Abstract:
Scars are the final result of the four processes that constitute cutaneous wound healing, namely, coagulation, inflammation, proliferation, and remodeling. Permanent scars are produced if the wounds reach the reticular dermis. The nature of these scars depends on the four wound healing processes. If the remodeling process is excessive, collagen degradation exceeds collagen synthesis and atrophic scars are produced. If the inflammation phase is prolonged and/or more potent for some reason, inflammatory/pathological scars such as keloids or hypertrophic scars can arise. If these pathological scars are located on joints or mobile regions, scar contractures can develop. When used with the appropriate timing and when selected on the basis of individual factors, surgical techniques can improve mature scars. This review paper focuses on the surgical techniques that are used to improve mature scars, burn scars, and scar contractures. Those methods include z-plasties, w-plasties, split-thickness skin grafting, full-thickness skin grafting, local flaps (including the square flap method and the propeller flap), and expanded flaps, distant flaps, regional flaps, and free flaps.
摘要:
疤痕是构成皮肤伤口愈合的四个过程的最终结果,即,凝血,炎症,扩散,和重塑。如果伤口到达网状真皮,则会产生永久性疤痕。这些疤痕的性质取决于四个伤口愈合过程。如果重塑过程过度,胶原蛋白降解超过胶原蛋白合成,并产生萎缩性疤痕。如果炎症阶段由于某种原因而延长和/或更有效,可能出现炎性/病理性疤痕,例如瘢痕疙瘩或肥厚性疤痕。如果这些病理性疤痕位于关节或活动区域,瘢痕挛缩可以发展。当使用适当的时机和根据个别因素选择时,手术技术可以改善成熟的疤痕。这篇综述论文的重点是用于改善成熟疤痕的手术技术,烧伤疤痕,和疤痕挛缩。这些方法包括z-plasties,w-plasties,裂层植皮,全层植皮,局部皮瓣(包括方形皮瓣法和螺旋桨皮瓣),和扩张的皮瓣,远处的皮瓣,区域襟翼,和自由皮瓣。