The Complete Solution of Scar Problems

Conception

After the epidermis is destroyed by surgery, burns, trauma, inflammation, the body start a series of wound healing mechanisms and finally make wound recover, scar is the result of wound healing.

The type of scar

1. Hypertrophic scars
(1)The concept
It occurs within one month after injury and always happen in the original site of injury, the main features are red, bulge, and hard scar.
(2) Simple clinical manifestations
a. Always in the original site of injury
b. Can occur in any part of the body, but area with persistent pressure and continuous stretch by regular exercise is easier to happen.
c. Appearance: Red, bulge, hard;
d. Morbidity: 4.5%-16%, African and Hispanic morbidity is higher, the proportion between male and female is the same.
e. May disappear as time goes by.
f. Accompanied by symptoms such as itching and insensitivity

Pathophysiology of wound healing

1. After the epidermis is destroyed by surgery, burns, trauma, inflammation. The tissue enters an inflammatory phase. At this moment it mainly shows Thrombosis and complement reaction. A large of quantity of chemokine (prostaglandin and interleukin) being formed, these chemokine lead to a massive inflammatory cells infiltrating to the inflammatory tissue, these inflammatory cells and some inflammatory mediators jointly result in temporary wound matrix formation.
2. The proliferation phase
After the wound matrix forming, proliferation phase begins with a feature that fibroblasts, endothelial cells and keratinocyte migrate to the wound. Keratinocytes start the regeneration of the wound epidermis, of course, with reconstruction of the basal layer of epidermis, endothelial cells reconstruct blood vessel of inflammatory tissue, fibroblast reconstruct collagen of inflammatory tissue.
3. Remodeling phase
Collagen network and Proteoglycans are remodeled in this phase. Finally presentation is three basic types of Hypertrophic scars, keloids and atrophic scar.