Georgetown University School of Medicine, Washington, DC, USA.
MedStar Washington Hospital Center/Georgetown University Dermatology Residency Program, Washington, DC, USA.
Arch Dermatol Res. 2023 Aug;315(6):1487-1495. doi: 10.1007/s00403-022-02509-x. Epub 2022 Dec 11.
While normal, controlled wound-healing results in scars that are nearly imperceptible, hypertrophic scars (HTS) and keloids are the result of an abnormal wound-healing process that can leave unsightly, difficult-to-treat lesions. While such scars are classically associated with surgical incisions, they may also result from burns or accidental trauma to the skin. Several different measures can be taken to prevent the formation of scars or treat those that have already formed. Prevention focuses on reducing inflammation during the wound-healing process, and minimizing tension in the lesion when appropriate. Treatments range from non-invasive modalities such as pressure therapy, topicals, and symptom management, to invasive methods such as injections, lasers, and even surgery. While some treatments, such as corticosteroid injections, have been used in the treatment of HTS and keloids for decades, other newer therapies have only been described in case reports or are still in early phases of clinical trials. Because optimal scar management will not be the same for every patient, further investigation of newer agents and methods is warranted and may benefit a great number of patients. This paper will review the evidence-based management of scars, including current widely used treatment options and promising newly emerging therapies.
虽然正常的、受控制的伤口愈合会导致几乎察觉不到的疤痕，但增生性瘢痕（HTS）和瘢痕疙瘩是异常伤口愈合过程的结果，可能会留下难看且难以治疗的病变。虽然这种疤痕通常与手术切口有关，但也可能是由烧伤或皮肤意外创伤引起的。可以采取几种不同的措施来预防疤痕的形成或治疗已经形成的疤痕。预防措施侧重于减少伤口愈合过程中的炎症，并在适当情况下减轻病变处的张力。治疗方法包括非侵入性方式，如压力治疗、局部治疗和症状管理，以及侵入性方法，如注射、激光，甚至手术。虽然几十年来，皮质类固醇注射等一些治疗方法已被用于 HTS 和瘢痕疙瘩的治疗，但其他更新的治疗方法仅在病例报告中有所描述，或者仍处于临床试验的早期阶段。由于并非每个患者的最佳疤痕管理都相同，因此需要进一步研究新的药物和方法，这可能会使许多患者受益。本文将回顾基于证据的疤痕管理，包括当前广泛使用的治疗选择和有前途的新兴治疗方法。
