新人999如何治疗疤痕增生配图，仅供参考
The treatment of HTSCurrent treatment of HTS remains time-consuming,expensive and with few consistently successful approaches. One of the difficulties is that the outcome of HTS formation varies between patients,scar location and between conservative interventions. So it is extremely difficult for surgeons to predict which scars need surgical excision or which scars might resolve over time (Tredget et al. ). There are however a variety of therapeutic options available to treat HTS,including surgical excision and non-surgical treatment.
# Surgical therapy for HTS
Surgical excision is common management when used in combination with steroids and/or silicone gel sheeting. However,surgical excision of HTS without adjuvant therapy is associated with a high rate of recurrence,ranging from 50 % to 80 % (Darzi et al. ). HTS resulting from excessive tension or wound complications can be treated effectively with surgery options including intramarginal excision,skin grafts,local flaps and free flaps combined with surgical taping and silicone gel sheeting (Mustoe et al. ). But these technique are not suitable for immature scar.
There are two major kind of lasers,ablative nonselective lasers such as CO2 laser and nonablative selective lasers such as pulse-dye laser. Ablative lasers might carry a higher risk while nonablative lasers have the advantage of improving scars without incision or wounding. The flash lamp-pumped pulsed dye laser is extensively used to refine scars by causing direct destruction of the blood vessels and an indirect effect on the surrounding collagen,which result in collagen modeling and wound contraction (Lee et al. ).
# Non-surgical therapy for HTS
Non-surgical management of HTS includes the use of pressure garments,intralesional corticosteroid administration,silicone gel sheets and so on. Pressure garment are commonly used and are supplied by several companies based on individual patient measurements (Macintyre and Baird ). Pressure therapy should be applied 24 h a day until the scar is mature. The optimum pressure for effective treatment is still unknown,but the pressures applied should exceed capillary pressure and recommend that pressure be maintained between 24 and 30 mmHg (Mustoe et al. ). The possible mechanism of pressure garment may relate to reduced fibroblast proliferation,decreased collagen synthesis,increased myofibroblasts apoptosis (Armour et al. ; Anzarut et al. ).
Intralesional corticosteroid administration is also widely used to alleviate HTS. Triamcinolone acetonide is the most commonly used corticosteroid. The administration should be confined to the dermal region of the scar with 10 to 40 mg/ml at 2- to 6-weeks interval (Atiyeh ). Silicone gel is a cross-linked polymer of dimethylsiloxane,which has been used for treatment of immature scar. Applying silicone gel sheet topically is a noninvasive and relatively safe treatment since it may decrease the volume of HTS (Ahn et al. ). It has been shown that silicone gel sheets may accelerate scar maturation and improve pigmentation,vascularity,pliability,pain and itchiness associated with HTS (Momeni et al. ). Thus,prophylactic use of topical silicone gel following scar revision surgery may prevent the development of recurrent HTS (Gold et al. ).","department":"
