• Title/Summary/Keyword: Hypertrophic scar

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Hypertrophic Scar with Chronic Pain after Acute Herpes Zoster -A case report- (대상포진 후 발생한 비대흉터에 동반된 만성 통증 -증례 보고-)

  • Choi, Jong Cheol;Bae, Hong Beom;Jeong, Sung Tae;Kim, Seok Jai;Jeong, Seong Wook;Yoon, Myung Ha;Chung, Sung Soo;Yoo, Kyung Yeon;Jeong, Chang Young;Choi, Jeong II
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.229-231
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    • 2005
  • The most common and cumbersome complication of herpes zoster is postherpetic neuralgia, which typically presents as neuropathic pain. However, the painful symptoms of the postherpetic period might be associated with other causes, such as skin lesions of the herpes zoster. We report a case of a hypertrophic scar that developed in the lesion of an acute herpes zoster patient and was accompanied by pain.

Biocompatible Material Design Minimizing Hypertrophic Injury and Treatment Effects using a Mini-pig (비대성 흉터를 최소화하는 생체적합성 재료설계와 미니돼지에 대한 치료 효과)

  • Kim, Yong-Hwan;Kim, Jong-Woo;Jin, Seong-Hun;Kim, I-Su;Kang, Myung-Chang
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.16 no.6
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    • pp.95-100
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    • 2017
  • Recently, biomedical-grade texture material gauze has often been used to treat wounds. At this time, it is difficult to remove scratches and pushed gauze; if you remove it with force, the tissue may separate and bleeding may occur again. In this study, we studied a method to apply medical-grade silicone material. Similar to the research result that hypertrophic wounds reduce the thickness of scar marks. Through mini-pig experiments, we evaluated the effects on scar treatment. The test results showed that the silicone cover layer applied to the wound site had a sealing effect on the wound area, skin temperature, and histopathological examination. In conclusion, gel treatment utilizing a biocompatible substance had the effect of minimizing hypertrophic scars.

FREE SKIN GRAFTING WITH FIBRIN ABHESIVE - CLINICAL AND HISTOPATHOLOGIC REVIEWS - (조직 접착제를 이용한 유리 피부 이식술 - 임상적, 조직병리학적 고찰 -)

  • Min, Seung-Ki;Jin, Kook-Beum;Kang, Moon-Jeong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.1
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    • pp.81-88
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    • 1999
  • A fibrin adhesive have been widely used in oral and maxillofacial surgery for microvascular anastomosis, autogenous chip bone grafts, many kinds of soft tissue surgery (vestibuloplasty, bleeding control after extraction, primary healing by covering of suture of a gum after the extirpation of large cysts). There are two principal components in adhesive systems biologically: lyophilized human fibrinogen and bovine thrombin. The fibrinogen component contains coagulation factor XIII and enhance the initial wound healing, which polymerizes soluble fibrin monomers into an insoluble clot. The thrombin is dissolved in a solution of calcium chloride to provide the second component. We applied fibrin adhesive, Beriplast (Behring, Behringwerke AG, D-3350, Marburg, FRD), to 4 patients for fixation of free skin grafting donors who had facial scar around eye, nose, mouth corner which received from accidents, or burn. We have experienced initial accelerated graft fixation between donor and recipient sites with no additional fixation. And It's made easy bleeding control and easy manipulation during operation. But two cases showed partial hypertrophic scar engrowth in above 3 months follow up, but no significant. Histopathological reviews in general were showed similar scar findings such as abundant collagen bundles in H&E, M/T stain, but slight positive signs in elastic and collagen antibody immunopathologic findings in hypertrophic scar cases.

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Hydroalcoholic Extract of Scrophularia Striata Attenuates Hypertrophic Scar, Suppresses Collagen Synthesis, and Stimulates MMP2 and 9 Gene Expression in Rabbit Ear Model

  • Zarei, Hatam;Tamri, Pari;Asl, Sara Soleimani;Soleimani, Meysam;Moradkhani, Shirin
    • Journal of Pharmacopuncture
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    • v.25 no.3
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    • pp.258-267
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    • 2022
  • Objectives: Hypertrophic scars (HSs) are caused by abnormal wound healing. To date, no standard treatment has been made available for HSs. Scrophularia striata has been reported to accelerate wound healing and has the potential to prevent HS formation. In this study, we investigated the anti-scarring effects of S. striata extract (SSE) in a rabbit ear model of scarring. Methods: In this study, New Zealand white rabbit (weight: 2.3-2.5 kg) were used. In the prevention phase of the study, three test groups received 5%, 10%, and 15% ointments of SSE in the Eucerin base, the fourth group received Eucerin, and the fifth group received no treatment. The samples were obtained on day 35 after wounding. In the treatment phase of the study, the test groups received an intralesional injection of SSE (5%, 10%, and 15%), the fourth group received an intralesional injection of triamcinolone, the fifth group received a solvent (injection vehicle), and the sixth group received no treatment. To evaluate the anti-scarring effects of SSE, the scar elevation index (SEI), epidermis thickness index (ETI), collagen deposition, and MMP2 and MMP9 gene expression were evaluated. Results: A significant reduction in SEI, ETI, and collagen deposition was noted in animals treated with SSE compared with the control groups. In addition, topical SSE stimulated MMP2 and MMP9 gene expression. Conclusion: The findings of this study demonstrate the potential for SSE in the prevention and treatment of HS. SSE could be prepared as an appropriate formulation to treat wounds and prevent abnormal scarring.

Clinical Experience of Circumumbilical Incision for Infantile Hypertrophic Pyloric Stenosis (제대주위 절개술을 이용한 유문협착증 치험)

  • Kim, Chong-Suk;Jean, Hoon-Bae
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.100-101
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    • 1996
  • Infantile hypertrophic pyloric stenosis is one of the most common disorders requiring surgical therapy during the first few weeks of life. Although the pyloromyotomy, reported by Fredet and Ramstedt, was accepted as a standard procedure of choice, various laparotomy incisions have been reported by several authors. Currently, the most commonly used transverse or right upper quadrant incisions, offer many advantages, but is not without drawbacks. The authors utilized the circumumbilical skin incision and upper subcutaneous dissection followed by vertical division of linea alba in 16 cases of infantile hypertrophic pyloric stenosis. This incision avoids transection of rectus muscle and offers a much better cosmetic result. We prefer this procedure because of acceptable scar and no additional wound complication.

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The Effect of Injection of Steroid and 5-Fluorouracil on Hypertrophic Scars of Rabbit (가토의 비후성 반흔에서 스테로이드와 5-플루오르우라실 투여 효과)

  • Kim, Kyung-Rak;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.210-217
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    • 2011
  • Purpose: This study was to evaluate the synergistic effects of combined therapy of steroid and anti-neoplastic drug injection on hypertrophic scars in a rabbit model. Methods: Adult male white rabbits weighing about 2.5 kg were used. After full thickness wounding (about 6 mm) over the ventral surface of each ear sized was made, either saline (control group), triamcinolone, 5-fluoruracil, and mixture of triamcinolone and 5-fluoruracil were injected once 16 days after the wound was made. Rabbits were sacrificed 2, 4 and 8 weeks after injection, and tissue specimens were prepared for histologic and histomorphometric examinations. Results: With the combined injection of triamcinolone and 5-fluoruracil, collagen fiber thickness was arranged in a somewhat irregular manner 2 weeks after injection. After 4 weeks, blood vessels and inflammatory cells were decreased, and collagen fibers were arranged in an almost parallel manner. By 8 weeks, almost same amount of connective tissue compared with adjacent normal tissue was observed. Conclusion: These results indicated that combined injection of triamcinolone and 5-fluoruracil reduced the amount of hypertrophic scars by inhibition of fibroblasts and inflammatory cells. Therefore, combined injection of triamcinolone and 5-fluoruracil is a more potent and effective treatment of hypertrophic scars compared with the single injection of either triamcinolone or 5-fluorouracil.

Free-Breathing Motion-Corrected Single-Shot Phase-Sensitive Inversion Recovery Late-Gadolinium-Enhancement Imaging: A Prospective Study of Image Quality in Patients with Hypertrophic Cardiomyopathy

  • Min Jae Cha;Iksung Cho;Joonhwa Hong;Sang-Wook Kim;Seung Yong Shin;Mun Young Paek;Xiaoming Bi;Sung Mok Kim
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1044-1053
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    • 2021
  • Objective: Motion-corrected averaging with a single-shot technique was introduced for faster acquisition of late-gadolinium-enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging while free-breathing. We aimed to evaluate the image quality (IQ) of free-breathing motion-corrected single-shot LGE (moco-ss-LGE) in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods: Between April and December 2019, 30 patients (23 men; median age, 48.5; interquartile range [IQR], 36.5-61.3) with HCM were prospectively enrolled. Breath-held single-shot LGE (bh-ss-LGE) and free-breathing moco-ss-LGE images were acquired in random order on a 3T MR system. Semi-quantitative IQ scores, contrast-to-noise ratios (CNRs), and quantitative size of myocardial scar were assessed on pairs of bh-ss-LGE and moco-ss-LGE. The mean ± standard deviation of the parameters was obtained. The results were compared using the Wilcoxon signed-rank test. Results: The moco-ss-LGE images had better IQ scores than the bh-ss-LGE images (4.55 ± 0.55 vs. 3.68 ± 0.45, p < 0.001). The CNR of the scar to the remote myocardium (34.46 ± 11.85 vs. 26.13 ± 10.04, p < 0.001), scar to left ventricle (LV) cavity (13.09 ± 7.95 vs. 9.84 ± 6.65, p = 0.030), and LV cavity to remote myocardium (33.12 ± 15.53 vs. 22.69 ± 11.27, p < 0.001) were consistently greater for moco-ss-LGE images than for bh-ss-LGE images. Measurements of scar size did not differ significantly between LGE pairs using the following three different quantification methods: 1) full width at half-maximum method; 23.84 ± 12.88% vs. 24.05 ± 12.81% (p = 0.820), 2) 6-standard deviation method, 15.14 ± 10.78% vs. 15.99 ± 10.99% (p = 0.186), and 3) 3-standard deviation method; 36.51 ± 17.60% vs. 37.50 ± 17.90% (p = 0.785). Conclusion: Motion-corrected averaging may allow for superior IQ and CNRs with free-breathing in single-shot LGE imaging, with a herald of free-breathing moco-ss-LGE as the scar imaging technique of choice for clinical practice.

Axillary Approach for Thyroidectomy under Operating Microscope (수술현미경하 액와접근 갑상선 절제술)

  • Choi, Jong-Ouck;Jun, Byung-Sun;Lee, Jang-Woo;Lee, Dong-Jin;Sohn, Hang-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.32-36
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    • 2007
  • Background and Objective:A post-operative hypertrophic scar of the anterior neck is the leading complaint of the patients who underwent conventional thyroid surgery. In order to minimize the post-operative scar of the anterior neck, we performed thyroidectomy via axillary approach using operating microscope and a specialized retractor to determine technical feasibility. Patients and Methods:From January 2005 to December 2006, we performed thyroidectomy via axillary approach under operating microscope(f=400mm, ${\times}2.5$;OPMI $pico^{(R)}$;Zeiss, Germany) for benign unilateral nodule in 25 cases(all female, average age 34.5yrs). Under general anesthesia less than 7cm of skin incision was made in the axilla of ipsilateral side. A subcutaneous tunnel went over the pectoralis major muscle and the clavicle, and then through the sternocleidomastoid muscle and sternothyroid muscle was excised. The area around the thyroid was sufficiently dissected, and then a retractor designed for exposure via axillary approach was placed within the tunnel and under operating microscope thyroidectomy was performed. Results:There were 17 cases of thyroid nodulectomy and 8 cases of subtotal lobectomy. The mean average operative time was 102.64minutes. Postoperative complications included one case of postoperative bleeding, one case of temporary vocal cord paralysis, two cases of delayed wound healing, two cases of paresthesia of shoulder and arm, and two cases of hypertrophic scar of the axilla. Postoperative histopathology includes 17 cases of adenomatous hyperplasia, six cases of cyst, and two cases of follicular adenoma. For all cases hospitalization period was two days. Conclusion:Thyroidectomy via axillary approach under operating microscope has a good cosmetic advantage without a post-operative scar of the anterior neck. The procedure is simple due to direct vision using operating microscope, easy to identify important structures by magnifying them, and therefore surgical time can be reduced.

Regulation of Transforming Growth Factor ${\beta}1$, Platelet-Derived Growth Factor, and Basic Fibroblast Growth Factor by Silicone Gel Sheeting in Early-Stage Scarring

  • Choi, Jaehoon;Lee, Eun Hee;Park, Sang Woo;Chang, Hak
    • Archives of Plastic Surgery
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    • v.42 no.1
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    • pp.20-27
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    • 2015
  • Background Hypertrophic scars and keloids are associated with abnormal levels of growth factors. Silicone gel sheets are effective in treating and preventing hypertrophic scars and keloids. There has been no report on the change in growth factors in the scar tissue following the use of silicone gel sheeting for scar prevention. A prospective controlled trial was performed to evaluate whether growth factors are altered by the application of a silicone gel sheet on a fresh surgical scar. Methods Four of seven enrolled patients completed the study. Transforming growth factor (TGF)-${\beta}1$, platelet-derived growth factor (PDGF), and basic fibroblast growth factor (bFGF) were investigated immunohistochemically in biopsies taken from five scars at 4 months following surgery. Results In both the epidermis and the dermis, the expression of TGF-${\beta}1$ (P=0.042 and P=0.042) and PDGF (P=0.043 and P=0.042) was significantly lower in the case of silicone gel sheet-treated scars than in the case of untreated scars. The expression of bFGF in the dermis was significantly higher in the case of silicone gel sheet-treated scars than in the case of untreated scars (P=0.042), but in the epidermis, the expression of bFGF showed no significant difference between the groups (P=0.655). Conclusions The levels of TGF-${\beta}1$, PDGF, and bFGF are altered by the silicone gel sheet treatment, which might be one of the mechanisms of action in scar prevention.

A Case of Endometrioma at the Abdominal Scar (복부흉터에 발생한 자궁내막종)

  • Yi, Tae-Min;Kim, Yu-Jin;Kim, Sun-Goo;Lee, Se-Il
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.843-846
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    • 2010
  • Purpose: Plastic surgeon can easily misdiagnose the mass on the postoperative scar as hypertrophic scar. We present a case of endometrioma at abdominal scar after cesarean section. Methods: A 36 year-old female visited with a protruding, rubbery hard mass on her abdominal scar. The mass grew slowly after cesarean section performed 7 years ago. She has felt intermittent pain, not with menstrual cycle, for 2 months. The ultrasonography showed a solid irregular, ill defined mass with heterogenous echogenicity. The MRI finding is suggestive of malignant soft tissue tumor with deep fascial invasion. Incisional biopsy showed acanthosis, melanophage, lymphoplasmacytic infiltration. So we excised mass elliptically, we could see chocolatelike discharge from the mass, adhering to external oblique muscle fascia. The mass confirmed histologically as an endometrioma. Results: The mass was completely removed and did not recurr. The patient does not complain more about pain or any discomfort. Conclusion: Plastic surgeons should be aware of the possibility of endometrioma when the patient present with mass on her abdominal scar after surgery of the pelvis and abdomen.