RT Book, Section
A1 Moioli, Eduardo K.
A1 Bolotin, Diana
A2 Alam, Murad
A2 Dover, Jeffrey S.
A2 Waibel, Jill S.
A2 Arndt, Kenneth A.
A2 Kim, John Y. S.
A2 Thomas, J. Regan
A2 Gaball, Curtis W.
A2 Chan, Rodney K.
SR Print(0)
ID 1176876471
T1 Basic Science of Scars
T2 Treatment of Scars From Burns and Trauma
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9780071839914
LK dermatology.mhmedical.com/content.aspx?aid=1176876471
RD 2023/06/10
AB Cutaneous  wound  healing  in  adults  often  leads  to  scarring  and  involves  3  major  phases:  1)  inflammation,  2)  tissue  formation,  and  3)  tissue  remodeling.  At  the  end  of  the  inflammation  phase  of  wound  healing,  fibroblasts  and  endothelial  cells  become  some  of  the  main  protagonists  of  the  tissue  formation  phase.  Remodeling  of  the  extracellular  matrix  (ECM)  within  the  normal  scar  starts  early  after  wounding  and  continues  for  many  months  until  the  scar  takes  its  final  shape  and  composition.  Hypertrophic  scars  and  keloids  fail  to  progress  through  the  normal  and  balanced  stages  of  wound  healing,  demonstrating  aberrant  cellular  responses  and  ECM  deposition.  Physiologic  scarring  results  in  the  re-establishment  of  barrier  function  and  local  homeostasis;  however,  deleterious  effects  on  sensory  function,  movement,  adnexal  function,  and  cosmesis  result.  Although  multiple  growth  factors  and  cytokines  are  involved  in  wound  healing  and  scarring,  transforming  growth  factor  beta  (TGF-β)  deserves  special  attention.  The  overwhelming  imbalance  and  aberrance  of  growth  factor  and  cytokine  profiles  ultimately  result  in  excess  collagen  and  cellular  products.  Wounds  in  locations  of  high  tension  such  as  the  central  chest  have  a  higher  risk  of  developing  hypertrophic  scars  and  keloids.  The  pathogenesis  of  atrophic  scars  has  not  been  well  studied,  although  it  is  presumed  that  destruction  of  collagen  occurs  resulting  in  dermal  atrophy.