Methods of correction of scars

Methods of correction of scars.  Photo courtesy gettyimages.com

Please be aware that the appearance of scars future can not be predicted exactly, since it depends not only on the art of plastic surgery, but also on the individual response of the patient to the trauma. All the factors that influence the characteristics of the future of the scar can be divided into general and local.

General

  • the age of the patient — in childhood and young age of the regeneration are active, their intensity decreases in adulthood and is much slower in elderly patients
  • immune status of the patient — the immune cells of macrophages in the formation of scar fibroblasts influence (the cells that produce collagen), the level of activity of macrophages depends on the amount of collagen in the rumen
  • hereditary factor — skin reaction to trauma is every person has their own nuances. This is due to the genetic characteristics of fibroblasts, the concentration of biologically active substances in the tissues and blood, and much more

Local

  • localization of the wound — in each anatomical area skin has its own structural features differ according to the type of innervation and blood supply, and the thickness of the fat layer architectonics. Only a qualified doctor can take in the wound properly, perform the cut in a cosmetically favorable direction — along the lines of skin tension (Langer's lines).
  • the walls of the blood supply to the wound — new rumen after the correction will heal faster in areas with a good blood supply to the skin (eg, face, head) and slower on the skin with a reduced blood supply.
  • nature of injury — bruises, lacerations, burn wounds always heal unsightly disfiguring scars. With the most favorable prognostic point of view, are incised wounds, the edges of which are well comparable. That is why the need timely debridement and excision of the scar with the tension of the surrounding tissues.
  • extent of damage — with extensive damage only plastic surgeon can create favorable conditions for wound healing and scar formation of accurate re.

At the consultation, the surgeon explains the patient all aspects of the future of surgical correction, especially in the treatment of each case and is an aesthetic outlook.

Most methods of scar correction involves the removal of rough skin tissue deformation. The most efficient and effective way to improve the appearance of the injured area — cicatrectomy. Excision scar shown with a relatively small width and with its good mobility of the wound edges.

After removal of excess connective scar tissue overlap intradermal cosmetic seams. For this purpose, a special very fine sutures. Under favorable conditions, after complete healing of postoperative suture the skin is thready next (1-3 mm). The width of the new scar depends on the condition of the surrounding skin, the shape of the scar and its location.

In some cases, a significant excise the square patches of skin. Such measures are necessary to correct the common scars that have arisen, such as after burns. To close the resulting defect after resection of skin transplant surgeons use a full skin graft. Skin and fat or skin and fascial flap taken from the undamaged area.

One embodiment of this operation is to use tissue expanders. Tissue expanders — balloon that is placed under the skin near the scar. Periodically, for increasing the balloon added sterile saline. The volume of the balloon is increasing — skin gradually stretched over it. The balloon is removed, formed when sufficient in size over healthy skin. This excess skin will close the defect that occurs after excision of the scar

The long or wide scars on the face and extremities can restrict the mobility of the eyelids, lips and joints. Any movement in these cases causes pain relief skin and subcutaneous structures, often chronic skin cracks are formed in the areas of maximum tension. To improve the function of the affected areas produce lengthening hems. With the help of local plastics soft tissue form a counter triangular flaps in this way eliminating the excessive skin tension. Form a new Z-shaped seam. Changing the direction of cutaneous scar by Z-shaped seam brings its direction to the direction of Langer's lines. Number flaps depends on the initial length of the scar and stretch surrounding tissues.

One problem scar excision is not always sufficient to achieve the desired aesthetic result. A special approach is required for the correction of keloid and hypertrophic scars. At its core, excision — also trauma, and in response to the trauma of the skin can once again answer the formation of rough scar.

In order to prevent this from happening in the postoperative period, surgeons use a special silicone wafer. The plates are issued in the form of patches — it's soft, sticky silicone coating (of hardened gel) on the basis of tissue. Absorbable silicone patches began using in the early 1980th years. Many years of practice proved the high efficiency of this type of correction. Found that they reduce the excessive formation of connective tissue, thus contributing to the formation of scar normotroficheskogo.

The patch is designed to use reusable. It is non-toxic and does not cause skin irritation. The plate is superimposed on the pre-washed with soap and well dried skin so that its edges protrude beyond the rumen 5 mm. After 12 hours the patch is removed, the skin washed and again bonded to the plate. The optimal duration of the plate — 24 hours minimum — 12 hours a day. After 10 — 14 days the gel adhesive properties are lost, requiring replacement of the plate. The duration of treatment ranged from 2 to 6 months.

Prevention of problem scars

It is much better to prevent the formation of hypertrophic or keloid scars than to treat them. Prevention is the following rules:

  • In the event of long, wide, lacerations or any wounds on his face as soon as possible to seek the help of a plastic surgeon, so that he can fully treat the wound and, most importantly, timely impose a cosmetic seam.
  • If the treatment of damaged skin is held in the home, you need to handle every day the wound with antiseptic solutions and ointments for the prevention of sepsis. Its very strong or long-term inflammation is one of the reasons for the formation of rough scars.
  • Even a relatively small extent wound, edges which diverge, a hypertrophic scar will heal. Refer to a plastic surgeon to put it intradermal suture and pulling together a bandage around the edges seam.
  • If skilled care was not provided in a timely manner, and the scar had formed, the earliest use of the silicon wafer will help make rumen less noticeable. According to current data the biggest gains in the correction of hypertrophic or keloid scars with plaster achieved inII-III stage, ie at the old scar is not more than six months. Before using the patch rassasyvayuschego refer to the surgeon — he will tell you to consult about the features of the patch and determine the duration of treatment in this case.

Source: Medical center "Paracelsus 2001"

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