The Relationship Between Keloid Growth Pattern and Stretching Tension

Akaishi, Satoshi; Akimoto, Makio; Ogawa, Rei; Hyakusoku, Hiko

doi:10.1097/sap.0b013e3181238dd7

Cited by 152 publications

(97 citation statements)

References 15 publications

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“…The tape-based device showed better isolation from shear across the incision compared to staples and sutures, holding the wound intact and keeping the strains uniform along the incision. This would lead to better wound healing and reduced scarring [10-11]. …”

Section: Resultsmentioning

confidence: 99%

Mechanics of Wound Closure: Emerging Tape-Based Wound Closure Technology vs. Traditional Methods

Levi¹,

Ichiryu²,

Kefel³

et al. 2016

Cureus

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To date, there is still a lack of understanding of how wound closure methods perform comparatively under daily bodily movement during the course of healing and how they affect the mechanics of healing. The present study is a first step in understanding and objectively quantifying the gap. The study provides both a new method of metrology for noninvasive evaluation of skin mechanics at the onset of wound healing and an emerging tape-based wound closure technology. The latter shows better performance with respect to commonly used staples and sutures, holding the wound intact and providing uniform mechanical support across the incision.

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Section: Resultsmentioning

confidence: 99%

Mechanics of Wound Closure: Emerging Tape-Based Wound Closure Technology vs. Traditional Methods

Levi¹,

Ichiryu²,

Kefel³

et al. 2016

Cureus

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show abstract

“…21,50,58,87,88 This is supported by the increased incidence of abnormal scar formation in areas subject to the most movement, such as the scapular region and chest. 69,89,90 Minimization of movement over these areas has been shown to reduce the degree of abnormal scarring. 73,83,91,92 A number of investigations have found that mechanical force on wounds, particularly cyclical force, stimulates the release of growth factors such as TGF-β.…”

Section: Mechanical Stress and Scarringmentioning

confidence: 99%

The Role of Wound Healing and Its Everyday Application in Plastic Surgery

Ireton

Unger

Rohrich

2013

Plastic and Reconstructive Surgery Global Open

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Background:After surgery it is often recommended that patients should refrain from strenuous physical activity for 4–6 weeks. This recommendation is based on the time course of wound healing. Here, we present an overview of incisional wound healing with a focus on 2 principles that guide our postoperative recommendations: the gain of tensile strength of a wound over time and the effect of mechanical stress on wound healing.Methods:A systematic search of the English literature was conducted using OVID, Cochrane databases, and PubMed. Inclusion criteria consisted of articles discussing the dynamics of incisional wound healing, and exclusion criteria consisted of articles discussing nonincisional wounds.Results:Experiments as early as 1929 laid the groundwork for our postoperative activity recommendations. Research using animal models has shown that the gain in tensile strength of a surgical wound is sigmoidal in trajectory, reaching maximal strength approximately 6 weeks postoperatively. Although human and clinical data are limited, the principles gained from laboratory investigation have provided important insights into the relationship among mechanical stress, collagen dynamics, and the time course of wound healing.Conclusion:Our postoperative activity recommendations are based on a series of animal studies. Clinical research supporting these recommendations is minimal, with the most relevant clinical data stemming from early motion protocols in the orthopedic literature. We must seek to establish clinical data to support our postoperative activity recommendations so that we can maximize the physiologic relationships between wound healing and mechanical stress.

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“…45 In addition, the characteristic shapes of keloid scars, namely, the butterfly, crab’s claw, and dumbbell shapes, are largely determined by the direction of the local mechanical forces on the skin. 46 Our previous review has described the potential molecular signaling pathways behind this phenomenon. 47 …”

Section: Hypotheses On the Etiology Of Pathological Scarringmentioning

confidence: 99%

Keloids and Hypertrophic Scars

Huang

Murphy

Akaishi

et al. 2013

Plastic and Reconstructive Surgery Global Open

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125

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Summary:The development of cutaneous pathological scars, namely, hypertrophic scars (HSs) and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated. The generally held concepts that keloids and HSs represent “aberrant wound healing” or that they are “characterized by hyalinized collagen bundles” have done little to promote their accurate clinicopathological classification or to stimulate research into the specific causes of these scars and effective preventative therapies. To overcome this barrier, we review here the most recent findings regarding the pathology and pathogenesis of keloids and HSs. The aberrations of HSs and keloids in terms of the inflammation, proliferation, and remodeling phases of the wound healing process are described. In particular, the significant roles that the extracellular matrix and the epidermal and dermal layers of skin play in scar pathogenesis are examined. Finally, the current hypotheses of pathological scar etiology that should be tested by basic and clinical investigators are detailed. Therapies that have been found to be effective are described, including several that evolved directly from the aforementioned etiology hypotheses. A better understanding of pathological scar etiology and manifestations will improve the clinical and histopathological classification and treatment of these important lesions.

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The Relationship Between Keloid Growth Pattern and Stretching Tension

Abstract: These stretching results have advanced understanding of keloid formation under various conditions. Our results suggest that stretching tension is an important condition associated with keloid growth.

Cited by 152 publications

References 15 publications

Mechanics of Wound Closure: Emerging Tape-Based Wound Closure Technology vs. Traditional Methods

Mechanics of Wound Closure: Emerging Tape-Based Wound Closure Technology vs. Traditional Methods

The Role of Wound Healing and Its Everyday Application in Plastic Surgery

Keloids and Hypertrophic Scars

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