Scar Appearance Research Articles

Treatment of Surgical Scars with Fractional Carbon Dioxide (CO2) Laser: A Randomized Controlled Trial.

Object: The aim of this study was to compare the long-term effects of fractional carbon dioxide (CO2) laser treatment with traditional therapy on surgical scars by analyzing and comparing observational indicators. Approach: A randomized controlled trial was conducted on 116 patients who received scar treatment in our hospital, of which 58 patients received fractional CO2 laser treatment, and 58 patients received injection treatment. The outcome measures comprised the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). The observation intervals occur at specific times. Evaluated at 6 months of follow-up, the outcome was blinded, on-site evaluation using the dermatological appearance scale (DAS) and visual analog scale (VAS). Results: Patients in the fractional carbon-dioxide laser (CO2FL) group rated better than those in the injection group in the POSAS, VSS, DAS, and VAS scores (p < 0.05). The therapeutic efficacy and patients' satisfaction of the research group were superior to those in the control group. Innovation: Scars following surgical procedures can be treated in a variety of methods, but there is no consensus on the best method. CO2FL has exhibited safety and is more effective than traditional injection treatments for surgical scars. It is a worthwhile approach to consider in clinical treatment. Conclusions: This study demonstrates that CO2FL achieves more significant long-term results in surgical scars, including improved scar appearance, safety, and patient satisfaction.

A strategy for selective screening of dual-target bioactive compounds against hypertrophic scar through inhibiting angiotensin II type 1 receptor while stimulating type 2 receptor from Chinese herbs

BackgroundCutaneous hypertrophic scar is a fibro-proliferative hard-curing disease. Recent studies have proved that antagonists of angiotensin II type 1 receptor (AT1R) and agonists of type 2 receptor (AT2R) were able to relieve hypertrophic scar. Therefore, establishing new methods to pursue dual-target lead compounds from Chinese herbs is in much demand for treating scar.MethodsTo this end, we immobilized AT1R or AT2R onto the surface of silica gel from cell lysates through a specific covalent bond by bioorthogonal chemistry. The columns containing immobilized AT1R or AT2R were jointly utilized to pursue potential bioactive compounds simultaneously binding to AT1R and AT2R from the extract of Rhei Radix et Rhizoma. Their functions on AT1R and AT2R expressions were investigated by in vitro and in vivo experiments.ResultsAloe-emodin and emodin were identified as the potential bioactive compounds binding to both of the two receptors, thereby improving the appearance and pathomorphology of hypertrophic scar. They blocked the AT1R pathway to down-regulate the expression of transforming growth factor-β1 (TGF-β1) and stimulate matrix metalloproteinase-1 (MMP-1) expression. As such, the expression of collagen I/III reduced. Conversely, the bindings of the two compounds to AT2R reduced the production of nuclear factor-кB1 (NF-кB1), whereby the generation of interleukin-6 (IL-6) was blocked.ConclusionWe reasoned that aloe-emodin and emodin had the potential to become dual-target candidates against hypertrophic scar through the regulation of AT1R and AT2R signaling pathways. It showed considerable potential to become a universal strategy for pursuing multi-target bioactive compounds from Chinese herbs by the utilization of diverse immobilized receptors in a desired order.

Quantitative Evaluation of the Effectiveness of Erbium Glass Laser Therapy for Acne Scars

Background: Acne scarring presents a significant esthetic and psychological concern, commonly classified into atrophic and hypertrophic types. Effectively managing these lesions often involves the use of therapeutic strategies such as laser treatments, dermabrasion, and fillers. This study investigates the efficacy of 1550 nm erbium glass laser therapy in the treatment of atrophic acne scars through a quantitative assessment. Material and Methods: Participants with mild to moderate atrophic acne scars received two sessions of fractional erbium glass laser therapy at one-month intervals. Skin density and epidermal thickness were measured using a high-frequency ultrasound device (DUB SkinScanner), while the Antera 3D imaging system facilitated a comprehensive analysis of skin parameters, including texture, volumetric depressions, and pigmentation. Results: The use of this therapy led to significant improvements across multiple parameters. Skin density and epidermal thickness increased. Significant reductions were observed in fold depth, pore volume, and depression volume, indicating enhanced smoothness and minimized scar appearance. Improvements in texture roughness and pigmentation contributed to a visually coherent skin surface. Conclusions: Fractional erbium glass laser therapy effectively ameliorates the appearance of atrophic acne scars by increasing skin density, reducing dermal depressions, and improving texture and pigmentation uniformity. The Antera 3D system and high-frequency ultrasound device demonstrated high efficacy in capturing subtle changes, supporting its value in clinical applications for optimizing treatment parameters.

Comparative analysis of small-incision and traditional techniques in costal cartilage harvesting: Outcomes on thoracic deformities and scar appearance.

This study aims to compare the postoperative thoracic deformity and scar aesthetic outcomes of auricular reconstruction between the conventional large-incision technique and small-incision technique with perichondrium preservation for costal cartilage harvesting. A retrospective analysis was performed on 134 patients who underwent auricular reconstruction using tissue expanders and autologous costal cartilage harvested from the right chest wall between January 2021 and September 2023. Patients were divided into two groups according to the harvesting technique: the traditional large-incision group (n=64) and the small-incision group with perichondrium preservation (n=70). Preoperative and postoperative chest CT scans were reviewed for thoracic deformities by measurements of the modified Haller Index (mHI) and modified correction index (mCI). Thoracic scar dimensions were measured in postoperative follow-up. In the conventional group, significant difference were observed between the left and right hemithorax in anterior-posterior diameter, maximum transverse diameter, cross-sectional area, and mHI values (p<0.05), showing thoracic deformities. In contrast, within the small-incision group, there were no significant differences between hemithoraces. Additionally, postoperative thoracic scars were significantly smaller in the small-incision group, with shorter scar length (5.63±1.33 cm vs. 11.44±1.31cm) and width (1.41±0.55cm vs. 3.75±1.54cm; p<0.001). The small-incision technique with perichondrium preservation significantly reduces postoperative thoracic deformities and results in smaller, less conspicuous scars compared to the traditional large-incision method. This approach minimizes disruption to the chest wall structure and reduces donor-site morbidity, offering improved patient outcomes.

Comparison of Incision Closure in Hand Plastic Surgery Using Non-absorbable Versus Absorbable Sutures: A Systematic Review of Randomized Controlled Trials.

Surgeons prioritize scar appearance after surgery, making suture choice crucial. Traditionally, non-absorbable sutures were standard but require removal, causing patient discomfort and extra visits. Absorbable sutures, while offering convenience, might raise concerns about scar quality. This study aims to provide an overview of the plastic surgery literature and clinically based evidence of the efficacy and outcome of absorbable and non-absorbable sutures. A systematic review of search databases in MEDLINE, EMBASE and the Cochrane Library was made to identify studies related to absorbable and non-absorbable sutures. The inclusion criteria for this study included RCTs comparing AS and NAS in plastic hand surgery, without any limitations of age or sex on recruited patients. A total of 532 hands were treated with a combined sample size of 517 patients undergoing plastic hand surgery. Two hundred seventy-three (51%) of patients had their wound closed with non-absorbable sutures, and 259 (49%) had absorbable sutures. Overall patient satisfaction among the studies that reported number of patients satisfied with the wound closure appearance was 64 (64%) in non-absorbable sutures cohort and 58 (59%) in absorbable sutures. Wound inflammation happened in 8 (3%) of wounds closed with non-absorbable sutures and in 9 (3.4%) of wounds closed with absorbable sutures. In both patients cohorts, the overall patient satisfaction and complication rates were not significantly different. Non-absorbable sutures appearedto have slightly higher patient satisfaction rates. However, absorbable sutures may offer some benefits in terms of convenience with lower risk of wound dehiscence. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

New Concepts in Circumareolar Mastopexy: The "Star Interlocking Suture"-A Case Series.

The circumareolar approach is one of the most popular and versatile in breast surgeries. Nevertheless, this approach usually implies a closure under tension which could lead to areolar distortion, scar widening and hypertrophic scarring. To prevent these complications, different surgical adjustments to this technique have been proposed, such as the Hammond's "Interlocking Gore-Tex suture." Here, we propose a modification of the Hammond interlocking suture, the "Star Interlocking Suture." Between 2019 and 2023, the "Star Interlocking Suture" was used in 19 patients undergoing breast surgery with circumareolar approach. 3-0 Ethibond suture (Ethibond Excel; Ethicon, US LLC) was used for suturing. All 19 patients showed good results in terms of areolar scar appearance and diameter stability during a mean follow-up period of 12months. No infections, skin fistulas or suture extrusion were observed. All patients were satisfied with the appearance of their areola and the suture material, green colored, was not visible. Only one patient did report palpability of the suture's knot.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effectiveness of stepwise progressive ultra-tension-reducing suture method in treatment of high-tension wounds on chest, back, and limbs

To investigate effectiveness of a novel suture method-stepwise progressive ultra-tension-reducing suture method in closing high-tension wounds on the chest, back, and limbs. A retrospective analysis was conducted on 25 patients with high-tension wounds on the chest, back, and limbs who were treated with stepwise progressive ultra-tension-reducing suture method between January 2022 and December 2022. Among the patients, there were 8 males and 17 females, with an average age of 30.5 years (range, 18-56 years). All wounds after scar or tumor resection were located on the chest, back, upper limbs, and lower limbs in 8, 6, 9, and 2 cases, respectively. The size of wounds ranged from 3.5 cm×2.8 cm to 40.0 cm×15.0 cm. All patients were advised to use topical silicone-based treatments postoperatively. The protrusion of the incision, the height of the protrusion, and the duration of the tension reduction effect were observed. The scar formation at the incision site at 6 months after operation was observed, the scar appearance was evaluated by Vancouver Scar Scale (VSS) score, and the scar width was measured. The patient's satisfaction and adverse reactions to incisions were also evaluated. The incisions significantly elevated, with a height of 0.3-2.5 cm, and the tension reducing effect lasted for 8.5-18.0 weeks after operation, with an average of 13.6 weeks. All incisons healed by first intention. One patient experienced transient hyperpigmentation, which resolved spontaneously. Three keloid patients showed localized redness postoperatively, and 2 experienced local recurrence, which improved significantly after treatment with triamcinolone, 5-fluorouracil injections, and laser therapy. All patients were followed up 6.0-13.5 months, with an average of 10.1 months. At 6 months after operation, all patients had linear scars, with VSS scores ranging from 1.0 to 3.5 (mean, 2.0). The width of the scars ranged from 0.5 to 3.0 mm (mean, 1.4 mm). The patients expressed satisfaction with the effectiveness. The stepwise progressive ultra-tension-reducing suture method for high-tension wounds can effectively reduce the tension at the wound edges, providing a prolonged tension-reducing effect and satisfactory effectiveness.

The Role Of Purse String Closure As The Primary Treatment Of Hemangioma

Hemangioma is a common congenital disorder which happens in neonates or infant, with predilection sites in the face and neck. Not every case of hemangioma requires a surgical treatment. Some will regress spontaneously. In some cases which requires resection, the aesthetic aspects of the repair must be considered as the sites of the lesion involved the face and neck areas, which is greatly exposed.Two patients with hemangioma of the left cheek were admitted to Plastic Surgery Department of Cipto Mangunkusumo Hospital. The patients underwent excision and primary closure with purse string technique. Patients were evaluated at one week after surgery and a month after to assess scar appearance. Follow up evaluation revealed less visible scar compared to the immediate result. A well-known technique used by many plastic surgeons is the circular incision followed by purse-string closure. The use of this technique was known to produce less visible scar. Hemangiomas acts as a tissue expander, which make it applicable to close the defect using purse string closure.

A Comparative Assessment of Clinical Outcomes Using Cyanoacrylate Glue versus Subcuticular Sutures in Cosmetic Procedures at a Tertiary Care Center: Evaluation Based on the Southampton Scoring System.

Introduction Cosmetic surgery has advanced significantly, with wound closure techniques crucial for determining aesthetic and healing outcomes. Recently, cyanoacrylate glue and subcuticular sutures have gained attention for their unique benefits in cosmetic procedures. Cyanoacrylate glue, a non-invasive tissue adhesive, facilitates faster wound closure with minimal trauma, while subcuticular sutures offer durable, concealed closures, particularly suited for areas under mechanical stress. This study uses the Southampton scoring system to compare these techniques, evaluating clinical outcomes, complications, and patient satisfaction to guide optimal wound closure methods in cosmetic surgery. Methods This prospective observational study at a tertiary care center compared wound closure outcomes using cyanoacrylate glue and subcuticular sutures in 50 patients undergoing cosmetic procedures.Patients aged 18-65 with no wound healing disorders or chronic skin conditions were included, while those with active infections, on immunosuppressive therapy, or allergic to cyanoacrylate were excluded. Patients were evenly divided into two groups: one receiving cyanoacrylate glue and the other subcuticular sutures. The same surgical team performed all procedures. Wound healing was assessed using the Southampton scoring system on days 1, 7, and 30 postoperatively. Secondary outcomes included pain (visual analog scale), healing time, and complication rates. Patient satisfaction was evaluated at the 30-day follow-up. Statistical analysis was conducted using SPSS software, with significance set at p<0.05. Results The study evaluated 50 patients (split equally between cyanoacrylate glue and subcuticular sutures groups) undergoing cosmetic procedures, focusing on postoperative wound healing using the Southampton scoring system. On postoperative day 7, infection rates were significantly lower with cyanoacrylate glue (8% Grade 1a, 4% Grade 1c, and no Grade 2b) than with subcuticular sutures (16% Grade 1a, 12% Grade 1c, and 4% Grade 2b; p=0.000). Additionally, cyanoacrylate glue reduced operative time, with its non-invasive nature contributing to higher patient satisfaction scores. However, both techniques yielded comparable long-term cosmetic outcomes, with no significant differences in scar appearance after 30 days. Overall, each technique demonstrated unique strengths, influencing clinical outcomes and patient satisfaction. Conclusion The study highlights the respective benefits and limitations of cyanoacrylate glue and subcuticular sutures, offering insights to aid cosmetic surgeons in making informed decisions tailored to individual patient needs. These findings can ultimately improve short-term recovery and long-term patient satisfaction with cosmetic outcomes. The use of the Southampton scoring system facilitated a standardized evaluation, providing valuable data on the effectiveness of each wound closure method in various surgical contexts.

The Effectiveness of Early Treatment With Intense Pulsed Light Combined With Fractional Erbium Laser in Preventing Post-traumatic Hypertrophic Scar Formation.

Once scars form and begin to proliferate, treatment becomes challenging. Traditional methods of scar treatment often provide suboptimal results. Therefore, early intervention has become widely accepted, with a focus on prevention during the wound-healing phase rather than later treatment. Here, the authors evaluate the effectiveness of early treatment with intense pulsed light (IPL) combined with fractional erbium laser in preventing the formation of post-traumatic hypertrophic scars. A total of 120 patients who underwent emergency cosmetic suture surgery for facial trauma between January 2019 and December 2021 were selected for the study. The control group received conventional antiscar therapy (pressure therapy or antiscar medication), while the observation group received IPL combined with fractional erbium laser in addition to the conventional treatment. The specific treatment doses were adjusted based on the patient's age, scar color, texture, and thickness. A treatment course consisted of 3 to 5 sessions, with 4-week intervals between treatments. Follow-up was conducted within 1 year after treatment to assess the improvement in scar appearance before and after therapy. After IPL combined with fractional erbium laser treatment, patients in the observation group showed significantly lower scores in color, thickness, vascular distribution, softness, and total scores on the Vancouver Scar Scale (VSS) compared with the control group. During the follow-up, 3 complications were observed: 2 cases of skin blisters and 1 case of pigmentation. No immediate skin lesions, depigmentation, infections, ulcers, or other adverse reactions were reported. For patients with early-stage superficial scars following trauma surgery, early treatment with IPL combined with fractional erbium laser not only leads to significant improvements in appearance and effectively prevents hypertrophic scar formation but also promotes rapid recovery with few complications. This approach has clinical value.

Efficacy of a Combination Treatment of Ablative Fractional Carbon Dioxide Laser Therapy and Recombinant Human Epidermal Growth Factor for Atrophic Acne Scars.

Atrophic acne scars (AAS) are disfiguring and permanent changes caused by inflammatory acne. Fractional carbon dioxide is a common ablative device used to treat this condition. However, issues such as unclear effectiveness, frequent treatments, and potential side effects exist. In recent years, recombinant human epidermal growth factor (rhEGF) has also been frequently reported for its application in the treatment of acne scars. To explore the potential synergistic effect of fractional carbon dioxide laser combined with rhEGF in AAS treatment. We enrolled 15 patients with AAS. They received fractional carbon dioxide laser treatment and were then randomly assigned to receive either rhEGF or a placebo on one side of the face. The procedure was repeated three times, and the results were evaluated using the échelle d'évaluation clinique des cicatrices d'acné (ECCA) score and analyzed using the CBS camera system, 3D analysis (3DMD). Reflectance confocal microscopy (RCM) examination was also conducted. Both sides exhibited significant improvement in the appearance of the acne scars after treatment, as confirmed by the ECCA score, 3DMD data, and CBS texture score. On the rhEGF-treated side, the pore number and epidermal pigment area significantly improved as compared to the control side, whereas no significant differences were observed in the other data. Under RCM, a significant increase in epidermal thickness and appearance of reticular collagen fibers in the dermal layer after treatment was observed. Compared to the sole use of laser, the combination of fractional carbon dioxide laser and rhEGF does not significantly enhance scar therapeutic effects. However, it does shorten the recovery period after laser treatment and improves the pore appearance.

Effect of a Chest Compression Device for Scar Prevention Combined with Nurse-Patient WeChat Group on Scar Formation after Keloid Excision

Objective: To investigate the effect of a chest compression device for scar prevention combined with a nurse-patient WeChat group on scar formation after keloid excision. Methods: Forty patients with chest wall keloids who underwent keloid excision surgery at the Department of Plastic and Reconstructive Surgery, First Medical Center of PLA General Hospital from June 2022 to June 2024 were selected. They were randomly divided into two groups: the observation group (20 cases) and the control group (20 cases). Both groups underwent routine keloid excision, followed by compression therapy for 6 months. The observation group used a chest compression device, while the control group used a compression garment. Scar width, hypertrophy, and Vancouver Scar Scale (VSS) scores were compared between the two groups. Results: There were no significant differences between the two groups in terms of gender, age, disease course, lesion area, and lesion site (P &gt; 0.05). The overall effective rate in the observation group was 95.00%, significantly higher than the 65.00% in the control group, with a statistically significant difference (P &lt; 0.05). After a 6-month follow-up, all VSS indicators (except for pliability) in the observation group (using the chest compression device) were significantly lower than those in the control group (P &lt; 0.05). Conclusion: Compared to the traditional compression garment, the chest compression device for scar prevention is more effective in preventing scar hypertrophy after chest wall keloid excision and improving the appearance of scars. It is worth promoting for clinical application.

EFFECT OF FAT GRAFTING ON IMPROVEMENT OF SCAR-AN INTERVENTIONAL STUDY

Background: Scars are inevitable after effect of wound healing, a natural process that restores tissue integrity following injury, burns or surgery. They can be aesthetically displeasing and functionally impairing, depending on their location, size, and depth. Depending on the severity of the injury, scars can be hypertrophic, atrophic, or keloid. These variations can lead to pain, itching, contractures (limited movement), and psychological distress, impacting a patient's quality of life. Objective was to evaluate the efficacy of autologous fat grafting in improving the appearance and quality of scars, with a focus on patients presenting with facial scars due to burns, trauma, surgery or acne at a tertiary care hospital in Karachi, Pakistan. Methods: In this quasi-experimental study, 30 patients of age 18 years to 60 years, irrespective of gender having facial scar because of burn, trauma, surgery or acne were included in the study. A comprehensive scar assessment was performed using the Patient and Observer Scar Assessment Scale (POSAS) before treatment, and follow-up evaluations were conducted on the seventh day, at three months, and at six months post-fat grafting. Fat grafting was executed using a tumescent technique based on Klein's formula, with the aspirated fat injected into the subdermal plane of the scar. Data analysis was performed using SPSS version 23. Results: The patient cohort had a mean age of 26.77 years, with a predominance of female participants (73.3%). Trauma was the most common cause of scars (50%), with the forehead being the most frequent location (36.67%). Significant improvements in scar quality were observed, with both patient and observer POSAS scores showing notable reductions from baseline to 6 months (p&lt;0.05). All patients (100%) demonstrated an improvement in scar appearance. Conclusion: Fat grafting presents a promising treatment for improving the appearance and quality of facial scars.

Polynucleotide-based treatments for various facial scars including combat injuries

Introduction This study examines the therapeutic efficacy of polynucleotide-based therapies, specifically REJURAN®, for managing scars and burns. Scars and burns present significant challenges in dermatology, often affecting patients’ quality of life. Traditional treatments can be limited in effectiveness, prompting the exploration of innovative approaches like polynucleotide therapy, which utilizes salmon DNA to stimulate tissue repair, modulate inflammation, and enhance collagen production. Methods A series of case studies was conducted, including diverse patient profiles with various types of scars and burns. The study evaluated the impact of REJURAN® on scar appearance, texture, and overall skin quality. Some cases also explored the combination of polynucleotide therapy with other treatments such as Platelet-Rich Plasma (PRP) and botulinum toxin. Results Notable improvements were observed across cases, including reduced scar visibility and enhanced skin texture. The therapy proved effective in treating post-traumatic, post-operative, and burn-related scars, demonstrating its versatility and potential benefits. Combination therapies showed promising results, though further research is needed. Conclusion Polynucleotide-based therapy with REJURAN® shows promise in scar and burn management, offering a novel approach that leverages the body’s regenerative processes. Further studies are recommended to confirm these findings and refine treatment protocols.

A Novel Technique for Top Surgery in Small-Breasted Individuals Who Experience Gender Dysphoria – Concentric Periareolar Mastectomy, Interlocking Suture and Waterjet-Assisted-Liposuction

Background: In small-breasted individuals, who experience gender dysphoria, the concentric periareolar approach is typically the preferred method for mastectomy. However, this method carries a notable risk of hypertrophic scars and changes in the areolar dimensions. This study introduces the periareolar interlocking suture (PIS) as a new scar-minimizing procedure, with a low complication rate and high patient satisfaction. Patients and Methods: We performed a concentric periareolar mastectomy (CPM) combined with PIS and waterjet-assisted liposuction (WAL) in patients with small breasts (A to B-Cup) and good skin quality/elasticity. Outcome measures included complication rates, patient satisfaction (assessed via the BODY-Q Chest and Nipples Scale and scar appearance), nipple sensitivity, and the rate of surgical corrections. Results: Between April 2017 and December 2023, we conducted 2312 mastectomies in 1156 people who experience gender dysphoria, with 410 breasts treated using CPM combined with PIS and WAL. The mean patient age was 23 years, mean hospital stay was 4 days, and mean operation time was 96.1 minutes. The overall complication rate was 7.8%, with acute hematomas occurring in 4.6% of the cases. Secondary revisions were necessary in only 2.2% of cases. Patient satisfaction, measured using the BODY-Q scale, was statistically significant and very high. Conclusion: Individuals with gender dysphoria are well-informed and increasingly demand aesthetic outcomes. Whenever feasible, procedures with minimal scarring are preferred. The technique presented here resulted in very high patient satisfaction, preserved nipple sensitivity, and a low rate of complications and secondary aesthetic corrections in a carefully selected cohort of patients with small breasts.

Paradigms in periorbital scar management

Periocular scarring following surgery or trauma is of great aesthetic and functional concern and is difficult to predict. In today’s era, with increasing scientific knowledge and technological advances, both physicians and their patients are highly concerned with minimizing scar appearance as a rising number of patients feel disappointed with their scars and are frequently seeking help for functional and aesthetic improvement. Although various non-surgical and surgical treatment strategies are available it is still difficult to improve excessive scarring. Thus, the importance of thorough knowledge of eyelid anatomy and heal­ing mechanisms along with appreciation of wound closure techniques like placing the sutures at natural cosmetic subunit junctions and along relaxed skin tension lines (RSTLs) in order to achieve scar camouflage and to ensure decreased tension on the wound cannot be more emphasised. Periorbital area should be tackled by the oculoplasty surgeons in view of their distinct anatomy and close proximity to the eye.Scars are commonly treated with a combination of non-surgical techniques, including watchful waiting, scar massage, pressure therapy, silicone gel sheeting, topical or intralesional injections, cryotherapy, laser therapy or radiotherapy. Surgical approaches include pincushioning debulking, direct scar excision, broken line closure techniques, scar lengthening procedures (Z plasty, V-Y/Y-V advancement) and scar excision with lid reconstruction. Mastery of this content is essential for consistent operative success. For good cosmetic and functional outcomes, scar revision techniques should be thoughtfully tailored to the individual and scar subtype.

Cleft Lip Scar Appearance is Associated With Speech Outcomes After Primary Palatoplasty.

This study aims to investigate the correlation between the quality of cleft lip scar and velopharyngeal insufficiency (VPI). Clinical photographs from 56 patients with repaired cleft lip and palate (CLP) were collected and anonymized by cropping the image to the region of interest around the lip and nose. A survey displaying each cleft lip scar image with five associated scar quality features, including scar color, thickness, width, lip shortening, and overall appearance, was distributed. Surveys were distributed using Amazon Mechanical Turk (MTurk), an online crowdsourcing platform, to obtain ratings from 330 laypeople. The same surveys were also distributed to 45 medical students. Hypernasality was used as the primary speech outcome measure. Ordinal logistic regression was used to compare the ratings for each of the five scar quality categories with the patients' CAPS-A-AM hypernasality rating for both MTurk and medical student raters. Significance was set at α = 0.05. For medical student ratings', ordinal logistic regression showed a statistically significant relationship between lip shortening (P=0.019) and overall appearance (P=0.044) with CAPS-A-AM hypernasality score, whereas the other scar categories showed no significant association. There was no statistically significant relationship between MTurk ratings and hypernasality for any of the scar categories. The association found between lip shortening and overall scar appearance, thought by the authors to indicate scar contracture, and hypernasality, an indicator of VPI severity, provides an interesting insight into how to potentially identify patients who may be at increased risk for developing VPI.

Systematic Review: Keloid and Hypertrophic Scar Management Updates

Keloids and hypertrophic scars pose significant challenges in clinical management due to their propensity for recurrence and their impact on patient’s quality of life. This systematic review evaluates the efficacy of various treatment modalities for these scars, with an emphasis on clinical outcomes, symptom alleviation, and recurrence rates. A comprehensive literature search identified studies published between 2014 and 2024, encompassing randomized controlled trials and observational studies. Results indicate that advanced therapies, such as botulinum toxin type A (BTX-A) and platelet-rich plasma (PRP), exhibit superior outcomes compared to traditional treatments, including triamcinolone acetonide (TAC), particularly concerning scar appearance and safety profiles. Furthermore, combination therapies, such as intralesional cryotherapy and CO2 fractional laser with intense pulsed light (IPL), demonstrated promising results in enhancing scar reduction and patient satisfaction. This review underscores the necessity of personalized treatment strategies tailored to individual patient requirements, taking into account factors such as scar characteristics and skin types. Future research should concentrate on optimizing treatment regimens to maximize efficacy while minimizing adverse effects, thereby ensuring long-term success in the management of keloids and hypertrophic scars.

The versatility of using platelet-enriched autoplasm in medical practice

The search for highly effective and safe methods in regenerative medicine has always been and remains an urgent problem. There are many drugs on the pharmacological market, but they cannot be considered to meet the requirements. One of the potential compounds capable of solving this problem is platelet-enriched autoplasm, which is economical and obtained directly from human blood with further centrifugation and platelet activation. An impressive number of studies are presented in the domestic and foreign literature, which confirm its effectiveness in assessing the area of a wound defect, the rate of regeneration and the absence of side effects. This is ensured by the content of a large number of growth factors and various biologically active compounds. In modern surgical practice, platelet-enriched autoplasm has found extensive use in the treatment of chronic wounds of various etiologies, prone to long-term course and frequent relapses; in cosmetology and aesthetic medicine in the issue of improving the appearance of scars; in urology in the treatment of erectile dysfunction; in obstetric and gynecological practice in improving pregnancy and pregnancy outcomes, reducing recurrence of adhesions, correcting functional sexual dysfunction and a favorable course of in vitro fertilization.

Assessing the Influence of Hyaluronan Dressing on Wound Healing on Split-Thickness Skin Graft Donor Sites Using a Three-Dimensional Scanner.

Objectives: The topical application of hyaluronic acid after injury may accelerate the wound healing process. We aimed to retrospectively investigate whether the topical application of hyaluronic acid on standardized wounds after split-thickness skin graft removal on the thigh would accelerate wound healing and improve scarring outcomes. Additionally, we aimed to evaluate the usefulness of three-dimensional (3D) scanning to assess scars. Methods: The wound healing process of a hyaluronan group (n = 20) and a control (n = 21) were analyzed and evaluated using 3D scans at 7 and 14 days and 1, 3, and 6 months post-operatively. Scar evaluations by the patients were conducted 6 months post-operatively using the patient and observer scar assessment scale and the Manchester scar scale. Experts evaluated the scars after 6 months using a modified version of both scales. Results: On days 7 and 14, significantly larger areas of the wound surface were closed in the hyaluronan group compared to the control group (p < 0.05). After 1 month, significantly more crusted areas remained in the control group than in the hyaluronan group (p < 0.05). At the 6-month self-assessments, the hyaluronan group evaluated their scars as being significantly better compared to the control group. Conclusions: The topical application of hyaluronic acid in combination with polyurethane foam as a wound dressing after split skin removal accelerated the wound healing rate and positively influenced scar appearance after 6 months. Three-dimensional scanning is useful for evaluating and documenting the wound healing process.