![]() A recent preclinical study by DeBruler et al. While the exact mode of action has not been fully understood, pressure garment therapy supposedly decreases capillary perfusion in the affected tissue, thus leading to localized tissue hypoxia which in turn increases the rate of fibroblast apoptosis, thus leading to a reduced production of collagen. Ever since, this method has become the gold standard for scar prevention in burn patients in many countries around the world. Use to prevent hypertrophic scar formation in burn patients. This led to the onset of pressure garment therapy This chapter explores the different modalities for scar prevention (see ◘ Table 22.1), their mode of action, and the evidence supporting their use.ĭiscovery of the clinical effects of pressure garments on hypertrophic burn scarring by Silverstein and Larson in the late 1960s, the results of further research on the topic performed at Shriners Burns Institute in Galveston, Texas, were published in the early 1970s. Since fractional photothermolysis has shown its potential in mitigating proliferative scarring and aiding scar remodeling in mature scars, more and more researchers are attempting to alter these ongoing processes in fresh scars to prevent excessive scarring. Through the advent of newer techniques for the treatment of hypertrophic scars and keloids and fresh insights into the pathophysiology of excessive scarring, new methods for scar prevention are currently making their way into routine practice. Flavonoids, too, have proven a promising option for the prevention of excessive scarring in recent years. Has long been established to steer the scar maturation process away from excessive and proliferative scarring disorders. The use of compression garments or silicone gel sheeting Hopes are that through early intervention in fresh scars, excessive scarring can be limited or prevented altogether. However, efforts have long been underway to prevent pathological scarring altogether. This has helped not only in improving functional and aesthetic results in the affected patients but also to ameliorate their oftentimes severely impaired quality of life. Classifications allow us to differentiate between individual types of scars and allow us to propose scientifically proven therapeutic regimes to improve even severe pathological scarring. KeywordsĮffective scar treatment has come a long way in recent years. This chapter explores the currently available methods for scar prevention and examines their application and the evidence regarding their efficacy. Here, the older pulsed dye laser, as well as newer, fractional ablative and nonablative lasers, is increasingly employed for the treatment of fresh scars, where initial research is showing significant promise. Recently, lasers have become a new focus in the effort to prevent pathological scarring. Its mode of action, however, remains unclear. Silicone gel sheeting has also been used for a long time, and it is well regarded for its efficacy in reducing scar height and improving pliability while boasting little side effects. However, reduced compliance, large treatment costs, and little hard evidence are points that should be taken into consideration regarding this well-established form of treatment. Pressure garments have long been successfully used in widespread burn scar prevention. While some forms of scar prevention have been known and used for decades, others are relatively new and have yet to prove themselves. During the last years, treatment of mature scars has evolved significantly however, researchers and clinicians are more and more focused on preventing excessive scarring altogether, thus avoiding long and strenuous treatment. Severe scarring is known for causing severe functional, aesthetic, and psychosocial impairments. ![]()
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