There are no two leaves in the world that are exactly the same. Similarly, there are no two scars in the world that are exactly the same. There are many types of scars, including superficial scars, hyperplastic scars, scars with scars, contracture scars, etc. The severity of scars also varies, from those that simply affect appearance to those that place limitations on function.
With the advancement of technology, the concept of scar treatment is undergoing a revolutionary change. First, scarring has changed from being treatment-based to prevention-based; scar treatment options have also evolved from a single surgery-based approach in the past to a combination of surgery and non-surgery. Taking into account the shape, texture and color of scars, the treatment is divided into scars from the essence of scar pathology, and the treatment plan is designed to take into account the functional and cosmetic repair of scars.
New concept of prevention over treatment After an injury, the skin will perform the action of repair. The surface wound will heal in about 1 to 2 weeks, but in fact, the whole traumatic area, it will take 6 months to 1 year to complete the reconstruction.
The degree of scarring is also affected by the individual’s body type and the area of injury. Usually, wounds on the face do not have obvious scars, but places with high skin tension, such as the front chest area, are more likely to produce significant scars.
Once the depth of injury reaches the dermis, scars may form. Therefore, “prevention is better than cure” is the highest principle of scar treatment. If there is already a wound, prevention of infection, proper suturing and wound care can prevent the formation of significant scars. When the wound is first injured, the wound should be flushed with plenty of water or saline to remove foreign bodies from the wound and reduce the amount of adherent bacteria, followed by disinfection with iodophor and application of antibiotic ointment.
Deeper wounds can be closed with the assistance of a physician to promote wound healing and prevent the formation of irregular scars, but depending on the injured area, the sutures must be removed within a certain period of time, otherwise the “centipede-like” suture scars will be more obvious.
Before stitch removal, daily change of medication and observation of the wound and application of appropriate antibiotic ointment can prevent wound infection; after stitch removal, “cosmetic tape” can be used to help the skin on both sides of the wound to come together and reduce the tension of the affected skin in order to reduce the degree of scar formation.
Revolution in preventive treatment methods The preventive treatment of scar is evolving from a single medication with elastic bandage compression to an integrated program of medication, compression, photoelectricity, and injection. Traditional early prophylactic treatment consisted only of using anti-scar medication after removal of the stitches and scabs and wearing elastic bandages if necessary usually after 1-2 summers or even longer, waiting for the scar to stabilize and then repairing it according to the degree of hyperplasia. Today, with the introduction of advanced technology, Plasma Ion Beam and/or Spike CO2 laser treatments can be started 2-4 weeks after the injury to control scar growth as soon as possible and reduce the deformity caused by later scars. Early photoelectric prophylaxis of scars has been clinically very effective and inhibits scar proliferation much better than traditional medication and compression therapy. Especially for patients with large burns and severe pruritic symptoms, it can significantly relieve the symptoms and relieve the pain. In contrast, with traditional methods, the improvement of severe itching is almost minimal, and individual patients are even tortured to the point of mental abnormality.
For severe red congestion but relatively thin scar can be treated with a combination of 595 laser and plasma. For severe red congestion with thicker scarring a combination of the 595 laser and spiked CO2 fractional laser can be used. For very severe areas of hyperplasia, medication is sometimes given in conjunction with laser treatment to enhance the treatment effect.
If the hyperplasia is not severe, treatment can be done with only the plasma ion beam or (and) the spike CO2 laser. plasma ion beam is more suitable for thinner scars and the spike CO2 laser is more suitable for thicker scars. Partly thick, partly thin scars can also be treated with both plasma ion beam and fractional laser. For early depressed scars, plasma ion beam treatment can also promote flattening.
Of course, there is no generalization, and the exact method to be used will be determined by the treating physician based on the texture of the scar, itching symptoms, etc. With early prophylactic treatment, most scars can be saved from reoperation or made easier to repair later.
Revolution in the treatment of old scars Old scars are generally scars that have atrophied after being burned or scalded many years ago. This type of scar affects the appearance and, if in a joint area, may also affect function. In the past, the means of scar repair for scars that have entered the stable stage was very single, namely surgery. Nowadays, in addition to surgery, there are photoelectric technology, electronic wire technology, peel and augment technology, fat injection technology, etc. The concept of repair has also evolved from a single surgical repair to a combination of non-surgical repair, surgical repair and non-surgical repair. For doctors, it is necessary to apply these repair methods to scar patients correctly to obtain the best treatment effect.
For example, for patients with keloid scars, a combination of electron beam irradiation is needed after surgery to prevent the recurrence of scar growth. For large scars with no functional impairment, a combination of spiked CO2 laser and plasma ion beam or drug closure can be completely improved without resorting to riskier and more invasive flap grafting or skin grafting. For small scars on the face, it is sometimes possible to achieve very satisfactory results with plasma beam treatment alone. Some keloid scars have subcutaneous adhesions that appear as grooves or pits that are aggravated by movement and have a significant impact on appearance. Previously, surgery was the only way to repair these adhesions, but now, plasma ion beam treatment combined with debridement can provide the same or better results than surgery. The peel and augment operation takes only a few minutes and requires no sutures or stitch removal. The risks and pain are not comparable to surgery.
Scar prevention and treatment still has a long way to go Although the prevention and treatment of scar has made great progress, scar repair is still a worldwide medical problem, and there is no single method that can completely solve all the problems of scars. and color. Although all treatments to date have failed to achieve complete repair and restore the possibility of normal skin. Scar repair is not only a struggle for patients, but also a challenge for doctors. As scar doctors, scar and research still has a long way to go, and we will still work tirelessly for this purpose to further strengthen the basic clinical and research on scar.