Treatment Of Scar Formation Research Articles

Die topische Applikation von Mitomycin C in der Behandlung von Stenosen und Narben in Hohlorganen in der Hals-Nasen-Ohrenheilkunde – Ein Erfahrungsbericht aus 10 Jahren

The antibiotic und antitumoral effect of Mitomycin C (MMC), a derivative of Streptomyces caespitosus, has been known since 1956. Besides its use as an adjunction in the treatment of breast, lung and prostate cancer, or as a second-line cytostatic drug for head and neck squamous cell carcinoma (HNSCC), since 1963, MMC has also been successfully used in the suppression of post-operative scar formation, particularly in the field of ophthalmology. This is due to its modulation of fibroblast activity, which enables decreased scarring and fibrosis. In this résumé, we wish to recapitulate our long years of experience in the topical application of Mitomycin C in the treatment of scar formation and stenosis in head and neck organs. A retrospective analysis on the basis of clinical disease courses and findings (image documentation, questionnaires, pulmonary function tests) covering an examination period of 10 years, was performed on 40 patients with stenosising lesions and a mean age of 54 years. The fields of application included laryngeal, tracheal, oesophageal stenosis and stenosis of the external ear canal and the choane. After combined application of MMC and surgical intervention in cases of recurrent stenosising processes in head and neck organs, especially the larynx and the trachea, a sustained improvement was achieved in the pre-operative stenosis level as well as in the pre-operative, severely limited, forced inspiratory volume in 1 second (F1V1). The topical application of MMC appears to be an effective adjunction as a concept of treatment for stenosising, scar-forming lesions. This topical application, however, is not a substitute for correct diagnosis and appropriate surgical treatment. It must be regarded as a purely adjunctive manoeuvre. During the 10 years in which it was used, the clinical findings confirmed an enhancement in the containment of complex cases without the occurrence of any complications.

Die Behandlung der brandverletzten Hand

Although burn injuries of the hand only account for approximately 2.5-3% of the total body surface area (TBSA), they are of great importance due to functional outcome, appearance and economic aspects. Initial treatment and diagnosis are important factors, which influence the further course of thermal injuries of the hand and which are found in up to 80% of treated burn injuries. Early decision-making is necessary if escharotomy or skin grafting is indicated. After preliminary evaluation and wound management a differentiation between non-surgical and surgical procedures is necessary. In the case of full thickness thermal injuries, debridement and skin grafting should be carried out. Further interdisciplinary management involves different professional groups as surgeons and physical therapists. Fitting pressure garments and treatment of scar formation are integral parts of the successful rehabilitation of hand burns.

Consequences of excessive scar formation: dealing with the problem and aiming for the future

Scarring is the major hindrance to the healing of all tissues. Unfortunately, our knowledge about the factors that regulate scarring is quite limited. Even worse is the fact that there have been few gains in the treatment of pathologic scarring. This review sets the stage for the supplement on scar formation that provides the latest knowledge on the pathophysiology and treatment of scar formation.

The Treatment of Scar Formation Resulting from Gastric Ulcers

The Treatment of Scar Formation Resulting from Gastric Ulcers