Barone Sydney, Bao Eric, Rothberg Stephanie, Palacios Jose F, Smith Isabelle T, Tanna Neil, Bastidas Nicholas
Division of Plastic and Reconstructive Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA.
Division of Plastic and Reconstructive Surgery, Northwell Health, New York, NY 10022, USA.
Medicina (Kaunas). 2025 Mar 21;61(4):553. doi: 10.3390/medicina61040553.
: Pediatric patients can acquire scars from both accidental injury and surgical procedures. While scars cannot be avoided if a full-thickness injury occurs, scar visibility may be minimized through a variety of approaches. In this narrative review, we evaluate the current evidence and propose an algorithm for scar management in pediatric patients. : A review of the literature was performed for scar management techniques for pediatric patients. Management modalities based on the type of scar and dosing, treatment regimen, and safety profiles are described in this article and used to create a scar management algorithm. : The initial step to scar management in the pediatric population involves ensuring minimal wound tension, which can be achieved through making the incision along relaxed skin tension lines, and early, minimal tension wound closure. Subsequent treatments to optimize scar care should begin 2-3 weeks following wound closure and involve the application of silicone gel or sheets and scar massaging. When topical products are insufficient, laser therapy can be utilized for the management of immature erythematous or thick scars. When mature, pathological scars form such as atrophic scars, hyperpigmentation, hypertrophic scars, or keloids, a combination of modalities is recommended. These modalities vary by scar type and include retinoids and dermabrasion for atrophic scars; retinoids, hydroquinone, and laser therapy for hyperpigmentation; and pressure therapy, corticosteroids, and laser therapy for hypertrophic scars and keloids. When mature, pathological scars persist following 12 months of non-invasive therapies, surgical excision should be considered. : Several treatment options are available to manage scars in the pediatric population depending on scar type.
儿科患者可能因意外伤害和外科手术而留下疤痕。如果发生全层损伤,疤痕无法避免,但通过多种方法可将疤痕的可见度降至最低。在这篇叙述性综述中,我们评估了当前的证据,并提出了一种儿科患者疤痕管理的算法。
对儿科患者疤痕管理技术的文献进行了综述。本文描述了基于疤痕类型、剂量、治疗方案和安全性的管理方式,并用于创建疤痕管理算法。
儿科人群疤痕管理的第一步是确保伤口张力最小化,这可以通过沿着皮肤松弛张力线进行切口以及早期、最小张力的伤口闭合来实现。优化疤痕护理的后续治疗应在伤口闭合后2-3周开始,包括应用硅胶凝胶或硅胶片以及疤痕按摩。当局部产品效果不佳时,激光治疗可用于处理未成熟的红斑或增厚疤痕。当形成成熟的病理性疤痕,如萎缩性疤痕、色素沉着、增生性疤痕或瘢痕疙瘩时,建议采用多种方法联合治疗。这些方法因疤痕类型而异,包括用于萎缩性疤痕的维甲酸和磨皮术;用于色素沉着的维甲酸、对苯二酚和激光治疗;以及用于增生性疤痕和瘢痕疙瘩的压力治疗、皮质类固醇和激光治疗。当成熟的病理性疤痕在12个月的非侵入性治疗后仍然存在时,应考虑手术切除。
根据疤痕类型,儿科人群有几种治疗疤痕的选择。