Pressure Garment Therapy Alone and in Combination with Silicone for the Prevention of Hypertrophic Scarring

Steinstraesser, Lars; Flak, E.; Witte, Bernd; Ring, Andrej; Tilkorn, Daniel J.; Hauser, Jörg; Langer, Stefan; Steinau, Hans-Ulrich; Al-Benna, Sammy

doi:10.1097/prs.0b013e3182268c69

Cited by 85 publications

(73 citation statements)

References 16 publications

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“…excision, laser, IFN injection, etc. ), none of these treatments has been confirmed to be effective in fully avoiding excessive scar tissue formation or regeneration of healthy dermal tissue [30]. The feasibility of ADSCs to attenuate the formation of hypertrophic scars through secreting anti-fibrosis cytokines and decreasing the α-SMA and collagen type Ι gene expression was demonstrated in a rabbit ear hypertrophic scar model by locally intralesional injection of ADSCs [31].…”

Section: Mesodermal Potential Of Adipose Tissue-derived Stem Cellsmentioning

confidence: 99%

Adipose Tissue-Derived Stem Cells in Regenerative Medicine

Frese

Dijkman

Hoerstrup

2016

Transfus Med Hemother

353

245

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In regenerative medicine, adult stem cells are the most promising cell types for cell-based therapies. As a new source for multipotent stem cells, human adipose tissue has been introduced. These so called adipose tissue-derived stem cells (ADSCs) are considered to be ideal for application in regenerative therapies. Their main advantage over mesenchymal stem cells derived from other sources, e.g. from bone marrow, is that they can be easily and repeatable harvested using minimally invasive techniques with low morbidity. ADSCs are multipotent and can differentiate into various cell types of the tri-germ lineages, including e.g. osteocytes, adipocytes, neural cells, vascular endothelial cells, cardiomyocytes, pancreatic β-cells, and hepatocytes. Interestingly, ADSCs are characterized by immunosuppressive properties and low immunogenicity. Their secretion of trophic factors enforces the therapeutic and regenerative outcome in a wide range of applications. Taken together, these particular attributes of ADSCs make them highly relevant for clinical applications. Consequently, the therapeutic potential of ADSCs is enormous. Therefore, this review will provide a brief overview of the possible therapeutic applications of ADSCs with regard to their differentiation potential into the tri-germ lineages. Moreover, the relevant advancements made in the field, regulatory aspects as well as other challenges and obstacles will be highlighted.

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Section: Mesodermal Potential Of Adipose Tissue-derived Stem Cellsmentioning

confidence: 99%

Adipose Tissue-Derived Stem Cells in Regenerative Medicine

Frese

Dijkman

Hoerstrup

2016

Transfus Med Hemother

353

245

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“…However, a randomized controlled trial with intraindividual comparison showed no added beneficial effect when applying silicone underneath the pressure garment in burn hypertrophic scars [36]. Silicone gel sheeting in pathological scars has been reported to have at best a class 3 scientific evidence [37].…”

Section: Classical Treatment and Preventive Options For Keloids Anmentioning

confidence: 99%

Up-to-date approach to manage keloids and hypertrophic scars: A useful guide

Arno

Gauglitz

Barret

et al. 2014

Burns

312

314

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Keloids and hypertrophic scars occur anywhere from 30 to 90% of patients, and are characterized by pathologically excessive dermal fibrosis and aberrant wound healing. Both entities have different clinical and histochemical characteristics, and unfortunately still represent a great challenge for clinicians due to lack of efficacious treatments. Current advances in molecular biology and genetics reveal new preventive and therapeutical options which represent a hope to manage this highly prevalent, chronic and disabling problem, with long-term beneficial outcomes and improvement of quality of life. While we wait for these translational clinical products to be marketed, however, it is imperative to know the basics of the currently existing wide array of strategies to deal with excessive scars: from the classical corticotherapy, to the most recent botulinum toxin and lasers. The main aim of this review paper is to offer a useful up-to-date guideline to prevent and treat keloids and hypertrophic scars.

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“…Firstly, the exact optimal pressure required for effective treatment has never been scientifically established151617. Some studies indicated that 15 mmHg pressure was required to achieve a therapeutic effect318. Pressure less than 15 mmHg (low-PT) may not show the desired effect and a pressure of more than 40 mmHg is more likely to cause severe discomfort and may be potentially harmful15.…”

mentioning

confidence: 99%

The effectiveness of pressure therapy (15–25 mmHg) for hypertrophic burn scars: A systematic review and meta-analysis

Liu

Pei

et al. 2017

Sci Rep

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Although pressure therapy (PT) represents the standard care for prevention and treatment of hypertrophic scar (HS) from burns, its practice is largely based on empirical evidence and its effectiveness remains controversial. To clarify the effect of PT (15–25 mmHg) for HS, we performed the systematic review and meta-analysis. Several electronic databases were screened to identify related randomized controlled trials (RCTs). 12 RCTs involving 710 patients with 761 HS resulting from burn injuries were included. Compared with non/low-PT, cases treated with PT (15–25 mmHg) showed significant differences in Vancouver Scar Scale score (MD = −0.58, 95% CI = −0.78–−0.37), thickness (SMD = −0.25, 95% CI = −0.40–−0.11), brightness (MD = 2.00, 95% CI = 0.59–3.42), redness (MD = −0.79, 95% CI = −1.52–−0.07), pigmentation (MD = −0.16, 95% CI = −0.32–−0.00) and hardness (SMD = −0.65, 95% CI = −1.07–−0.23). However, there was no difference in vascularity (MD = 0.03, 95% CI = −0.43–0.48). Our analysis indicated that patients with HS who were managed with PT (15–25 mmHg) showed significant improvements. Due to limitations, more large and well-designed studies are needed to confirm our findings and the side-effects of the PT may also need to be evaluated.

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Pressure Garment Therapy Alone and in Combination with Silicone for the Prevention of Hypertrophic Scarring

Abstract: Therapeutic, II.

Cited by 85 publications

References 16 publications

Adipose Tissue-Derived Stem Cells in Regenerative Medicine

Adipose Tissue-Derived Stem Cells in Regenerative Medicine

Up-to-date approach to manage keloids and hypertrophic scars: A useful guide

The effectiveness of pressure therapy (15–25 mmHg) for hypertrophic burn scars: A systematic review and meta-analysis

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