Hypertrophic scars and keloids are a common surgical problem. There is increasing knowledge of the pathology of this condition but the exact pathogenesis is yet unknown. Treatment remains difficult and is associated with high recurrence rates in certain forms. The psychological implications for the patient are enormous and have still to be fully defined. This article is a review of the current aetiology, pathology and management of hypertrophic scars and keloids. Various treatment options are discussed and psychological aspects have been emphasised.
References
1.
AlsterTSWestTB (1997): Treatment of scars: A review. Annals of Plastic Surgery39 (4):418–432.
2.
AlsterTS (1997): Laser treatment of hypertrophic scars, keloids and striae. Dermatologic clinics15 (3):419–429.
3.
BakerBLWhitakerWL (1950): Interference with wound healing by local action of adrenocortical steroids. Endocrinology46:544.
4.
BaryzaMJBaryzaGA (1995): The Vancouver scale: An administration tool and its interrater reliability. Journal of Bum care and Rehabilitation4:535–538.
5.
BermanBBieleyHC (1996): Adjunct therapies to surgical management of keloids. Dermatologic surgery, 22(2):126–130.
6.
BlumenfieldMReddishPM (1987): Identification of psychological impairment in patients with mild/moderate thermal injury: Small burn. Big problem. General Hospital Psychiatry9:142–146.
7.
CohenJKDiegelmannRF (1950): The biology of keloid and hypertrophic scar and the influence of corticosteroids. Clin Plast Surg4:297–299.
8.
EdsmyrFLarsonLGOnyangoJWanguruSWoodM (1973): Radiotherapy in the treatment of keloids in South Africa. East African Medical Journal50:457.
9.
GlatPMLongakerMT (1997): Wound Healing. In AstonSJBeasleyRWThomeCHM: Grabb and Smith'sPlastic Surgery 5th Edition, 3–12.
10.
HurrenJS (1995): Rehabilitation of the burned patient. BurnsVol 21No. 2, 116–126.
11.
KreigerLMPanFSDoongH (1993): Thermal response of the epidermis to surface gels. Surgical forum44:738–740.
12.
LeungKSCheungJCYMaGFYClarkJALeungPC (1984): Complications of pressure therapy for post-burn hypertrophic scars and biochemical analysis based on five patients. Burns10:434–438.
13.
LinaresHALarsonDLWillis-GalstaunBA (1993): Historical notes on the use of pressure in the treatment of hypertrophic scars or keloids. Burns19:17–21.
14.
MercerNSG (1989): Silicone gel in the treatment of keloid scars. British Journal of Plastic Surgery42:83–87.
15.
McGregorIAMcGregorAD (1995): Hypertrophic scars and keloids. In Fundamental Techniques of Plastic Surgery 9th Edition, 127–130.
16.
NorrisJE (1995): Superficial X-ray therapy in keloid management: a retrospective study of 24 cases and literature review. Plastic and Reconstructive Surgery95 (6):1051–1055.
17.
PerkinsKDaveyRBWallisKA (1983): Silicone gel: a new treatment for burns scars and contractures. Burns9, 201–204.
18.
QuinnKJ (1987): Silicone gel in scar treatment. Burns13:533–540.
19.
RockwellWBCohenIKEhrlichHP (1989): Keloids and Hypertrophic scars: a comprehensive review. Plastic and Reconstructive Surgery84 (5):827–837.
20.
RoseMPDeitchEA (1985): The clinical use of a tubular compression bandage, Tubigrip for burn scar therapy. Burns Incl. Therm. Inj. 12:58.
21.
ShakespeareV (1998): Effect of small burn injury on physical, social and psychological health at 3–4 months after discharge. Burns24:739–744.
22.
StaleyMJRichardRL (1997): Use of pressure to heat hypertrophic burns scars. Advances in Wound Care10 (3):44–46.
23.
SullivanTSmithJKermodeJMcIverECourtemancheDJ (1990): Rating the burn scarJournal Burn Care and Rehabilitation11:256–260.
24.
SuCWAlizadehKBoddieRNLeeRC (1998): The Problem Scar. Clinics in Plastic SurgeryVol 25(3):451–465.
25.
WilliamBRJr (1996): Wound healing and problem scars. In Bernard M Barrett: Patient Care in Plastic Surgery 2nd Edition. pp:200–222.