Hypertrophic Scars: Are Vitamins and Inflammatory Biomarkers Related with the Pathophysiology of Wound Healing?

Correia‐Sá, Inês; Serrão, Paula; Marques, Marisa; Vieira-Coelho, Maria Augusta

doi:10.1007/s11695-017-2740-4

Cited by 6 publications

(8 citation statements)

References 56 publications

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“…4 Also, the availability of micronutrients and amino acids is critical for wound healing, and systemic supplementation of vitamins, iron, and thyroid hormones are known to improve wound healing. 15,16 However, there are challenges in their use for augmenting wound healing because of the existence of several biochemical and physiological barriers. The treating clinicians hence face challenges in the treatment of nonhealing wounds probably as a result of various coexisting factors and comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Apart from local wound care, other coexisting conditions and systemic factors also have to be addressed to achieve successful wound healing and standardized care for wound treatment, as emphasized by many physicians and authors. [15][16][17] As reported by Mani et al, 17 DFUs usually have associated neuropathy and infection, making healing complicated, whereas venous ulcers are associated with changes in the veins, increased capillary permeability, hemosiderin deposition in tissues, skin dryness, and thickening of skin. Thus, a holistic approach that includes standardized wound care, specific systemic therapies, and supportive measures such as offloading in DFU, compressions in venous ulcers, and newer technologies such as radio frequency (electromagnetic) stimulation 30,31 may be needed for successful wound healing.…”

Section: Discussionmentioning

confidence: 99%

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Fifty-Patient Study Evaluating the Efficacy of Modified Collagen With Glycerin in Periwound Skin Management

Nair

2018

The International Journal of Lower Extremity Wounds

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The management of chronic nonhealing ulcers pose a great challenge because they are associated with morbidity and increased costs. This report presents the observations of standard management along with application of modified collagen with glycerin (MCG) in the periwound area for management of nonhealing wounds. This observational report included 50 patients (33 male, 17 female) aged 24 to 94 years having nonhealing wounds. All wounds were treated using standard treatment protocols (TIME concept), whereas the periwound severity was assessed using the Harikrishna Periwound Skin Classification (HPSC). All patients received once-daily application of MCG lotion directly in the periwound areas and compression bandaging until there was complete wound healing. Patient compliance was ensured by regular follow-up and counseling. All diabetic patients were counseled to ensure glycemic control during the entire follow-up period. The criteria used for wound healing were based on clinical observation, and proper epithelialization of the wound was the end point. The median age of the wounds was 12.0 weeks (95% CI = 8.00 - 58.08). Majority of the non-healing wounds were diabetic foot ulcers with age of wound between 4 weeks to 15 years. The median time to complete wound healing was 12.71 (95% CI = 10.00-16.67) weeks. Standard treatment protocol of TIME principle with periwound area assessment based on HPSC 2015 and treatment accordingly with topical application of MCG along with additional measures has shown complete healing of nonhealing wounds. However, further large-scale comparative studies are needed to substantiate these effects on a larger population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fifty-Patient Study Evaluating the Efficacy of Modified Collagen With Glycerin in Periwound Skin Management

Nair

2018

The International Journal of Lower Extremity Wounds

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“…Scars were evaluated at 6 months after surgery, and hypertrophic scars—defined as scars elevated above or beyond the original wound boundaries—were observed in 27% of patients. The patients who developed hypertrophic scars had significantly lower circulating 25(OH)D levels compared to patients who did not develop hypertrophic scars (15.46 vs. 23.52 ng/mL, respectively) 106 . In another study conducted in Turkey, Ince et al reported on 84 patients presenting to their outpatient clinic with existing linear hypertrophic scars resulting from prior surgeries on the trunk or extremities 107 .…”

Section: Keloids: More Than Just ‘Scars’mentioning

confidence: 99%

“…have been two studies that reported associations between vitamin D deficiency and hypertrophic scar formation in surgical patients. In the first, Correia-Sa et al examined hypertrophic scar formation in a cohort of 62 patients in Portugal undergoing bodycontouring surgery 106. Scars were evaluated at 6 months after surgery, and hypertrophic scars-defined as scars elevated above or beyond the original wound boundaries-were observed in 27% of patients.…”

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confidence: 99%

A role for vitamin D and the vitamin D receptor in keloid disorder

Hahn

Combs

Powell

et al. 2023

Wound Repair Regeneration

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Keloids are disfiguring fibroproliferative lesions that can occur in susceptible individuals following any skin injury. They are extremely challenging to treat, with relatively low response rates to current therapies and high rates of recurrence after treatment. Although several distinct genetic loci have been associated with keloid formation in different populations, there has been no single causative gene yet identified and the molecular mechanisms guiding keloid development are incompletely understood. Further, although it is well known that keloids are more commonly observed in populations with dark skin pigmentation, the basis for increased keloid risk in skin of colour is not yet known. Because individuals with dark skin pigmentation are at higher risk for vitamin D deficiency, the role of vitamin D in keloid pathology has gained interest in the keloid research community. A limited number of studies have found lower serum vitamin D levels in patients with keloids, and reduced expression of the vitamin D receptor (VDR) in keloid lesions compared with uninjured skin. Vitamin D has documented anti‐inflammatory, anti‐proliferative and pro‐differentiation activities, suggesting it may have a therapeutic role in suppression of keloid fibrosis. Here we review the evidence supporting a role for vitamin D and VDR in keloid pathology.

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“…Among burn cases with systemic inflammation, the patients who undergo reconstructive surgery have been shown to develop scarring within 1 year [38]. Predisposing factors for scar development include A blood group, hyperimmunoglobulin E syndrome (high allergy risk), Afro-American, and Asian ethnicity [43].…”

Section: Hot Topics In Burn Injuriesmentioning

confidence: 99%

Burn Etiology and Pathogenesis

Kara¹

2018

Hot Topics in Burn Injuries

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As a trauma type, "Burn" is one of the high-frequency accidents in the world. It is mostly caused by electricity, hot water, and chemical agents. A trauma can have acute effects on burns, skin, and other organ systems. These complications might be seen as myocardial infarction, thromboemboli, respiratory, and renal failure. In case of acute burns, the skin surface is severely destroyed. During this period, infection may develop on damaged skin. Therefore, in the treatment of burn wounds, protecting the damaged skin and multidisciplinary approaches are needed for preventing scar formation while healing process.

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Hypertrophic Scars: Are Vitamins and Inflammatory Biomarkers Related with the Pathophysiology of Wound Healing?

Abstract: There is a different systemic inflammatory profile response in the patients during the formation of hypertrophic scars. Vitamin D plasma levels are marked reduced in these patients. Considering the powerful anti-inflammatory effect of vitamin D, these findings could be related.

Cited by 6 publications

References 56 publications

Fifty-Patient Study Evaluating the Efficacy of Modified Collagen With Glycerin in Periwound Skin Management

Fifty-Patient Study Evaluating the Efficacy of Modified Collagen With Glycerin in Periwound Skin Management

A role for vitamin D and the vitamin D receptor in keloid disorder

Burn Etiology and Pathogenesis

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