Miletta Nathanial R, Donelan Matthias B, Hivnor Chad M
Laser Surgery and Scar Center, San Antonio Military Health System, Texas, USA.
Shriners Hospitals for Children, Boston, Massachusetts, USA.
Cutis. 2017 Jul;100(1):18-20.
Recent advances in laser surgery and our understanding of wound healing have ushered in a new era of trauma and burn scar management. Traditional therapy has centered around scar excision followed by primary closure or tissue replacement with flaps and grafts. This approach represents a perpetuation of the common fallacy that extensive scar improvement requires extensive surgical intervention. Laser surgery in conjunction with pharmacotherapy and minor tissue-conserving surgery produces well-healed and remodeled existing tissue that provides the most natural appearance and function of the skin. Now, patients' hypertrophic, contracted, and disfiguring scars represent their most valuable reconstructive anatomy. With this paradigm shift, dermatologists are uniquely positioned to provide transformative and cost-effective scar therapy due to their proficiency in the necessary treatment modalities and expertise in the utilization of local anesthesia. We hope to further expand military and civilian patient access to such care in their local community through peer education and advocacy. We present a brief overview and outline of scar treatment practices that can be performed by dermatologists in office using devices and techniques they often already possess.
激光手术的最新进展以及我们对伤口愈合的理解开创了创伤和烧伤疤痕管理的新时代。传统疗法主要围绕疤痕切除，然后进行一期缝合或用皮瓣和移植物进行组织置换。这种方法延续了一个常见的错误观念，即广泛的疤痕改善需要广泛的手术干预。激光手术结合药物治疗和微创组织保留手术能够使现有组织良好愈合和重塑，从而提供最自然的皮肤外观和功能。如今，患者的增生性、挛缩性和毁容性疤痕成为了最有价值的重建解剖结构。随着这种范式转变，皮肤科医生凭借其在必要治疗方式方面的熟练程度以及局部麻醉使用方面的专业知识，处于独特的地位，能够提供变革性且具有成本效益的疤痕治疗。我们希望通过同行教育和宣传，进一步扩大军队和平民患者在当地社区获得此类护理的机会。我们简要概述了皮肤科医生可在诊室使用他们通常已具备的设备和技术来实施的疤痕治疗方法。
