Hypertrophic scar

Introduction to hypertrophic scars Hypertrophic scars occur mostly in the depth of injury and only in the dermis. The pathological difference between hypertrophic scar and normal scar is only the thickening of collagen fibers in the deep scar, which is characterized by irregular arrangement, or wave-shaped, or wound into a rope. Hypertrophic scars often occur after wound healing in deep burns. Reticulated hypertrophic scars are also common in sutures around the skin after skin grafting of the III degree burn wound. In addition, the most common is that any incision scar after suturing is also included in this type. Hypertrophic scars are characterized by prominent surfaces, irregular shapes, uneven heights, flushing and congestion, and firmness. It has a burning and itching sensation. basic knowledge The proportion of illness: 0.02%-0.08% Susceptible people: no specific people Mode of infection: non-infectious Complications: scar cancer

Cause of hypertrophic scar

The scar is significantly higher than the surrounding normal skin, and the local thickening and hardening. In the early stage, due to capillary congestion, the surface of the scar was red, flushed or purple. In this period, itching and pain are the main symptoms, and even the surface can be broken due to scratching. After a considerable period of time, the congestion is reduced, the surface color becomes lighter, the scar becomes softer and flatter, and the itching is relieved and disappears. The length of this proliferative phase varies from person to person and from the lesion. Generally speaking, children and young adults have a longer proliferative period, while older people over 50 years old have a shorter proliferative phase; they occur when the blood supply is more abundant, such as facial hyperplasia, and the blood supply is worse, such as limbs. The scar, proliferative phase of the distal end, anterior tibial region and the like is shorter. Although hypertrophic scars can be as thick as 2cm or more, they are not tightly adhered to deep tissues and can be promoted, and generally have obvious boundaries with normal skin around them. The contractility of hypertrophic scars is smaller than that of contracture scars. Therefore, hypertrophic scars occurring in non-functional parts generally do not cause severe dysfunction, and large areas of hypertrophic scars in the joints, due to their thick and hard splinting, hinder joint activities and cause dysfunction. Proliferative scars located in the flexion of the joint can cause significant contraction in the advanced stage, resulting in obvious dysfunction such as jaw and neck adhesion.

Proliferative scar prevention

1. The first step in preventing scars is proper wound care. Whether it is trauma, burns, skin infections or surgery, scars will develop after wound healing. Correct wound care can avoid abnormal scars.

2. After the wound is removed or the wound is initially healed, massage therapy and compression therapy are started as appropriate.

3, with a cosmetic adhesive tape or silicone film pressed on the healing wound, the cosmetic adhesive paper should be adhered to 24 hours a day, the silicone film should be attached for about 12 hours, the pressure must be larger than the wound itself and include the surrounding normal skin. Only effective.

4. Compression therapy can reduce the strength of the wound to stretch outward, making the scar more flat and thin.

5, massage therapy can soften the hard palate, and the effect of tissue expansion, can improve the bulge or scars with a tendency to collapse.

6. For large-area wounds, consider the compression treatment of tight-fitting elastic clothing.

Hypertrophic scar complications Complications scar cancer

Scar is an inevitable outcome of the process of human wound repair. In a broad sense, there is no wound healing without scars. The main component of scar tissue is fibrin. Scar tissue collagen production and deposition increase the strength of the wound, which is beneficial in the general sense, but is harmful in appearance. Moreover, if the scar tissue is not formed enough, the damaged tissue can not get normal tension, which can cause many complications, such as weak scars in the abdominal wall incision healing, and the scar can be re-cracked under the action of intra-abdominal pressure or The contents of the abdomen gradually bulge outward to form an abdominal wall. Conversely, if the scar is excessively formed, it will cause serious physical or functional problems. The hazard of scar depends on its nature and characteristics, as well as the secondary fixation of deep tissue.

Thus scars are always an imperfect replacement relative to the tissue after injury. From a mechanical point of view, its resistance is weakened; from a nutritional point of view, it causes obstacles to the exchange of oxygen and nutrients; from a functional point of view, the deformity and dysfunction of damaged tissue are aesthetically pleasing, resulting in a shape The destruction.

Hypertrophic scar symptoms common symptoms pruritus burning and congestion

Hypertrophic scars occur mostly in the depth of injury and only in the dermis. The pathological difference between hypertrophic scar and normal scar is only the thickening of collagen fibers in the deep scar, which is characterized by irregular arrangement, or wave-shaped, or wound into a rope. Collagen anabolism is very frequent and exceeds the rate of catabolism, forming a large amount of collagen fibers for a considerable period of time. The common cause is related to the presence of some local or systemic induced dysfunction.

Hypertrophic scars often occur after wound healing in deep burns. Reticulated hypertrophic scars are also common in sutures around the skin after skin grafting of the III degree burn wound. In addition, the most common is that any incision scar after suturing is also included in this type.

Hypertrophic scars are characterized by prominent surfaces, irregular shapes, uneven heights, flushing and congestion, and firmness. It has a burning and itching sensation.

Hypertrophic scars are manifested by increased ambient temperature, emotional agitation, or increased symptoms when eating spicy food. Hypertrophic scars often last for months or years before degenerative changes occur.

Examination of hypertrophic scars

Perform a skin test. Physical examination of skin diseases is a physical examination of the skin, such as skin scratch test, slide examination and so on. The appearance of the skin is observed, and the skin is non-destructive, and the non-lesional state is normal. Check the skin should be carried out under natural light. In addition to examining the exposed skin, the skin of the trunk and the mucous membrane of the mouth should be examined. It is necessary to have a comprehensive impression not only to be diagnosed but also to be diagnosed correctly.

Diagnosis and diagnosis of hypertrophic scar

Early local swelling and hardening, its tissue structure is covered by a layer of atrophic epithelial cells, the middle layer is vasodilatation, and there is inflammatory cell infiltration, the bottom layer is less collagen fibers and a large number of connective tissue hyperplasia. This scar is higher than the surface of the skin, with early local thickening and hardening, and capillary congestion is red or dark red. The base of the scar generally does not adhere to the deep tissue, can be pushed, and has less contractility, and most of them do not cause serious dysfunction, but affect the beauty in the face and exposed parts, so there is often a need for treatment.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.