Potential cellular and molecular causes of hypertrophic scar formation

Veer, Willem M. van der; Bloemen, M.C.T.; Ulrich, Magda M. W.; Molema, Grietje; Zuijlen, Paul P. M. van; Middelkoop, Esther; Niessen, Frank B.

doi:10.1016/j.burns.2008.06.020

Cited by 308 publications

(244 citation statements)

References 185 publications

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“…When evaluated regarding the changes in MVSS scores between the 3 rd and 6 th months in the study groups, the changes in the height, pliability, and total MVSS scores were significantly higher in silicone group than in the control group. The severity of inflammation and type of immune response predisposes individuals to excessive scar formation [1]. The effects of corticosteroids are mainly owing to their suppressive effects on the inflammatory process and also due to decreases in collagen and glycosaminoglycan synthesis and increases in collagen and fibroblast degeneration [20].…”

Section: Discussionmentioning

confidence: 99%

“…Pathological cutaneous scars such as keloids and hypertrophic scars (HS) occur due to general failure of normal wound healing processes. These scars are usually characterized by inflammation, excessive fibroblast proliferation, and abnormal deposition of extracellular matrix proteins [1]. Both HS and keloids usually develop within 1 to 3 months after an injury, trauma, or surgical incision [2].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the effectiveness of topical silicone gel and corticosteroid cream on the pfannenstiel scar prevention — a randomized controlled trial

et al. 2017

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Objectives: To compare the effects of topical silicone gel and corticosteroid cream for preventing hypertrophic scar and keloid formation following Pfannenstiel incisions. Material and methods:Fifty patients operated for benign gynecological diseases through primary Pfannenstiel incision were included. The wounds were randomly allocated to the treatment and control arms. In the treatment arm, the wounds were divided into two halves; one was treated with silicone gel and the other with methylprednisolone cream. No treatment was administered to the control group. Scars using the modified Vancouver Scar Scale (MVSS), patient satisfaction, and side effects were evaluated before and after (3 rd month when treatment discontinued and 6 th month) the treatment.Results: Thirty-nine patients (21 patients in the treatment group and 18 patients in the control group) completed the study. Intragroup comparisons of the 3 rd month and 6 th month scores of the MVSS revealed that the scores of all parameters (height, pigmentation, vascularity, pliability, and total MVSS score) significantly decreased at the 6 th month evaluation as compared with the 3 rd month evaluation in all groups (control, silicone, and methylprednisolone groups). Multiple group comparisons at the 6 th month revealed that the most prominent improvements occurred in the methylprednisolone group in all MVSS parameters as compared with the control group and in the height, vascularity, and pigmentation parameters as compared with the silicone group. No side effects were experienced by the patients with either treatment and patient satisfaction was higher in the methylprednisolone group. Conclusion:The use of topical methylprednisolone cream in fresh wounds at the postoperative early period appears to be promising.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the effectiveness of topical silicone gel and corticosteroid cream on the pfannenstiel scar prevention — a randomized controlled trial

et al. 2017

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“…They also stimulate collagen expression and promote re-epithelialization and angiogenesis. Consequently, macrophages play an important part in the transition between the inflammatory phase and proliferative phase, given the latter is heavily dependent on their cytokine secretion profile [2,3,9] . Although it is not a definitive end, the presence of macrophages can act as a tentative marker to denote the end of the inflammatory phase and the start of the proliferative phase [3] .…”

Section: Inflammationmentioning

confidence: 99%

“…In addition, fibrocytes also secrete various pro-inflammatory cytokines and growth factors including interleukin 6, 10, TGF-, PDGF and tumor necrosis factor alpha, with TGF- being the most prominent [9,10] . Both human and murine fibrocytes express CXCR4 and have been found to migrate in response to SDF-1 expression in vitro and in vivo, indicating the significance of the SDF-1/CXCR4 pathway in fibrosis [39] .…”

Section: The Role Of Blood-borne Cell Migration In Fibrosismentioning

confidence: 99%

A Potential Role of SDF-1/CXCR4 Chemotactic Pathway in Wound Healing and Hypertrophic Scar Formation

Campeau¹,

Ding²,

Tredget

2015

Receptor Clin Invest

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Fibroproliferative disorders are an ongoing clinical issue that is prevalent within society today. These disorders generally manifest themselves by an overproduction of fibrotic tissue with unknown provocation resulting in numerous detrimental defects. Cellular migration of blood-borne cells via the chemotactic pathway, consisting of stromal cell-derived factor 1 and its receptor, CXCR4, has been strongly implicated in post-burn hypertrophic scar formation. Evidence has shown this pathway has potential as a therapeutic target in the formation of hypertrophic scar and likely in other fibroproliferative disorders.

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“…There is augmented neovascularization with macrophages, mast cells and others directly and indirectly involved in the activation of fibroblasts which in turn leads to production of excess extracellular matrix [11]. Nicotine is known to have anti-inflammatory properties and oral treatment with nicotine in a rat model showed renoprotective effects reducing renal inflammation and halting renal protein loss where the rat had proteinuria-induced renal inflammation.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Nicotine in the Treatment of Keloids: A Pilot Study

T¹

2017

MOJS

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To determine whether topically applied nicotine has an effect in preventing the return of keloids following excision. This would serve as a pilot study to indicate whether a beneficial effect was evident and further randomized control trials would be justified. Introduction BackgroundDermal keloids are an ongoing problem for genetically predisposed patients. Minor injuries may result in abnormal scarring. Surgical excision results in a return of keloids in 50%-80% of cases, and available treatment options, namely steroid injections, radiation therapy and silicone dressings, or pressure garments are not always feasible options. These methods are not hundred percent effective, cannot be used in all persons, have side effects (for instance pain on injection), and are not effective to treat large areas. Even dermal substitutes have resulted in keloid return [1,2]. The ideal treatment should be painless, have few side effects, should be useful in large areas (for instance post burn scars) and should be easy to use maximizing compliance. The cost of the intervention should render it affordable. Steroid injections are painful, cannot be used successfully in large areas or children and there are costs involved. Triamcinolone is not always available as other steroids are purchased in the primary care setting. Radiation cannot be used in large areas and various side effects are associated. It is not safe for use in the very young or fertile age groups. Pressure garments demonstrate inadequate results and compliance. Seldom is the right amount of pressure obtained and loose fitting garments are a problem. Dermal substitutes show high return rates at high cost [3]. The burden of keloids is an ongoing problem. Resources of staff, drugs and dressings are utilized repeatedly with unsatisfactory results for patients and staff alike. The psychological burden on patients, especially young people with keloids is tremendous, leading to loss of adequate social functioning. This in turn may lead to loss of productivity in the school or workplace [4,5]. The study sought to determine if a cream, painless and easy to apply, produced at very low cost may be the answer to this burden. Our hypothesis was that this cream may be applied to large areas post excision, leading to maintenance of normal skin texture. AbstractBackground: Dermal keloid scarring after minor injuries remain a problem in genetically predisposed individuals. Simple excision results in return of keloids within 4-6 months in more than 50%-80% of patients. Available treatment options, such as steroid injections and radiotherapy, are not a hundred percent effective and cannot be used in all persons. Nicotine influences wound healing by suppressing Vascular Endothelial Growth Factor (VEGF), thought to play a key role in keloid pathogenesis, as well as suppressing inflammatory processes and possibly Transforming Growth Factor Beta (TGF-Beta). The authors sought to investigate if a nicotine containing cream may influence return of keloids post excision.Methods: A prospective...

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Potential cellular and molecular causes of hypertrophic scar formation

Cited by 308 publications

References 185 publications

Comparison of the effectiveness of topical silicone gel and corticosteroid cream on the pfannenstiel scar prevention — a randomized controlled trial

Comparison of the effectiveness of topical silicone gel and corticosteroid cream on the pfannenstiel scar prevention — a randomized controlled trial

A Potential Role of SDF-1/CXCR4 Chemotactic Pathway in Wound Healing and Hypertrophic Scar Formation

The Effects of Nicotine in the Treatment of Keloids: A Pilot Study

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