Abstract
BackgroundBurn scars frequently tend to have pathological discolorations, which is manifested in the development of persistent erythema. Affected people suffer from psychological and physiological issues when they are restricted or rejected in their daily life. In this context, medical needling seems to be an efficient therapy for erythematous scars with a relatively low-risk rate of postoperative complications. Study research has already shown significant improvements in the scar quality with reference to the parameters “moisture and transepidermal water loss.” Clinical data is up-to-date and provides an innovative therapy outcome of scar treatment with medical needling.ObjectiveThe aim of our study was to examine the influence of medical needling on the pathological and persistent erythema of hypertrophic burn scars. By means of reliable measurement methods, we were able to prove positive and sustainable outcomes for normal and healthy skin. The patient cohort included 20 patients with an average age of 34.63 years. Our examinations involved scars that were at least two years old and had healed by secondary intent. Every scar showed the pathological values of persistent erythema according to the participation requirements.MethodsFor the practical implementation of medical needling or percutaneous collagen induction (PCI), we used a roller covered with needles of 3 mm length. The needling device is rolled over the scar alternatively in a vertical, horizontal, and diagonal orientation. Multiple micro-wounds at a close distance cause intradermal bleeding, which evokes modified skin regeneration provoked by the effects of medical needling. Every patient has been followed up for 12 months postoperatively. Further on, valid results have been evaluated objectively as well as subjectively by the patient and observer.ResultsOur study has shown that persistent erythema of hypertrophic scars can be considered as an indication of PCI. The needling procedure influences vascularization by stimulating angiogenesis in the post-needling wound healing cascade. As the method is based on percutaneous collagen induction, the synthesis of collagen improves the vital thickness of the epidermis, which is directly associated with less transparency. Examined scars showed a significant reduction of erythema and were less reddened after treatment. Based on the outcomes of objective measurements, medical needling achieves a normalization of the skin color and an adjustment to healthy skin after repetitive treatments.ConclusionMedical needling seems to be a suitable therapy approach for treating erythematous, hypertrophic burn scars.
Highlights
Burns represent the fourth leading cause of injuries worldwide [1]
Our study has shown that persistent erythema of hypertrophic scars can be considered as an indication of percutaneous collagen induction (PCI)
As the method is based on percutaneous collagen induction, the synthesis of collagen improves the vital thickness of the epidermis, which is directly associated with less transparency
Summary
Burns represent the fourth leading cause of injuries worldwide [1]. A large number of burn victims are frequently confronted with dysfunctional and aesthetic deficits in their daily life. The locally intensified vascularization favors blood circulation, which enhances the development of erythema Another important factor is a thinner epidermis of the scar tissue, showing a parallel orientated collagen structure, which is more transparent for local blood flow. This is why a thinned-out skin texture in scars supports the effect of erythema, as the intense circulation of blood becomes more apparent. Affected people suffer from psychological and physiological issues when they are restricted or rejected in their daily life In this context, medical needling seems to be an efficient therapy for erythematous scars with a relatively lowrisk rate of postoperative complications. Study research has already shown significant improvements in the scar quality with reference to the parameters “moisture and transepidermal water loss.” Clinical data is up-to-date and provides an innovative therapy outcome of scar treatment with medical needling
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