Prevention and treatment of scar formation

  Scarring, commonly known as scarring and scarla, is an inevitable result of healing from various traumas (including surgery) and is a problem that everyone inevitably encounters. However, if the scar is overgrown, or because the direction of the scar does not follow the skin pattern, or because the scar occurs in special areas, such as around the eyes, mouth, neck, limb joints, etc., it may be itchy, painful, affect the appearance, or damage the appearance or cause dysfunction in joints and other parts of the body, causing more serious psychological and physical effects to the patient.  There are many factors that affect the growth of scar. Although scarring is inevitable after any trauma to the deep or full dermis, the size of the scar varies from person to person, depending on the individual’s physical condition (including race), the depth of the wound, followed by the presence or absence of infection, foreign body, hematoma, suture technique, age, wound direction, suture tension, postoperative stitching time, etc. So far, we have not seen any scarring deep to the full dermis and no scar after wound healing. To date, no case has been seen where the wound healed without any scarring, only the degree of scarring is different.  The manifestation of scar can be described as varied and influenced by many factors, the common ones are: superficial scar, hyperplastic scar, depressed scar, atrophic scar, contracture scar, linear scar, webbed scar, bridge scar, keloid scar, etc.  Treatment: Integrating the latest developments at home and abroad, the treatment of scarring is generally divided into two categories: non-surgical treatment and surgical treatment. Non-surgical treatment includes pressure therapy, local drug injection, radiation therapy and various topical scar treatment creams or medicines. These methods are used for different types of scars and have different effects. In any case, the best result of non-surgical treatment can only make the scar flatter, softer, or even change in color than before treatment, and it is impossible to make the scar area smaller or transform into normal skin.  Surgical treatment is by far one of the most effective methods, sometimes the only method, for treating all kinds of scarring in China and abroad. Since there is no fixed procedure, the results of treatment are greatly influenced by the skill level of the surgeon, and there may be several different treatment options for the same scar by different surgeons, and the final results of many methods may not be identical, and sometimes even very different. Of course, the patient must be aware that due to the limitations of medical development, there is no method that can achieve 100% results.  Examples from movies and television are artistic and difficult to find in real life. The best result of plastic surgery is to make a large scar as small as possible, to make a visible scar as inconspicuous as possible, and to make a scar that affects function as little or as much as possible, in other words, to get the maximum improvement on the original basis, not to “recover” it completely. Commonly used surgical methods include simple excision and suturing, split excision and suturing, post-excision flap repair, skin grafting, soft tissue expansion, etc. You should choose the most suitable plan according to the size, direction and location of the scar to ensure the best results.  As for prevention: once trauma occurs, you should clear the wound as early as possible so that the tissue is sutured in layers, try to avoid hematoma, foreign body retention inside the wound, infection, etc., so that the skin, especially the dermis, gets good pair and, the epidermis is not met or finely stitched with fine sutures, the incision should be made as smoothly as possible, as short as possible, and sutured in layers, striving to achieve trauma-free operation, tension-free suture, postoperative anti-infection, and stitch removal in due time.  In short, so far, no matter how magical the advertising, no matter how individual doctors (or fake doctors) boast about the package treatment, it is not yet possible for the domestic and foreign medical community to completely eliminate the scar and restore the patient to the pre-injury level, but with careful treatment by plastic and cosmetic surgeons, it is entirely possible to maximize the pain relief and restore you to near normal appearance and normal function. Of course, with the rapid development of science and technology, it is believed that this problem will be overcome in the near future.