Management of Hypertrophic Scars and Keloids

Abstract

Plastic Surgery| January 01 2003 Management of Hypertrophic Scars and Keloids AAP Grand Rounds (2003) 9 (1): 9–10. https://doi.org/10.1542/gr.9-1-9-a Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Management of Hypertrophic Scars and Keloids. AAP Grand Rounds January 2003; 9 (1): 9–10. https://doi.org/10.1542/gr.9-1-9-a Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: hypertrophic cicatrix, keloid Source: Mustoe TA, Cooter RD, Gold MH, et al. International clinical recommendations on scar management. Plast Reconstr Surg. 2002;110:560–571. An international group of authors presents a very extensive systematic review of the clinical literature on the prevention and treatment of abnormal hypertrophic and keloid scars. They provide evidence-based recommendations and, where studies are insufficient, a consensus view of the best practices for prevention and treatment based on a standard scar classification scheme. Preventative recommendations included meticulous surgical technique, hypoallergenic taping, and silicone gel sheeting. Non-surgical scar treatments include triamcinolone injections, cryotherapy, silicone gel sheeting, pressure sheeting, and radiation therapy. Surgical treatment only for hypertrophic scars and keloids results in a recurrence rate of 45–100%. Additional therapy with steroid injections decreases recurrence rates to between 9 and 50%. Recurrence rates after adding radiation therapy post-operatively range from 50 to 100%, while radiation therapy used preoperatively can reduce keloid recurrence to 10%. While older carbon and argon lasers failed to demonstrate long-term improvement, several promising modalities include a variety of different lasers of the erbium and flash lamp types. There is emerging evidence that injections of interferon, 5-flurouracil and bleomycin may result in significant scar reduction. Based on the graded review of evidence the following management is recommended: Hypertrophic scars and keloid formation after trauma or surgery are a major challenge and may only be partially responsive to treatment. This report offers a very good survey of available treatment modalities and rates them based on the available evidence. Most exciting are the promising new medical therapies including interferon,1 bleomycin, and 5-flurouracil injections.2 Experimental work in animals with transforming growth factors and other modifiers of collagen synthesis may also have eventual clinical applicability.3 You do not currently have access to this content.