A scar develops following the appearance of a deep tissue defect as part of the physiological wound healing process. The initial inflammatory response is followed by proliferation of connective tissue cells, which form fibrosis as a final tissue substitute. Disorders can occur at all stages of the process and are most commonly manifested as impaired wound healing or the formation of atrophic and hypertrophic scars or keloids. The focus of this article is on the treatment of pathologic scars, which are an indication for therapy due to functional limitations, complaints, and stigmatization, among other reasons. Conservative medical, physical, surgical and laser therapeutic approaches are pursued. The basis for this is an understanding of the pathophysiological mechanisms and factors influencing the choice of therapy, as well as an interdisciplinary and interprofessional therapeutic approach.
anderen Institution Erklärung zu nicht-finanziellen Interessen: DDG. ZusammenfassungEine Narbe entsteht nach Auftreten eines tiefen Gewebedefekts im Rahmen des physiologischen Wundheilungsprozesses. Der initialen Entzündungsreaktion folgt eine Proliferation von Bindegewebszellen, die eine Fibrose als definitiven Gewebeersatz ausbilden. Störungen können in allen Stadien des Prozesses auftreten und äußern sich hauptsächlich in Wundheilungsstörungen oder der Ausbildung atropher und hypertropher Narben beziehungsweise Keloiden. Schwerpunkt dieses Artikels ist die Therapie pathologischer Narben, die unter anderem wegen funktioneller Einschränkungen, Beschwerden und Stigmatisierung eine Therapieindikation darstellen. Dabei werden konservativ-medikamentöse, physikalische sowie chirurgische und lasertherapeutische Ansätze verfolgt. Grundlage ist das Verständnis pathophysiologischer Mechanismen und Einflussfaktoren zur Therapiewahl sowie ein interdisziplinärer und interprofessioneller Therapieansatz. SummaryA scar develops following the appearance of a deep tissue defect as part of the physiological wound healing process. The initial inflammatory response is followed by proliferation of connective tissue cells, which form fibrosis as a final tissue substitute. Disorders can occur at all stages of the process and are most commonly manifested as impaired wound healing or the formation of atrophic and hypertrophic scars or keloids. The focus of this article is on the treatment of pathologic scars, which are an indication for therapy due to functional limitations, complaints, and stigmatization, among other reasons. Conservative medical, physical, surgical and laser therapeutic approaches are pursued. The basis for this is an understanding of the pathophysiological mechanisms and factors influencing the choice of therapy, as well as an interdisciplinary and interprofessional therapeutic approach. † Die beiden erstgenannten Autoren haben gleichermaßen zum Artikel beigetragen.
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