Biology and principles of scar management and burn reconstruction

• Published in: The Surgical clinics of North America Vol. 94; no. 4; p. 793
• Main Authors: Tredget, Edward E, Levi, Benjamin, Donelan, Matthias B
• Format: Journal Article
• Language: English
• Published: United States 01.08.2014
• Subjects: Burns - pathology; Burns - physiopathology; Burns - therapy; Cicatrix, Hypertrophic - pathology; Cicatrix, Hypertrophic - physiopathology; Cicatrix, Hypertrophic - therapy; Contracture - therapy; Cytokines - antagonists & inhibitors; Cytokines - metabolism; Fibroblasts - pathology; Fibrosis - pathology; Humans; Interferons - therapeutic use; Laser Therapy - methods; Postoperative Care; Receptors, CXCR4 - antagonists & inhibitors; Reconstructive Surgical Procedures - methods; Time Factors; Toll-Like Receptors - physiology; Wound Healing - physiology; Heterotopic ossification; Burn reconstruction; Fibrocytes; Scar; Laser
• ISSN: 1558-3171
• DOI: 10.1016/j.suc.2014.05.005

Hypertrophic scarring is extremely common and is the source of most morbidity related to burns. The biology of hypertrophic healing is complex and poorly understood. Multiple host and injury factors contribute, but protracted healing of partial thickness injury is a common theme. Hypertrophic scarring and heterotopic ossification may share some basic causes involving marrow-derived cells. Several traditional clinical interventions exist to modify hypertrophic scar. All have limited efficacy. Laser interventions for scar modification show promise, but as yet do not provide a definitive solution. Their efficacy is only seen when used as part of a multimodality scar management program.