1/7. Ischaemic necrosis of subcutaneous colonic neoesophagus: an unusual complication of presternal hypertrophic scar.Hypertrophic scars and keloids not only pose aesthetic problems but also cause functional and anatomical dysfunction by leading to contractures and sometimes by compression of underneath structures. A 76-year-old man presented with progressive dysphagia of two months duration. Examination showed the unusual complication of a presternal hypertrophic scar, causing ischaemic necrosis of a subcutaneously-transposed colon, used for oesophageal reconstruction in a patient with inoperable carcinoma of the oesophagus. Such a complication of hypertrophic scar has never been reported in the literature.- - - - - - - - - - ranking = 1keywords = keloid (Clic here for more details about this article) |
2/7. The use of collagen-glycosaminoglycan copolymer (Integra) for the repair of hypertrophic scars and keloids.Integra dermal matrix (Integra life Sciences Corp., Plainsboro, NJ) was introduced in 1981, and its use in acute surgical burns is well established. However, Integra also has been found to be useful in the surgical treatment of scars. The Integra neodermis is placed at the time of scar excision and then overgrafted several weeks later with a very thin (6/1000-inch) skin graft. The stabilized matrix appears to resist recurrence better than traditional skin grafts, which have a reported recurrence rate of 59%. Many surgeons have had anecdotal success using Integra for both hypertrophic and keloidal scars. This case series presents several patients who underwent reconstructive surgery with the use of Integra to treat their debilitating scar formation. None of the patients developed significant scar morbidity at the donor site when the skin was harvested for grafting during the second stage of the procedure. All patients had documented success with improved appearance, range of motion, and skin quality.- - - - - - - - - - ranking = 5keywords = keloid (Clic here for more details about this article) |
3/7. Silicone gel sheeting for the prevention and management of evolving hypertrophic and keloid scars.BACKGROUND. Hypertrophic scars and keloids remain a problem for surgeons. Topical and intralesional corticosteroids, positive pressure dressings, cryotherapy, and laser therapy are helpful but not uniformly successful. OBJECTIVE. To document the effectiveness of silicone gel sheeting in the prevention and/or reduction of evolving hypertrophic scars and keloids. methods. Silicone gel sheeting was placed over evolving scars in 20 cases. The dressing was worn for at least 12 hours a day. Biopsies were examined for the presence of silica in the tissue. RESULTS. Lesions improved during the treatment period in 85% of the cases. The mechanisms of action are unknown. Positive pressure was not necessary. No silica from the dressing was found at the wound site. CONCLUSION. Daily treatments with silicone gel sheeting should begin as soon as an itchy red streak develops in a maturing wound. The dressing is effective in reducing the bulk of these lesions.- - - - - - - - - - ranking = 6keywords = keloid (Clic here for more details about this article) |
4/7. Atypical facial scarring after isotretinoin therapy in a patient with previous dermabrasion.The increased use of isotretinoin therapy for severe cystic acne has posed new problems for dermatologic surgeons. There have been recent reports in the literature of unexpected "atypical" scarring after dermabrasion in patients who have previously taken isotretinoin. This scarring was considered atypical because it occurred outside the typical "danger zones" (e.g., mandible and malar eminences) where scarring most often occurs after dermabrasion. This is the first reported case of atypical scarring in a patient who began isotretinoin therapy 2 months after dermabrasion.- - - - - - - - - - ranking = 0.0026572821737644keywords = acne (Clic here for more details about this article) |
5/7. Topical silastic gel sheeting for treating and controlling hypertrophic and keloid scars: case study.Hypertrophic and keloid scars form in a healed skin wound by the overgrowth of fibrous tissue after injury or surgery. In this case study the treatment and control of hypertrophic and keloid scars in an adult Chinese male with third degree burns is presented, emphasizing the use of topical silastic gel for scar treatment and control.- - - - - - - - - - ranking = 6keywords = keloid (Clic here for more details about this article) |
6/7. Acne keloidalis nuchae and tufted hair folliculitis.Acne keloidalis nuchae is a chronic, scarring folliculitis that affects mostly black patients and is located on the back of the neck of young adults. The course is progressive and leads to hypertrophic scarring, chronic abscesses and hair loss. We discuss the relationship between acne keloidalis and tufted hair folliculitis, pointing out the possibility that tufted hair folliculitis is not a specific disease but secondary to other progressive folliculitis like folliculitis decalvans, dissecting cellulitis or acne keloidalis.- - - - - - - - - - ranking = 7.0053145643475keywords = keloid, acne (Clic here for more details about this article) |
7/7. Static-electric field induction by a silicone cushion for the treatment of hypertrophic and keloid scars.Silicone gel and silicone occlusive sheeting are widely used at present for the treatment of hypertrophic and keloid scars, without any scientific explanation as to their mode of action. In a recent paper the possibility was raised that static electricity generated by friction-activated silicone sheeting could be the reason for this effect, and that it can, with time, cause involution of hypertrophic and keloid scars. The objective of this study was to test this hypothesis and to observe whether a continuous and also an increased negatively charged static-electric field will shorten the treatment period. A device to implement these requirements gradually evolved over a 5-year period. A number of prototypes were tested until the final product was attained. Some of the patients in this study were treated initially with a silicone sponge inserted in the cushion. Later this version was changed to the final design described herein. A silicone cushion was developed with the purpose of increasing a negative static-electric charge to accelerate the regression process. The cushion is custom-made using a silicone occlusive sheeting envelope of 0.75-mm thickness, which does not deteriorate with use, and is partially filled with high viscosity silicone oil. Its edges are sealed, and its size is designed to extend a little beyond the scarred area. static electricity readings, generated by activating the cushion by pumping action with the fingers, stretching or deforming the cushion, are invariably much higher when compared with those obtained with silicone occlusive sheeting and silicone gel sheeting. The interaction between the negatively charged ions of the cushion and the ionic charges of the tissue fluids may be the critical factor in achieving hypertrophic and keloid scars involution. Of the 30 patients enrolled in the study, 3 patients dropped out. Treatment with the silicone cushions yielded 63.3 percent cessation of itching and burning followed by pallor and flattening of the scar, some markedly so, over a few weeks to 6-month period. An additional 26.6 percent had their scars resolved in up to 12 months of treatment. Good contact of the cushion over the scar has been shown to be important in this clinical trial, and much creativity is needed for making elastic strap bindings that ensure this contact. The clinical trials extended over a 12-month period. Ten patients (33.3 percent) who had recalcitrant scars with little response to the use of the silicone cushion were given intralesional corticosteroid injections, in addition to the continued use of the cushion, resulting in a fairly rapid resolution of these scars over a period of months to a year.- - - - - - - - - - ranking = 7keywords = keloid (Clic here for more details about this article) |