Recent Understandings of Biology, Prophylaxis and Treatment Strategies for Hypertrophic Scars and Keloids

Ho Lee; Yong Jang

doi:10.3390/ijms19030711

Predictors of the recurrence of surgically removed previous caesarean skin scars at caesarean section: A retrospective cohort study

Scars Burns & Healing ◽

10.1177/20595131211023388 ◽

2021 ◽

Vol 7 ◽

pp. 205951312110233 ◽

Cited By ~ 1

Author(s):

İhsan Bağlı ◽

Rei Ogawa ◽

Sait Bakır ◽

Cuma Taşın ◽

Ayhan Yıldırım ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Caesarean Section ◽

Retrospective Cohort ◽

Treatment Strategies ◽

Surgical Excision ◽

Hypertrophic Scars ◽

Group 2 ◽

Risk Factor For Recurrence ◽

Group 1

Background: Caesarean skin scars (CSS; hypertrophic scars and keloids) are very stressful for women and treatment strategies vary. However, there is a lack of knowledge about the outcome of surgical excision of CSS during caesarean section (CS). The study aims to determine the rate of recurrence and risk factors of recurrence for surgically removed CSS. Method: This is a retrospective cohort study that used STROBE guidelines. Pfannenstiel incisions of 145 patients were evaluated. Patients were divided into two groups: recurred (group 1, n = 19) and non-recurred group (group 2, n = 126). The groups were compared. Results: The rate of recurrence of CSS was 13% in the total cohort (19/145), one of the main outcomes of the study. While emergency CS was performed for 12 patients in group 1 (63%), CS was carried out in 25 patients in group 2 (20%); this difference was significant ( P = 0.001). Before surgery, white blood cell and neutrophil counts were significantly higher in group 1 ( P = 0.014 and P = 0.023, respectively). There were 11 dark-skinned women (26%; Fitzpatrick type 4) in group 1 and 31 (74%) in group 2. This difference was statistically significant ( P = 0.031). As the other main outcome, emergency CS could be accepted as a risk factor for recurrence in the multivariate regression analysis ( P = 0.060; odds ratio = 5.07; 95% confidence interval = 0.93–17.51). Conclusion: The rate of recurrence of surgically removed previous CSS at CS is promising without adjunct therapy. Emergency CS was found to be a risk factor for recurrence. Lay Summary Background Caesarean skin scars (CSS; hypertrophic scars and keloids) are very stressful and are generally itchy and painful for women. Treatment strategies vary. However, there is a lack of knowledge about the outcome of only surgical excision of CSS scars during caesarean section (CS). The issue being explored There are few data in the literature for CSS in the lower abdomen. These scars can be removed during the second or third CS, but the results are not known exactly. How was the work conducted? In our clinic, 145 patients with CSS were given a CS and their scars were removed at the same time. While most of these scars were reported as hypertrophic by pathological examination, some were reported as keloid. At the earliest, one year after surgery, the rate of recurrence was found to be 13%. What we learned from the study Asymptomatic patients who are planning another pregnancy and do not want to receive any other radiotherapy or steroid injection therapy can wait to remove their CSS at the next CS, especially elective CS with or without adjunct therapy. Emergency CS was found to be a risk factor for the recurrence of these scars.

Download Full-text

Treatment Strategies for Hypopigmentation in the Context of Burn Hypertrophic Scars

Plastic & Reconstructive Surgery Global Open ◽

10.1097/gox.0000000000001642 ◽

2018 ◽

Vol 6 (1) ◽

pp. e1642 ◽

Cited By ~ 4

Author(s):

Bonnie C. Carney ◽

Jacqueline P. McKesey ◽

Dean S. Rosenthal ◽

Jeffrey W. Shupp

Keyword(s):

Treatment Strategies ◽

Hypertrophic Scars

Download Full-text

Keloids and hypertrophic scars: Review and treatment strategies

Seminars in Cutaneous Medicine and Surgery ◽

10.1016/s1085-5629(99)80040-6 ◽

1999 ◽

Vol 18 (2) ◽

pp. 159-171 ◽

Cited By ~ 124

Author(s):

Sandy S. Urioste ◽

Kenneth A. Arndt ◽

Jeffrey S. Dover

Keyword(s):

Treatment Strategies ◽

Hypertrophic Scars

Download Full-text

Fibroblasts During Hypertrophic Scar Formation and Resolution

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100072587 ◽

1973 ◽

Vol 31 ◽

pp. 428-429

Author(s):

C. W. Kischer

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Cell Proliferation ◽

Fine Structure ◽

Metabolic Activity ◽

Hypertrophic Scar ◽

Normal Skin ◽

Ground Substance ◽

Hypertrophic Scars ◽

Scanning Electron

The morphology of the fibroblasts changes markedly as the healing period from burn wounds progresses, through development of the hypertrophic scar, to resolution of the scar by a self-limiting process of maturation or therapeutic resolution. In addition, hypertrophic scars contain an increased cell proliferation largely made up of fibroblasts. This tremendous population of fibroblasts seems congruous with the abundance of collagen and ground substance. The fine structure of these cells should reflect some aspects of the metabolic activity necessary for production of the scar, and might presage the stage of maturation.A comparison of the fine structure of the fibroblasts from normal skin, different scar types, and granulation tissue has been made by transmission (TEM) and scanning electron microscopy (SEM).

Download Full-text

A Language Approach to Treatment of Phonological Process Problems

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1401.47 ◽

1983 ◽

Vol 14 (1) ◽

pp. 47-53 ◽

Cited By ~ 5

Author(s):

Edna Carter Young

Keyword(s):

Treatment Strategies ◽

Phonological Process ◽

Conceptual Skills

Treatment strategies and therapy materials for remediation of phonological process problems are described. This approach uses the child's language and conceptual skills to facilitate the use of the sound contrasts necessary to convey meaning to the listener.

Download Full-text

Multidisciplinary Evidence to Treat Bilingual Individuals with Aphasia

Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations ◽

10.1044/cds15.3.66 ◽

2008 ◽

Vol 15 (3) ◽

pp. 66-72 ◽

Cited By ~ 1

Author(s):

José G. Centeno

Keyword(s):

Stroke Rehabilitation ◽

Culturally Diverse ◽

Treatment Strategies ◽

The United States ◽

Intervention Strategies ◽

Steady Increase ◽

Clinical Procedures ◽

Bilingual Speakers ◽

Aphasic Clients

Abstract The steady increase in linguistic and cultural diversity in the country, including the number of bilingual speakers, has been predicted to continue. Minorities are expected to be the majority by 2042. Strokes, the third leading cause of death and the leading cause of long-term disability in the U.S., are quite prevalent in racial and ethnic minorities, so population estimates underscore the imperative need to develop valid clinical procedures to serve the predicted increase in linguistically and culturally diverse bilingual adults with aphasia in post-stroke rehabilitation. Bilingualism is a complex phenomenon that interconnects culture, cognition, and language; thus, as aphasia is a social phenomenon, treatment of bilingual aphasic persons would benefit from conceptual frameworks that exploit the culture-cognition-language interaction in ways that maximize both linguistic and communicative improvement leading to social re-adaptation. This paper discusses a multidisciplinary evidence-based approach to develop ecologically-valid treatment strategies for bilingual aphasic individuals. Content aims to spark practitioners' interest to explore conceptually broad intervention strategies beyond strictly linguistic domains that would facilitate linguistic gains, communicative interactions, and social functioning. This paper largely emphasizes Spanish-English individuals in the United States. Practitioners, however, are advised to adapt the proposed principles to the unique backgrounds of other bilingual aphasic clients.

Download Full-text

Perceived Voice Disorders in Older Adults and Impact on Social Interactions

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00059 ◽

2021 ◽

pp. 1-8

Author(s):

Connie K. Porcaro ◽

Clare Singer ◽

Boris Djokic ◽

Ali A. Danesh ◽

Ruth Tappen ◽

...

Keyword(s):

Older Adults ◽

Social Interactions ◽

Social Engagement ◽

Leisure Activities ◽

Treatment Strategies ◽

Voice Disorders ◽

Community Dwelling ◽

Vocal Performance ◽

Older Individuals ◽

Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

Download Full-text