“…Traditionally, hypertrophic scarring is assessed using various scales including the Vancouver Scar Scale (VSS) or the modified patient and observer scar assessment scale (POSAS) [232]. Recent methods for scar assessment include the use of a three-dimensional camera [233]. Three-dimensional stereo-photogrammetry was recently introduced as a reliable method for assessing scar volume in clinics [234].…”
Section: Molecular Modulation Of Hypertrophic Scarring Following Severe Burnsmentioning
Cutaneous fibrosis results from suboptimal wound healing following significant tissue injury such as severe burns, trauma, and major surgeries. Pathologic skin fibrosis results in scars that are disfiguring, limit normal movement, and prevent patient recovery and reintegration into society. While various therapeutic strategies have been used to accelerate wound healing and decrease the incidence of scarring, recent studies have targeted the molecular regulators of each phase of wound healing, including the inflammatory, proliferative, and remodeling phases. Here, we reviewed the most recent literature elucidating molecular pathways that can be targeted to reduce fibrosis with a particular focus on post-burn scarring. Current research targeting inflammatory mediators, the epithelial to mesenchymal transition, and regulators of myofibroblast differentiation shows promising results. However, a multimodal approach addressing all three phases of wound healing may provide the best therapeutic outcome.
“…Traditionally, hypertrophic scarring is assessed using various scales including the Vancouver Scar Scale (VSS) or the modified patient and observer scar assessment scale (POSAS) [232]. Recent methods for scar assessment include the use of a three-dimensional camera [233]. Three-dimensional stereo-photogrammetry was recently introduced as a reliable method for assessing scar volume in clinics [234].…”
Section: Molecular Modulation Of Hypertrophic Scarring Following Severe Burnsmentioning
Cutaneous fibrosis results from suboptimal wound healing following significant tissue injury such as severe burns, trauma, and major surgeries. Pathologic skin fibrosis results in scars that are disfiguring, limit normal movement, and prevent patient recovery and reintegration into society. While various therapeutic strategies have been used to accelerate wound healing and decrease the incidence of scarring, recent studies have targeted the molecular regulators of each phase of wound healing, including the inflammatory, proliferative, and remodeling phases. Here, we reviewed the most recent literature elucidating molecular pathways that can be targeted to reduce fibrosis with a particular focus on post-burn scarring. Current research targeting inflammatory mediators, the epithelial to mesenchymal transition, and regulators of myofibroblast differentiation shows promising results. However, a multimodal approach addressing all three phases of wound healing may provide the best therapeutic outcome.
“…Our previous study compared the traditional evaluation methods with Antera3D score and recommended the further application of Antera3D score, which reflected the therapeutic efficacy in four aspects, namely color, texture, melanin, and hemoglobin. 12 However, in clinical practice, systemic evaluation is conducted based on the combined application of VSS, UNC4P, and Antera3D score, rather than the summation of these scores. The purpose of applying these three evaluation methods in combination is to make up for the deficiency of each individual score and to better guide the clinical treatment.…”
Section: Discussionmentioning
confidence: 99%
“…Age (y) 28. of Antera3D score, which reflected the therapeutic efficacy in four aspects, namely color, texture, melanin, and hemoglobin. 12 In a retrospective clinical review, the postinflammatory hyperpigmentation is observed in 51% cases. 13 In addition, it is demonstrated that superficial fractional CO 2 laser therapy causes more epithelial damage, thus resulting in an increased risk of hyperpigmentation.…”
Section: Demographic Characteristics N = 79mentioning
The cesarean section rate is reported to be 25.3% at a tertiary hospital in Sydney, which increases from 18.7% in 1989-1994 to 30.4% in 2010-2016. 1 Irrespective of the complications, the incision scar of cesarean is the greatest source of annoyance for mothers. Various treatments have been introduced to satisfy the maternal demand for scar therapy, including suture technique, physical therapy, and steroid injection. Of them, laser therapy is promising in the treatment for incision scar. Nowadays, numerous reports have focused on the laser application, which has been approved to be promoted in clinical application. Typically, fractional CO 2 laser therapy is the most common choice. New collagen fibers are observed in the dermis after fractional CO 2 laser therapy, which are arranged in a more organized and parallel fashion. 2 Nonetheless, there are still shortcomings in clinical practice. In addition to various modes and setting parameters, the diverse evaluation methods may also lead to the controversial results. Therefore, aiming to offset the disadvantages of each evaluation method, multiple evaluation methods were jointly adopted in this
“…We also objectively assessed the patients' scar height, pigmentation, and vascularity using a three‐dimensional skin imaging device (Antera 3D™; Miravex Limited) that quantified these characteristics for an accurate comparison of the before and after images with little error. This device has been widely used in studies of various skin disorders 19–22 …”
Objectives
The pulsed dye laser (PDL) is an effective modality for preventing and improving hypertrophic scars (HSs). However, the heterogeneity of the parameter settings of the laser and subjective scar assessment methods used in most studies resulting in uncertainty with treatment plans. Therefore, we investigated the treatment effect of the PDL (V‐beam; Candela Laser Corporation) on HSs in post‐thyroidectomy patients using three‐dimensional imaging analysis and intended to provide a systemic and optimal treatment protocol.
Methods
Nineteen patients with HS after thyroidectomy underwent eight treatment sessions with the 595 nm PDL (with the dose gradually increased by 0.5 J/cm2) at 4‐ to 6‐week intervals. Patients with an elevated lesion also received intralesional corticosteroid (ICS) treatment. After every two treatment sessions, we assessed the patients' HS using the Vancouver Scar Scale (VSS), a patient satisfaction questionnaire, and with a three‐dimensional (3D) skin imaging device (Antera 3D™; Miravex Limited).
Results
In repeated‐measures analysis of variance, the mean VSS and patient satisfaction significantly improved (p < 0.001), with significant differences in these values observed until the sixth and eighth treatment sessions, respectively. In the quantitative analysis using Antera 3D™, the mean height, pigmentation, and vascularity scores were observed to be significantly improved (p < 0.001). Significant differences in these values were observed until the fourth, second, and eighth treatment sessions, respectively. Subgroup analysis according to ICS treatment showed no significant differences in scar characteristics between those with and without ICS treatment.
Conclusions
In this study, we found that the PDL was effective in reducing scar height, vascularity, and pigmentation in patients with thyroidectomy HS using 3D imaging analysis. Furthermore, we have suggested a cost‐effective treatment plan with the 595 nm PDL.
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