lower neck and torso).

ACE wraps or stockings are not useful for areas such as the head and face this is primarily because of discomfort and patient compliance Is not likely. Optimal results with latex-free compression garments are achieved usually in 6 -12 months during the maturation of the wound.

Do’s and Dont’s of Reducing Scars

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Scars are made up of the protein collagen which is found in the second layer of your skin. When the integrity of the skin is compromised through injury beyond a superficial this layer must repair itself. It is in the body’s only healing process that scarring takes place.

The key to preventing scars is to break up the collagen that collects in the dermal tissue during the healing process. When the collagen does not bond to your skin’s top layer scar formation is reduced.
It is possible to lighten and revision an old scar, your best approach is to limit scars before they form.

DON’T

DON’T Use Hydrogen Peroxide: While the solution cleans, it also destroys new skin cells that immediately begin to grow in the wound. This slows down the healing process and increased the risk of scars forming.

DON’T Treat with Vitamin E. Recent studies show that it, like hydrogen peroxide, vitamin E impairs healing. One-third of people will also develop an allergic reaction to vitamin E.

DON’T Expose To Sun: Ultraviolet rays slow the healing process and can discolor the scar. The sun stimulates the cells that produce pigment, and when your skin is sensitive and healing, it’s prone to discoloration. Cover the wounded skin with a minimum SPF blocker of higher than 15.

DO

DO Cover A Cut: Should a cut “breathe,” or does it require a Band-Aid over it? When you don’t cover a cut, it dries out and scabs over. Scabbing is not a good thing; it only presents a barrier to healing. Treating cuts with Neosporin (or another antibiotic cream) and covering with a band-aid for a week in aids the healing and prevents infections and minor skin wounds. Do this until new skin begins to grow.

DO Place Pressure On Cut:Use special pads that serve to flatten scars. These scars don’t allow the collagen to pop up above the skin when a wound is healing. Some examples of these pads are: Curad Scar Therapy Cosmetic Pads, ReJuveness Pure Silicone Sheeting, Scar Fx and Sypres Scar Sheets.

DO Massage The Wound: Once new skin has grown, massage the mark. Massaging helps break down the dense bonds of collagen. If they are not allowed to take hold, the appearance of the scar will be much less noticeable, or may not form at all. Massage – with lotion – in a circular motion for 15 to 30 seconds a few times a day.

Understanding Burn Scars

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Man's severe burn scar revised

Quality of Life and Scarring
Scars are an inevitable part of most peoples’ lives. There is nearly a person on earth who does not have some type of scarring. Severe scarring though affects individual’s quality of life and often decreases their self image. Self image is so much a part of person’s happiness and success that medical science has gone a long way to reduce the adverse effects of scarring no matter how the scar occurred.

Uniqueness of Burn Scars
Burn scars are often very traumatic, disfiguring and they are the hardest to treat through revision. When a person has significant scarring from burns there is often associated trauma that takes priority prior to addressing the issue of scarring. Life saving measures, infections and other complications take persistent over issues that will arise from burn scars.

Pain management is very vital because the pain from burn is one of the most excruciating types of pain one can bear. Where healthy skin and burned skin intersect pain can be a life time issue. Psychological issues such as severe depression are a compounding factor for people disfigured from burns. Scar tissue does not maintain the suppleness or laxity of healthy skin. As scars mature the fibrotic tissue composing it shrink and becomes more rigid. The location of such scars near joints of the hands, feet, limbs and neck can adversely affect the mobility of the joints.

Another issue with burn scarring is the need for skin grafting and the associated healing and scarring with those procedures. In addition burn scars because of the severity often are comprised of a combination of types of scars. This includes:

• Hypertrophic scarring
• Hypotrophic scarring
• Hyper-pigmentation scarring
• Keloid scarring

The Treatment
Traumatic burn scars necessarily are to be treated in absolute sterile clinical conditions, usually in specialty “burn centers”. Pain management is one of the important reasons as well as reducing the risk of infection to a minimum. Topical numbing creams do not penetrate burn scar tissue sufficiently and medical needling must be done under general anesthetic in most cases. Treatment for burns is a long process that can easily reach up to one year and intervals of specialized care are scheduled through a close monitoring process. It is during these interval medical treatments that the patient and doctor can discuss the possibility or revisioning scars.

Scar Revision Primer

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The skin is the largest organ of the body covering it in its’ entirety. Serving as the body’s protective barrier it also makes the skin the most vulnerable part of the body. There is probably no human on earth whose skin does not have a mark or scarring from some incident of disorder. The process of healing from injury or surgery leaves scarring on the skin. This can be from the tiniest of insect bites or blemish to a life saving surgery.
Breast Scars Revision

The amount of scarring may be determined by the size, depth, and location of the wound; the age of the person; heredity; and skin characteristics including color (pigmentation). No scar can be removed completely. The degree of improvement will depend on variables such as the direction and size of the scar, the age of the person, skin type and color, and hereditary factors that may precondition the extent of the healing process.

Scars can be a lasting a giveaway of cosmetic surgery. Thus, one of the concerns for many patients when they consider elective surgery is the possibility of scarring. Scar revision can help to mitigate the appearance of a scar through several options. A doctor can offer a topical to help a scar to fade and, in some cases, minimally invasive procedures or even perform revision surgery to help obscure a scar.

While there is no procedure that allows for complete removal of a scar, there are several types of procedures that improve the appearance of your scar. Scar revision surgery treatment methods include injections, skin grafting, Z-plasty, laser and lightening techniques that can drastically diminish the appearance of your scar.

There are several things to consider before undergoing a procedure to help improve the appearance of a scar. If the scar is a problem, you don’t smoke and you are otherwise healthy, scar revision may be an option. Also, a doctor can help you determine if you have any acne or other problems that may impact an attempt to improve the scar. Patients need to have realistic expectations. While scar revision can help minimize the aesthetics of the scar, it usually cannot remove the scar completely.