Clinical practice guideline for pediatric scar prevention and treatment (2025 edition)

Children constitute a key population for scar prevention and treatment, attributed to the unique features of their skin's physiological structure and psychosomatic growth. Current approaches for preventing and treating pediatric scars are formulated with reference to relevant consensuses and guidelines for adult, failing to fully consider the specific characteristics of pediatric scars and their special needs of growth and development. As a result, some strategies for prevention and treatment remain controversial. To address this limitation, the Chinese Burn Association brought together domestic and international experts in the field of scar prevention and treatment from relevant disciplines. Guided by evidence-based medicine, referring domestic and international literature, and combining the clinical experience of specialist physicians, the Clinical practice guideline for pediatric scar prevention and treatment (2025 edition) was finally developed after consultations on clinical issues and then multiple rounds of expert meetings for discussions. This guideline outlines 20 recom-mendations addressing 10 key issues in pediatric scar prevention and treatment, and discusses the controversial issues in this field, aiming to provide scientific guidance for the entire process of prevention, treatment, and rehabilitation of scars in children aged 1-14 years.

Objective: To assess the quality of the clinical practice guideline for diagnosis, treatment and prevention of pulmonary thromboembolism, 2018 in China, providing the references for updating and developing clinical practice guidelines of this field in the future. Methods: The quality of the clinical practice guideline for diagnosis, treatment and prevention of pulmonary thromboembolism, 2018 in China was assessed using the internationally recognized instrument Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ). AGREE Ⅱ instrument consisted of 23 items in six domains, followed by two overall assessment items. Each item was scored from 1 to 7. The final overall guideline quality considered all domain items. Results: The scores of the six AGREE Ⅱ domains were: Scope and purpose 76.4%, Stakeholder involvement 55.6%, Rigor of development 78.1%, Clarity and presentation 83.3%, Applicability 55.2%, and Editorial independence 66.7%. The guideline was recommended for clinical use. Among the 101 recommendations, recommendations based on Levels High, Moderate and Low evidence accounted for 7 (6.9%), 31 (30.7%) and 63 (62.4%), respectively. Conclusion: The methodological quality of the clinical practice guideline for diagnosis, treatment and prevention of pulmonary thromboembolism, 2018 in China was great, but the levels of evidence were not high. More efforts were urgently required to improve in Stakeholder involvement and applicability. Especially corresponding economic research evidence, as well as preferences of patients and the public should be considered in the future development of clinical practice guidelines.

Traumatic scars not only affect local appearance and function, but also may be accompanied by pain, itching, and even psychological problems, which seriously affect the quality of patients' life. The prevention and treatment of scars are still quite challengeable for plastic and cosmetic surgery. Recently, photoelectric therapy and radio-frequency technology have brought breakthroughs in the clinical prevention and treatment of traumatic scars due to the developments of theory and practice on selective photothermolysis and fractional photothermolysis. Based on the analysis and summary of experience of treatment of traumatic scars with photoelectric therapy and radiofrequency technology in the past 5 years, the experts in the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, together with expert consensus on treatment of scar using laser at home and abroad, organize the experts in the field of scar management from different regions in China to discuss and write the consensus on treatment of skin traumatic scars with photoelectric therapy and radio-frequency technology (2018 version). This consensus is suitable for currently medical environment in China and aimed to provide standardized protocols for the treatment of skin traumatic scars in clinic.

Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK

Electrospinning is a promising method for the rapid and cost-effective production of nanofibers from a wide variety of polymers given the high surface area morphology of these nanofibers, they make excellent wound dressings, and so have significant potential in the prevention and treatment of scars. Wound healing and the resulting scar formation are exceptionally well-characterized on a molecular and cellular level. Despite this, novel effective anti-scarring treatments which exploit this knowledge are still clinically absent. As the process of electrospinning can produce fibers from a variety of polymers, the treatment avenues for scars are vast, with therapeutic potential in choice of polymers, drug incorporation, and cell-seeded scaffolds. It is essential to show the new advances in this field; thus, this review will investigate the molecular processes of wound healing and scar tissue formation, the process of electrospinning, and examine how electrospun biomaterials can be utilized and adapted to wound repair in the hope of reducing scar tissue formation and conferring an enhanced tensile strength of the skin. Future directions of the research will explore potential novel electrospun treatments, such as gene therapies, as targets for enhanced tissue repair applications. With this class of biomaterial gaining such momentum and having such promise, it is necessary to refine our understanding of its process to be able to combine this technology with cutting-edge therapies to relieve the burden scars place on world healthcare systems.

According to the data of seventh national census in China, the elderly population (≥60 years old) accounts for 18.7% (260.4 million) of the total population in 2020. Among them, 30% are diabetes (78.13 million, and more than 95% being type 2 diabetes). Diabetic complications caused by poor glycemic control are the main risk factors influencing the healthy and survival of the elderly, and thus, diabetes prevention and treatment has been to be one of the key actions of Healthy China (2019-2030). The present guideline-"Clinical guidelines for prevention and treatment of type 2 diabetes mellitus in the elderly in China (2022 edition)" is formulated on the basis of the " Expert consensus of the diagnosis and treatment measures for Chinese elderly patients with type 2 diabetes (2018 edition)" and summarizes the domestic and foreign related guidelines for elderly diabetes and research information. The aim of the guide is to optimize the elderly diabetes prevention and control concept, to promote the implementation of standardized clinical prevention, diagnosis and treatment strategy and to improve the level of overall management of diabetes in the elderly.

Numerous treatments have been described for the treatment and prevention of scars, but the optimal management strategy is yet to be defined. In this article we present and evaluate new opportunities for the treatment and prevention of hypertrophic scars, keloids, and atrophic scars. Clinical, animal, and in vitro studies reporting novel techniques for the treatment and prevention of scarring were identified primarily from the MEDLINE/PubMed database. We found that a variety of new treatments exist with potential effectiveness for the treatment of hypertrophic scars and keloids, including interferon, imiquimod 5% cream, tacrolimus, botulinum toxin, 5-fluorouracil, bleomycin, and verapamil. For atrophic scars, different types of lasers represent modern treatment modalities with satisfactory results. Several agents have been reported to be effective in reducing scarring in vitro and in animal studies, representing potential opportunities for scarring management. We conclude that several novel modalities may be potential therapies for scarring.

Exploring facilitators and barriers to healthcare professionals’ use of clinical guidelines to prevent surgical site infection in Rwandan hospitals

The use of fluid silicone gels in the prevention and treatment of hypertrophic scars: a systematic review and meta-analysis

Scar formation is a common physiological process that occurs after injury, but in some cases, pathological scars can develop, leading to serious physiological and psychological effects. Unfortunately, there are currently no effective means to intervene in scar formation, and the structural features of scars and their unclear mechanisms make prevention and treatment even more challenging. However, the emergence of nanotechnology in drug delivery systems offers a promising avenue for the prevention and treatment of scars. Nanomaterials possess unique properties that make them well suited for addressing issues related to transdermal drug delivery, drug solubility, and controlled release. Herein, we summarize the recent progress made in the use of nanotechnology for the prevention and treatment of scars. We examine the mechanisms involved and the advantages offered by various types of nanomaterials. We also highlight the outstanding challenges and questions that need to be addressed to maximize the potential of nanotechnology in scar intervention. Overall, with further development, nanotechnology could significantly improve the prevention and treatment of pathological scars, providing a brighter outlook for those affected by this condition.

Numerous lasers and other energy-based devices have been explored in the treatment of scarring. The following review of the literature examines types of post-operative scarring, features that distinguish scars from normal skin, the pathogenesis of these skin changes, the evidence for laser and other energy-based modalities in the treatment of postsurgical scars, scar prevention using lasers, and future directions for therapy. Utilization of laser and light-based therapies can induce scar remodeling and significantly improve scar appearance. Pulse dye lasers have been the mainstay in laser-based scar therapy. Fractional lasers have provided a major breakthrough in the treatment of scars in all skin types. Based on current research, the most efficacious laser therapies include pulsed dye laser for erythematous, hypertrophic, or keloidal scars; fractional non-ablative lasers for atrophic, hypopigmented scars in almost all skin types; and fractional ablative lasers for patients and clinicians who wish to maximize scar improvements while reducing downtime relative to fully ablative laser technologies.

Purpose:To develop clinical practice guidelines (CPGs) for prevention, diagnosis, treatment and follow-up of ocular injuries caused by exposure to mustard gas.Methods:The clinical questions were designed by the guideline team. Websites and databases including National Guidelines Clearinghouse, National Institute for Clinical Excellence, Cochrane, and PubMed were searched to find related CPGs and explore possible answers to the clinical questions. Since there were no relevant CPGs in the literature, related articles in Persian and English languages were extracted. Each article along with its level of evidence was summarized. Additionally, hand search was performed by looking the reference list of each article. Consequently, recommendations were developed considering the clinical benefits and side effects of each therapeutic modality. The recommendations were re-evaluated in terms of customization criteria. All recommendations along with the related evidence were scored from 1 to 9 by experts from all medical universities of Iran. The level of agreement among the experts was evaluated by analyzing the given scores.Results:The agreement was achieved for all recommendations. The experts suggested a number of minor modifications which were applied to the recommendations. Finally, CPGs were developed with 98 recommendations under three major domains including prevention of injury, diagnosis and management of the acute and delayed-onset mustard gas ocular injuries.Conclusion:Considering the lack of CPGs for the prevention, diagnosis, and management of mustard gas-induced keratitis, these recommendations would be useful to prevent the serious ocular complications of mustard gas and standardize eye care services to the affected individuals.

Cancer-associated thrombosis (CAT) is an important prognostic factor for an increasing number of cancer patients. Understanding of CAT among cancer care providers has grown in recent years, and guidelines for the prevention and treatment of CAT have been published in Japan and around the world. In this article, we introduce these major guidelines and discuss differences we identified between the Japanese guidelines and those of other countries, with a focus on problems and issues. Insurance coverage of low-molecular-weight heparin and indications for primary prevention with direct oral anticoagulants in particular require urgent consideration.

Hypertrophic scars and keloids resulting from surgery, burns, trauma and infection can be associated with substantial physical and psychological distress. Various non-invasive and invasive options are currently available for the prevention and treatment of these scars. Recently, an international multidisciplinary group of 24 experts on scar management (dermatologists; plastic and reconstructive surgeons; general surgeons; physical medicine, rehabilitation and burns specialists; psychosocial and behavioural researchers; epidemiologists; beauticians) convened to update a set of practical guidelines for the prevention and treatment of hypertrophic and keloid scars on the basis of the latest published clinical evidence on existing scar management options. Silicone-based products such as sheets and gels are recommended as the gold standard, first-line, non-invasive option for both the prevention and treatment of scars. Other general scar preventative measures include avoiding sun exposure, compression therapy, taping and the use of moisturisers. Invasive treatment options include intralesional injections of corticosteroids and/or 5-fluorouracil, cryotherapy, radiotherapy, laser therapy and surgical excision. All of these options may be used alone or as part of combination therapy. Of utmost importance is the regular re-evaluation of patients every four to eight weeks to evaluate whether additional treatment is warranted. The amount of scar management measures that are applied to each wound depends on the patient's risk of developing a scar and their level of concern about the scar's appearance. The practical advice presented in the current guidelines should be combined with clinical judgement when deciding on the most appropriate scar management measures for an individual patient.

Scars formed by various injuries can affect the appearance and psychology of patients. Therefore, more and more people pay attention to the prevention and treatment of scar. With the development of the autologous fat grafting, it has been gradually applied to the prevention and treatment of scar. At present, it has been confirmed by scholars that the autologous fat grafting could be an effective method to prevent and treat scar from basic research and clinical practice. At the same time, the deficiency of autologous fat grafting in the prevention and treatment of scar was also pointed out. This paper reviews the application, mechanism, and deficiency of autologous fat grafting in scar prevention and treatment.