Best Reconstructive Techniques

Balaraman, Brundha; Geddes, Elizabeth R.; Friedman, Paul M.

doi:10.1097/dss.0000000000000496

Cited by 20 publications

(5 citation statements)

References 71 publications

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“…Scarring is the pathological outcome of the repair and reconstruction after tissue damage and may affect the patient’s personal appearance and physical function, causing deformity and possibly a great psychological burden, especially when the scar is on the face . Three of the most common types of scars are hypertrophic, atrophic, and keloid scars.…”

Section: Introductionmentioning

confidence: 99%

“…carring is the pathological outcome of the repair and reconstruction after tissue damage and may affect the patient's personal appearance and physical function, causing deformity and possibly a great psychological burden, especially when the scar is on the face. 1,2 Three of the most common types of scars are hypertrophic, atrophic, and keloid scars. For hypertrophic scars and keloids, studies have found that the abnormal accumulation of extracellular matrix (ECM), composed mainly of overproduced collagen, is one of the main causes.…”

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confidence: 99%

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Use of Condensed Nanofat Combined With Fat Grafts to Treat Atrophic Scars

2018

JAMA Facial Plast Surg

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In addition to the physical deformity, there is often great psychological burden of facial scars for patients. In this study, we use condensed nanofat combined with fat grafts in a novel technique to improve atrophic facial scars by raising both the surface and the bottom of the affected area.OBJECTIVE To assess whether the use of condensed nanofat combined with fat grafting can be effective in treating atrophic facial scars from both an aesthetic and a functional perspective. DESIGN, SETTING, AND PARTICIPANTSIn this prospective case series of 20 patients with 25 atrophic facial scars, each scar was treated with condensed nanofat combined with fat grafts at the

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Use of Condensed Nanofat Combined With Fat Grafts to Treat Atrophic Scars

2018

JAMA Facial Plast Surg

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“…The overproliferation of fibroblasts and the overproduction of nonfunctional extracellular matrix components have deleterious consequences 1 – 3 . Skin scars, which range from barely visible fine white lines to disfiguring hypertrophic scars or keloids, are well documented 4 – 7 . A scar can cause cosmetic problems, but scarring can also result in the loss of joint function or hinder growth in children 8 , 9 .…”

Section: Introductionmentioning

confidence: 99%

Angiotensin-converting enzyme inhibitor reduces scar formation by inhibiting both canonical and noncanonical TGF-β1 pathways

Fang

Wang

Zhao

et al. 2018

Sci Rep

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Angiotensin-converting enzyme inhibitors (ACEIs) can improve the fibrotic processes in many internal organs. Recent studies have shown a relationship between ACEI with cutaneous scar formation, although it has not been confirmed, and the underlying mechanism is unclear. In this study, we cultured mouse NIH 3T3 fibroblasts with different concentrations of ACEI. We measured cell proliferation with a Cell Counting Kit-8 and collagen expression with a Sirius Red Collagen Detection Kit. Flow cytometry and western blotting were used to detect transforming growth factor β1 (TGF-β1) signaling. We also confirmed the potential antifibrotic activity of ACEI in a rat scar model. ACEI reduced fibroblast proliferation, suppressed collagen and TGF-β1 expression, and downregulated the phosphorylation of SMAD2/3 and TAK1, both in vitro and in vivo. A microscopic examination showed that rat scars treated with ramipril or losartan were not only narrower than in the controls, but also displayed enhanced re-epithelialization and neovascularization, and the formation of organized granulation tissue. These data indicate that ACEI inhibits scar formation by suppressing both TGF-β1/SMAD2/3 and TGF-β1/TAK1 pathways, and may have clinical utility in the future.

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“…Previous studies investigating the association between suture techniques and cosmetic outcomes are limited. However, cosmetic satisfaction is sometimes even more important than the functional outcome of treatment, 30 playing an essential role in every aspect of our social life 1 . The VAS score of scar cosmetic appearance was reported in six trials by either professional observers or participants.…”

Section: Discussionmentioning

confidence: 99%

Comparing running vs interrupted sutures for skin closure: A systematic review and meta‐analysis

Luo

Tao

Wang

et al. 2022

International Wound Journal

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Continuous sutures and interrupted sutures have been widely applied to skin closure after non‐obstetric surgery or traumatic wounds. Usually, continuous sutures were divided into transdermal or subcuticular sutures according to whether the stitches were placed through or below the epidermal layer. Interrupted sutures, on the other hand, involved penetration of the loose connective tissue beneath the skin layers, with stitches placed through the external skin layer. Complications including infection, dehiscence, and poor cosmetic appearance were not rare after suturing. Whether a suture method is a suitable option for rapid wound healing and long‐term cosmetic appearance remains controversial. To examine the potential benefits and harms of continuous skin sutures vs interrupted skin sutures in non‐obstetric surgery or traumatic wounds. Searching websites such as PubMed, the Cochrane Central Library, Web of Science and Embase, and http://clinicaltrials.gov were systematically searched up to 5 January 2022 and were assessed and guided by Preferred Reporting Items for Systematic Reviews and Meta‐analysis rules as well as guidelines. All relevant randomised controlled studies comparing continuous sutures with interrupted sutures of skin closure were analysed. The suture techniques and material used in each trial were recorded. The transdermal and subcuticular continuous sutures were separately compared with interrupted sutures in the subgroup analysis of dehiscence and cosmetic appearance because the visual appearance of these two continuous suturing techniques was significantly different. Ten studies including 1181 participants were analysed. Subcuticular continuous sutures had comparatively higher visual analogue scale (VAS) scores among patients and doctors than interrupted sutures (OR = 0.27, 95% Confidence Intervals [CI] = 0. 07‐0.47, P < .01). Similarly, priority was found regarding transdermal continuous sutures and interrupted sutures (OR = 0.40, 95% CI = 0.21‐0.60, P < .01). Five randomised controlled trials (RCTs) demonstrated relevant data about dehiscence events. The incidence of continuous suture was significantly lesser than that of interrupted suture (OR = 0.16, 95% CI = 0.07‐0.37, P < .01). There was no significant difference between the infection events rates of two suture methods (OR = 0.69, 95% CI = 0.40‐1.21, P = .62, I2 = 0%). This systematic review indicated the superiority of both transdermal and subcutaneous continuous sutures over interrupted sutures in skin closure in terms of wound healing and cosmetic appearance.

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Best Reconstructive Techniques

Abstract: Armed with an understanding of relevant available therapies, skillful dermatologic surgeons may drastically improve the final scar cosmesis. This review discusses current and emerging laser therapy approaches to scar revision.

Cited by 20 publications

References 71 publications

Use of Condensed Nanofat Combined With Fat Grafts to Treat Atrophic Scars

Use of Condensed Nanofat Combined With Fat Grafts to Treat Atrophic Scars

Angiotensin-converting enzyme inhibitor reduces scar formation by inhibiting both canonical and noncanonical TGF-β1 pathways

Comparing running vs interrupted sutures for skin closure: A systematic review and meta‐analysis

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