Pathogenetic features of post-burn skin scarring: modern methods of early treatment and prevention (review)
Year: 2025, volume 21 Issue: №1 Pages: 30-36
Heading: Surgery Article type: Review
Authors: Komkov K.N., Chmyrev I.V., Kozyaev V.A.
Organization: Kirov Military Medical Academy, Saint Petersburg, Russia
Heading: Surgery Article type: Review
Authors: Komkov K.N., Chmyrev I.V., Kozyaev V.A.
Organization: Kirov Military Medical Academy, Saint Petersburg, Russia
Summary:
Objective: to analyze the effectiveness of modern methods of prevention and early treatment of scarring in burned patients, taking into account pathogenetic mechanisms. The methodology of writing a review. The review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology using the eLibrary, PubMed, and Medline databases. The search depth is from 2003 to 2024. Number of sources viewed —1372. The review includes 16 original studies. The most effective and widely used methods of early treatment and prevention of scars in burned patients have been established. Conclusion. The analysis of scientific papers revealed that early excision of granulation tissue and fibrously altered dermis, followed by autodermoplasty with full-layer skin grafts, as well as the complex use of drugs whose mechanism of action is aimed at suppressing the metabolic activity of fibroblasts (glucocorticosteroids, calcium channel blockers), worsening blood supply in the scar, removing excess extracellular matrix, reducing moisture loss from the skin surface, improves the characteristics of the emerging scar tissue.
Bibliography:
1. Alekseyev АА, Bobrovnikov АЕ, Malyutina NB, et al. Analysis and features of the work of burn hospitals in Russia in
2022. In: Burns: Diagnosis, treatment, rehabilitation Abstracts of the All-Russian scientific and practical conference. Makhachkala,
2023.
2. Sokolov VA, Efimenko NA, Admakin AL. Peacetime burns. Sources of danger. Clinical Medicine. 2015; (6):30-5.
3. Grechishnikov Ml. Algorithm of surgical treatment of patients with the consequences of burn injury. PhD diss. Moscow, 2015; 109 p.
4. Filippova OV, Afonichev КА, Krasnogorskiy IN, et al. Clinical and morphological features of the vascular bed of hy-pertrophic scar tissue at different periods of its formation. Orthopedics, Traumatology and Reconstructive Surgery for Children. 2017;5 (3):25-36.
5. Plomgaard AM, Alderliesten Т, Austin Т, et al. Early biomarkers of brain injury and cerebral hypo- and hyperoxia in the SafeBoos С II trial. PLoS One. 2017;12 (3):e0173440. DOM 0.1371/journal, pone.0173440
6. Bombaro KM, Engrav LH, Carrougher GJ, et al. What is the prevalence of hypertrophic scarring following burns? Burns. 2003;29 (4):299-302. DOI:10.1016/s0305-4179(03)00067-6
7. Ogawa R. Keloid and hypertrophic scars are the result of chronic inflammation in the reticular dermis. Int J Mol Sci. 2017;18 (3):606. DOI:10.3390/ijms18030606
8. Pakyari M, FarrokhiA, Maharlooei MK, GhaharyA. Critical role of transforming growth factor beta in different phases of wound healing. Adv Wound Care (New Rochelle). 2013;2:215-24. DOI:10.1089/wound. 2012.0406
9. Filippova OV. Surgical and morphological aspects treatment of scar deformities in children. DSc abstract. Saint-Petersburg, 2015; 50 p.
10. Yurova YuV, Zinovyev EV. Improving surgical treatment of skin burns to reduce the incidence of pathologic scarring. Innovative Medicine of Kuban. 2023; (1):38-45.
11. BogdanovSB, Babichev RG, Marchenko DN.etal. Plastic surgery with full-layer skin autografts wounds of various etiologies. Innovative Medicine of Kuban. 2016; (1):30-7.
12. Bogdanov SB, Babichev RG. New ways of surgical treatment of an opisthenar burns. Medical Herald of the South of Russia. 2017;8 (2):64-70.
13. Wiseman J, Simons M, Kimble R, et al. Effectiveness of topical silicone gel and pressure garment therapy for burn scar prevention and management in children: Study protocol for a randomised controlled trial. Trials. 2017;18 (1):72. DOI:10.1186/s13063-017-1820-z
14. Engrav L, Heimbach D, Rivara F, et al. 12-Year within-wound study of the effectiveness of custom pressure garment therapy. Burns. 2010;36 (7):975-83. DOM 0.1016/j. burns. 2010.04.014
15. Moiemen N, Mathers J, Jones L, et al. Pressure garment to prevent abnormal scarring after burn injury in adults and children: the PEGASUS feasibility RCT and mixed-methods study. Health Technol Assess. 2018;22 (36):1-162. DOI:10.3310/hta22360
16. Wiseman J, Simons M, Kimble R, et al. Effectiveness of topical silicone gel and pressure garment therapy for burn scar prevention and management in children 12-months post-burn: A parallel group randomised controlled trial. Clin Rehabil. 2021 ;35(8):1126-41. DOI:10.1177/02692155211020351
17. Momeni M, Hafezi F, Rahbar H, et al. Effects of silicone gel on burn scars. Burns. 2010;35 (1):70-4. DOI:10.1016/j.burns.2008.04.011
18. Van der Wal M, Van Zuijlen P, Van de Ven P, et al. Topical silicone gel versus placebo in promoting the maturation of burn scars: A randomized controlled trial. Plast Reconstr Surg. 2010;126(2):524-31. DOI:10.1097/PRS. 0b013e3181e09559
19. Van den Kerckhove E, Stappaerts K, Fieuws S, et al. The assessment of erythema and thickness on burn related scars
during pressure garment therapy as a preventive measure for hypertrophic scarring. Burns. 2005;31 (6):696-702. DOI:10.1016/j. burns.2005.04.014
20. ChoY, Jeon J, Hong A, et al. The effect of burn rehabilitation massage therapy on hypertrophic scar after burn: A randomized controlled trial. Burns. 2014;40(8):1513-20. DOI:10.1016/j. burns.2014.02.005
21. Ahuja R, Chatterjee P. Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids. Burns. 2014;40 (4):583-8. DOI:10.1016/j.burns.2013.09.029
22. Paramonov BA, Turkovskiy II, Antonov SF, et al. Enzyme therapy of pathological skin scars. Bulletin of Aesthetic Medicine. 2009;8 (2):24-9.
23. Paramonov BA, Turkovskiy II, Bondarev SV. Application of enzymes for treatment of patients with hypertrophic cicatrices. Grekov's Bulletin of Surgery. 2007;166 (4):84-5.
24. Godleski М, Holden S, Luby D, et al. Clinical outcomes from a foam wedge splinting program for axillary contracture prevention in the intensive care unit. J Burn Care Res. 2014;35 (6):e379-86. DOI:10.1097/BCR.0000000000000038
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