• Archives of Plastic Surgery
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• 제48권2호
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• pp.149-157
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• 2021

Scars vary from mature linear scars to abnormal excessive scars such as hypertrophic scars and keloid scars. Keloid scars are fibro-proliferative disease entities that reflect an abnormal process of wound healing. They can cause pain, itching, stiffness, and psychological distress, all of which can affect quality of life. Various treatment options have been advocated as ways to prevent and treat keloid scars. These include noninvasive treatments such as use of silicone gel sheeting and compression therapy, and invasive treatments such as intralesional corticosteroid injections, surgery, and radiotherapy. Novel treatments include chemotherapy, immunotherapy, and anti-inflammatory therapies. Unfortunately, keloids continue to pose a significant challenge due to the lack of efficacious treatments. Therefore, clinicians should be familiar with various therapeutic options and apply the most suitable treatment plan for patients. In this review, we introduce the current therapeutic options for the management of keloid scars.

• 한방안이비인후피부과학회지
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• 제26권4호
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• pp.127-134
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• 2013

Objective : Acne is very common disease, it can leave permanent scars. However, there are few reports about it in oriental medicine academia. This study performed to evaluate the effect of reconstruction of skin scars and auto microneedle therapy system on acne scars. Methods : Six patients were treated by using reconstruction of skin scars and auto microneedle therapy system. We compared the degree of treatment of acne scars on pre and post case photos and Qualitative Global Acne Scarring Grading System(QGASC). Satisfaction degree were asked from the patients. Results & Conclusion : After comparing case photos and QGASC, observing patients satisfaction, it can be considered that reconstruction of skin scars and auto microneedle therapy system to be valid acne scars treatment.

• Archives of Plastic Surgery
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• 제39권3호
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• pp.232-237
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• 2012

Background : Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period. Methods : Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Posttreatment evaluations were performed 1 month after the fourth treatment session. Results : All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves. Conclusions : This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.

• 대한한의학회지
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• 제36권3호
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• pp.144-153
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• 2015

Objectives: The purpose of this study is to evaluate the clinical effectiveness of acupotomy in the treatment of various facial atrophic scars except acne scars. Methods: Four patients with facial atrophic scars were treated by superficial dermal undermining with acupotomy. They were treated six times, and evaluated by comparing before and after photos, PGA(Physician's Global assessment), SESES(The Stony Brook Scar Evaluation Score) and patient satisfaction. Results and Conclusions: After observing case photos, PGA, SBSES, patient's satisfaction, it can be considered that acupotomy is an effective treatment modality for facial atrophic scars and it has no significant side effects.

• Medical Lasers
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• 제9권2호
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• pp.179-183
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• 2020

The picosecond laser has been widely used to remove tattoos, and improve wrinkles, acne scarring, and pigmented scars. This study was performed to investigate the efficacy and safety of a 1,064-nm fractional picosecond laser treatment for depressed traumatic scars. A total of twenty Korean patients with depressed scars were treated with a 1,064-nm fractional picosecond laser at a two-week interval with a spot size of 3 mm, fluence of 3.5 to 5.5 J/cm², and frequency of 2 Hz with a combination of microlens arrays. At 4 weeks after the final treatment, there was a statistically significant improvement in the modified Vancouver Scar Scale (mVSS) and the patient satisfaction score without any significant complication. A 1,064-nm fractional picosecond laser treatment is a safe and effective method to improve traumatic wound scars with depression.

• Applied Microscopy
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• 제3권1호
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• pp.29-38
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• 1973

Introduction. The human cutaneous scars manifest themselves many ways in different types according to the factors such as the age, sex, race of the patient as well as the location,. kind and heal ing process of the wound. Among the scars it is quiet difficult to verify the clinical course of the hypertrophic or keloidal scars from the true keloids. However, clinical observations indicate that stress, either mechanical or in the forms of chronic infections, can induce a functional change in the fibroblasts causing an excessive production of collagenous matrix. In this study, we preliminary attempt to justify any difference of the cellular structure between keloids and hypertrophic scars by using electron microscope. Material and Methods. A total of 23 cases: 2 scars, 2 hypertrophic scars and 19 keloids are examined. Immediately, the biopsy tissue was fixed in 10% neutral formalin and 4% glutaraldehyde solution in phosphate buffer for 4 hours, post fixed in 1 % osmium tetraoxide for two hours, dehydrated with graded alcohol, and embedded in Epon 812. Thick sections were stained with hematoxylin eosin, periodic acid-Schiff(PAS) and Van Gieson stain. Thin sections were cut and uranyle acetate, lead citratestain and examined with the electron microscope. Result. The morphologic features of keloid showed thick, homogenously eosinophilic bands of collagen and numberous large active fibroblasts. The hypertrophic scar and soft scar are more cellular than keloid and composed thinner collagenous fiber. For this paper in the etiology of keloids can not as be defined, but and interesting keloidal tissue fibroblast showed irregular nucleus with irregular shape dense bodies and fibril materials contained in to the cytoplasm.

• 대한두개안면성형외과학회지
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• 제18권1호
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• pp.9-15
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• 2017

Background: Relaxin is a transforming growth factor ${\beta}1$ antagonist. To determine the effects of relaxin on scar reduction, we investigated the scar remodeling process by injecting relaxin-expressing adenoviruses using a pig scar model. Methods: Scars with full thickness were generated on the backs of Yorkshire pigs. Scars were divided into two groups (relaxin [RLX] and Control). Adenoviruses were injected into the RLX (expressing relaxin) and Control (not expressing relaxin) groups. Changes in the surface areas, color index and pliability of scars were compared. Results: Fifty days after treatment, the surface areas of scars decreased, the color of scars was normalized, and the pliability of scars increased in RLX group. Conclusion: Relaxin-expressing adenoviruses improved the surface area, color, and pliability of scars. The mechanism of therapeutic effects on scar formation should be further investigated.

• Archives of Plastic Surgery
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• 제42권1호
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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.

• 한방안이비인후피부과학회지
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• 제28권3호
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• pp.101-113
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• 2015

Objectives : Microneedle therapy and Subcision are commonly used for therapeutic modalities of acne scars in Korean medicine. Beevenom could promote the expression of various cytokines, enzymes and receptors related to increasing collagen content of connective tissues. Through this mechanism, we considered that Beevenom pharmacopuncture therapy is applicable to the treatment of acne scars. We investigated twenty-seven patients with acne scars treated by Microneedle therapy and Subcision combined with Beevenom pharmacopuncture therapy and evaluated the clinical effect.Methods : Twenty-seven patients with acne scars were treated by Microneedle therapy and Subcision combined with Beevenom pharmacopuncture therapy and evaluated the clinical effect. for twelve weeks. The severity of acne scars and treatment effect were evaluate by standardized photography, GASC, ECCA scale and patient`s satisfaction. And side effects was also checked.Results : After twelve weeks for treatment, there was an improvement in GASC, ECCA scale. 77.8% of patient replied excellent or good on patient satisfaction survey. One patient sufferied from pruritus, papules and comedones as side effect of treatment.Conclusion : It can be considered that Microneedle, Subcision, Beevenom pharmacopuncture combining therapy are effective method for treating acne scars.

• Archives of Plastic Surgery
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• 제49권4호
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• pp.554-560
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• 2022

Background Hypertrophic scars cause aesthetic concerns and negatively affect the quality of life. A gold standard treatment for hypertrophic scars has not been established due to various responses of modalities. Extracorporeal shock wave therapy (ESWT) is a noninvasive and affects scar remodeling by fibroblast regulation. This study investigated the effectiveness of ESWT for hypertrophic scars. Methods Twenty-nine patients were enrolled. All patients underwent ESWT once a week for 6 consecutive weeks. Their scars were assessed using the Patient and Observer Scar Assessment Scale (POSAS), erythema index, melanin index, and scar pliability before treatment and again 4 weeks after treatment completion. Results Thirty-four hypertrophic scars in this study had persisted for between 6 months and 30 years. Most scars developed after surgical incision (55.88%). The chest and upper extremities were the predominant areas of occurrence (35.29% each). Most of the POSAS subscales and total scores were significantly improved 4 weeks after treatment (p < 0.05). Furthermore, the pain, itching, and pigmentation subscale were improved. The pliability, melanin index, and erythema index were also improved, but without significance. The patients were satisfied with the results and symptoms alleviation, although subjective score changes were insignificant. No serious adverse events were found. The patients reported pruritus in 62.5% and good pain tolerance in 37.5%. Subgroup analyses found no differences in scar etiologies or properties at different parts of the body. Conclusion The ESWT is a modality for hypertrophic scar treatment with promising results. Most of POSAS subscales were significantly improved.