Scar Assessment Tools: Implications for Current Research

Zuijlen, Paul P. M. van; Angeles, Adam P.; Kreis, R.W.; Bos, Kurt E.; Middelkoop, Esther

doi:10.1097/00006534-200203000-00052

Cited by 130 publications

(80 citation statements)

References 112 publications

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“…18,[90][91][92][93] However, KD in ethnic skin or otherwise does not always respond satisfactorily to current treatment modalities, which are often ill defined and lacking in high-quality evidence-based research. 94,95 Given the complex nature of KD management and the scarcity of effective treatment options, preventative measures should take precedence in management of KD. Presently, there is no levelone evidence of an effective treatment modality for the management of KD.…”

Section: Discussionmentioning

confidence: 99%

Strategic management of keloid disease in ethnic skin: a structured approach supported by the emerging literature

Uddin

Bayat

2013

Br J Dermatol

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SummaryKeloid disease (KD) is a common, benign, dermal fibroproliferative growth of unknown aetiology. Lesions tend to grow over time; they often recur following therapy and do not regress spontaneously. KD causes considerable discomfort due to pain, pruritus and inflammation, and a significant psychosocial impact with reduced quality of life. It is unique to humans and occurrence is higher in individuals with dark, pigmented, ethnic skin. There is a strong familial heritability, with a high ethnic predisposition in individuals of African, Asian and Hispanic descent. High recurrence rates and unknown resolution rates present a major problem for both the patient and clinician. Many treatment modalities exist; however, there is no single advocated therapy. Therefore, the aim of this review was to explore the most current literature regarding the range of treatment options for KD and to offer a structured approach in the management of KD, based on evidence and experience, to aid clinicians in their current practice. A focused history involving careful evaluation of the patient's symptoms, signs, quality of life and psychosocial well-being should direct targeted therapy, complemented with regular follow-up and re-evaluation. Many treatment modalities, such as intralesional steroid injection, silicone gel application, cryotherapy, lasers, 5-fluorouracil and, relatively recently, photodynamic therapy, are currently being used in clinical practice for the management of KD. Combination therapies have also been shown to be beneficial. However, there is a lack of robust, randomized, level-one, evidence-controlled trials evaluating these treatment options. Management of KD in ethnic pigmented skin remains a clinical challenge. Thus, a strategic approach with structured assessment, targeted therapy and focus on prevention of recurrence is highly recommended. Quality evidence is essential in order to tailor treatment effectively for the ethnic patient presenting with KD.What's already known about this topic?• Keloid disease (KD) is a common, benign, fibroproliferative tumour of unknown origin.• With high recurrence rates, treatment of KD remains a challenge for both the patient and clinician.• With lack of level-one evidence, there is no single advocated therapy.What does this study add?• A structured strategic approach for management of KD by utilizing a focused history, targeted therapy and regular follow-up of the patient.• Patients' symptoms, signs, quality of life and psychosocial well-being should be carefully evaluated and managed.

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Section: Discussionmentioning

confidence: 99%

Strategic management of keloid disease in ethnic skin: a structured approach supported by the emerging literature

Uddin

Bayat

2013

Br J Dermatol

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“…In this pilot study, vasculature of the cutaneous burn scar of a human subject was evaluated with the mOMAG microangiograms. Compared to a standard visual inspection of the burn scar, 40 the scar vascularity would be a potential indicator to assess the scar progression, providing early diagnosis and proper treatment of pathological scarring. 27 Vascular imaging was carried out over a 10-month-old scar resulting from an accident radiation burn with a laser on a left dorsal hand of a 34-year-old male subject.…”

Section: In Vivo Microangiographic Assessment Of Scarred Human Skinmentioning

confidence: 99%

Improved microcirculation imaging of human skinin vivousing optical microangiography with a correlation mapping mask

Choi¹,

Reif²,

Yousefi³

et al. 2014

J. Biomed. Opt

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Abstract. Optical microangiography based on optical coherence tomography (OCT) is prone to noise that arises from a static tissue region. Here, we propose a method that can significantly reduce this noise. The method is developed based on an approach that uses the magnitude information of OCT signals to produce tissue microangiograms, especially suitable for the case where a swept-source OCT system is deployed. By combined use of two existing OCT microangiography methods-ultrahigh-sensitive optical microangiography (UHS-OMAG) and correlation mapping OCT (cmOCT)-the final tissue microangiogram is generated by masking UHS-OMAG image using the binary representation of cmOCT image. We find that this process masks the residual static artifacts while preserving the vessel structures. The noise rejection capability of the masked approach (termed as mOMAG) is tested on a tissue-like flow phantom as well as an in vivo human skin tissue. Compared to UHS-OMAG and cmOCT, we demonstrate that the proposed method is capable of achieving improved signal-to-noise ratio in providing microcirculation images. Finally, we show its clinical potential by quantitatively assessing the vascular difference between a burn scar and a normal skin of human subject in vivo. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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“…Queda por dilucidar qué factores pueden condicionar el desarrollo de una hiperfibrosis de este tipo, ya sean relacionados con el paciente, sus hábitos, capacidad de cicatrización, etc. ; también los factores relacionados con el procedimiento en sí y otros factores añadidos tales como complicaciones y desviaciones del curso postoperatorio normal (16). Independientemente de los posibles condicionantes de la hiperfibrosis acaecida en el caso que exponemos, fue necesario en nuestro caso la detección oportuna del proceso, el evitar la exacerbación del cuadro y una vez agotadas las terapéuticas tradicionales, intentar un procedimiento correctivo con una base empírica y siempre resguardando un margen de seguridad, atentos en todo momento a la correcta evolución postoperatoria del cuadro.…”

Section: Discussionunclassified

Reparación de hiperfibrosis abdominal secundaria a liposucción

Sanza

García

2011

Cir. plást. iberolatinoam.

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ResumenEl desarrollo de hiperfibrosis secundaria a cualquier procedimiento quirúrgico es un problema que afecta al paciente que lo padece y al médico que le trata; puede tener resultados devastadores no solo sobre la estética, sino en casos extremos, también sobre la función. En el ámbito de la Cirugía Plástica, cuando la hiperfibrosis se desarrolla tras algún procedimiento estético y por ende 100% electivo, al paciente le es difícil entender y aceptar la génesis de dicho problema y exige al cirujano una reparación rápida y satisfactoria, lo cual no siempre es fácil o incluso factible. En este artículo presentamos el caso de una paciente sometida a liposucción abdominal que, tras la aparición en el postoperatorio y posterior resolución de una seroma, sufrió una hiperfibrosis que deformó la zona; presentamos también nuestra propuesta de tratamiento y los resultados finales conseguidos. Hay que recalcar que cuando estos casos, afortunadamente no muy comunes, aparecen, la evolución suele ser tórpida y en ocasiones resistente a los protocolos de tratamiento habituales, lo que puede llevarnos a desarrollar estrategias poco convencionales y, que en un caso como el que presentamos, resultan bastante efectivas.Palabras clave Liposucción, Complicaciones, Seroma postperatorio, Hiperfibrosis. Código numérico 5311-15311 AbstractThe development of hyperfibrosis after any surgical procedure is a problem that affects the patient and the doctor who treated, and can have devastating results that affect not only the aesthetic but, in extreme cases, the function. In the field of Plastic Surgery, when hyperfibrosis develops in a cosmetic procedure and therefore 100% elective, the patient does not understand and accept the genesis of the problem and the surgeon is required to fast repair, but this is not always satisfactory, easy or even feasible. We present the case of a patient undergoing an abdominal liposuction complicated with postoperative seroma; after seromas resolution she developed hyperfibrosis that deformed the area. We also present our proposal for treatment and our final results. It´s important to remark that these cases are usually rresistible to standard treatment protocols, and sometimes leads us to develop unconventional strategies.

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Scar Assessment Tools: Implications for Current Research

Cited by 130 publications

References 112 publications

Strategic management of keloid disease in ethnic skin: a structured approach supported by the emerging literature

Strategic management of keloid disease in ethnic skin: a structured approach supported by the emerging literature

Improved microcirculation imaging of human skinin vivousing optical microangiography with a correlation mapping mask

Reparación de hiperfibrosis abdominal secundaria a liposucción

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