scholarly journals Minimal-Invasive Technologies for Treatment of HTS and Keloids: Corticosteroids

2020 ◽  
pp. 243-250
Author(s):  
Juhee Lee ◽  
Jihee Kim
Keyword(s):  
Mechanism Of Action ◽  
Collagen Synthesis ◽  
Treatment Options ◽  
Healing Process ◽  
Minimal Invasive ◽  
Treatment Modalities ◽  
Wound Healing Process ◽  
Intralesional Injection ◽  
Hypertrophic Scars ◽  
Clinical Presentations

AbstractHypertrophic scars and keloids are common lesions caused by abnormal wound healing process. Especially in keloids, abnormal fibroblast activity and excessive synthesis of collagen is a histopathological hallmark in its pathogenesis. Due to heterogeneity of etiologies and clinical presentations, treatment of hypertrophic scars and keloids are often challenging. The response rate varies widely, depending on treatment modalities and the timing of therapeutic intervention. Corticosteroid is considered to be one of the best treatment options, yet paucity of information exists on its mechanism of action. It is mostly known to inhibit abnormal fibroblast proliferation leading to collagen synthesis and promote further degeneration of extracellular matrix. Intralesional injection of corticosteroid has been well advocated in the treatment of both hypertrophic scars and keloids. Locally delivered corticosteroid causes significant decrease in scar volume and ameliorates the symptoms of the scars such as pain and pruritus. However, the lesions are prone to localized adverse reactions upon repeated treatments. Therefore, appropriate use of steroids requires awareness of its mechanism of action in scar treatment.

scholarly journals Comparison of the effect of collagen (amino acid) and amnion (proteinase inhibitor) on the wound healing of soft tissues

2010 ◽  
Vol 22 (1) ◽  
Author(s):  
Weko Adhiarto ◽  
Sunardhi Mangundjaja ◽  
Makmuri Yusuf ◽  
Bambang Pontjo
Keyword(s):  
Wound Healing ◽  
Amino Acid ◽  
Soft Tissue ◽  
Collagen Synthesis ◽  
Soft Tissues ◽  
Proteinase Inhibitors ◽  
Healing Process ◽  
Control Group ◽  
Wound Healing Process ◽  
The Mean

The wound healing process of the soft tissue aims to accelerate the closing of the wound by recurring, restoring the function, and minimizing the scar tissue. This process has to occur in the surgery process to obtain better-wound healing. The aim of this study was to know the stimulation effect of the wound dressing to accelerate the wound healing process of the soft tissue using Collagen (amino acid) and Amnion (proteinase inhibitors). This true experimental study was done to 36 mice (Sprague Dawley) that were divided into three different groups, two groups were the treatment groups and one group was the control group. Each group was adapted in Pathology Laboratory of Faculty of Veterinary Medicine Bogor Agricultural University. All of the mice were injured on the skin by incising the right side of the back for 2 cm in length and 4 mm in depth and then cleaned with 0.9% NaCl solution. To the first group of treatment, the wound was applicated by Amnion, and the second group was applicated by Collagen. Each 4 mice of all group were a termination by ether and encryption on the wounded tissue was conducted on day 3rd, 7th, and 14th. Assessment for a number of fibroblast and collagen synthesis on the wound of back tissue was conducted with the histological examination by painted using hematoxylin-eosin. The results concluded that Collagen application was influencing the mean of fibroblast higher than Amnion, and the lowest was controlled with statistically significant. The mean of collagen used Collagen lower than Amnion, and the lowest was control with statistically significant. It could be concluded that collagen application was preeminent in increasing the productivity of the fibroblast, as well as in developing forms of the collagen synthesis compared with Amnion and control.

scholarly journals The Effectiveness of Depigmentation, Interleukin-1B, and Transforming Growth Factor-B Antibodies in Activating and Increasing Collagenase in Keloid as Adjuvant Therapy After Scar Excision

2021 ◽  
Vol 2 (1) ◽  
pp. 16-22
Author(s):  
Savira Butsainah Dienanta ◽  
Ayik Rochyatul Jannah ◽  
Faiza Rahma Ebnudesita ◽  
Reny I'tishom
Keyword(s):  
Growth Factor ◽  
Adjuvant Therapy ◽  
Collagen Synthesis ◽  
Type I Collagen ◽  
Transforming Growth Factor ◽  
Target Location ◽  
Drug Carrier ◽  
Healing Process ◽  
Wound Healing Process ◽  
Type I

Background: Keloid is an abnormal scar in previously traumatic skin after going through the wound healing process. One hundred million cases have been found in developing countries with the main complaint of scar appearances. To overcome this problem, 24 literatures from various journals and textbooks are reviewed. Reviews: Keloid formation is based on high melanin amount which inhibits the collagenase enzyme. Moreover, the high melanin amount would block interleukin (IL)-1B work resulting in collagen synthesis and collagenase reduction. Depigmentation effort with 4% hydroquinone is implemented to reduce the amount of melanin presented in the skin. With melanin reduction, IL-1B can work optimally by inhibiting fibroblast growth in keloid tissue without affecting on normal skin. It also induces Matrix Metalloproteinase (MMP)-1 which is an interstitial collagenase. IL-1B has an opposing effect compared to Transforming Growth Factor (TGF)-B, thus TGF-B antibody is needed to potentiate IL-1B therapeutic effect. TGF-B antibody can neutralize TGF-B ligand and avB6 integrin resulting in blocking of COL1A1 gene expression which is responsible for MMP-1 production and type-I collagen synthesis. These three components are combined in cream with liposome as a drug carrier. This combination is applicated for adjuvant therapy after scar excision. Liposomes are chosen because of their high biocompatibility, low toxicity, and low biodegradability. Liposomes also can release slowly in the extravascular area such as skin. This advantage may carry drug components effectively to the target location. Summary: The combination of depigmentation, IL-1B, and TGF-B antibodies has a potency to be developed as a future adjuvant therapy of keloid.

scholarly journals Effect of essential oil on hypertrophic scars

MEDISAINS ◽  
2021 ◽  
Vol 19 (1) ◽  
pp. 15
Author(s):  
Ave Olivia Rahman ◽  
Humaryanto Humaryanto ◽  
Anati Purwakanthi ◽  
Charles Apul Simanjuntak
Keyword(s):  
Essential Oil ◽  
Hypertrophic Scar ◽  
Healing Process ◽  
Alternative Therapy ◽  
The Body ◽  
Wound Healing Process ◽  
Test Design ◽  
Hypertrophic Scars ◽  
Scar Assessment ◽  
Post Test

Background: Hypertrophic scars are abnormal scars resulted from a disrupted wound healing process. Hypertrophic scars can affect the body aesthetic of the sufferers, but, on the other hand, conventional therapy has not been optimally effective. The application of essential oil combinations as an alternative therapy for hypertrophic scars has not been scientifically proven.Purposes: This study was to determine the effectiveness of the essential oil as a hypertrophic scar therapy.Methods: This study used a pre and post-test design. As many as 24 subjects aged 17-25 years with hypertrophic scars were given essential oil combinations every morning and evening for six months. Assessment of hypertrophic scars was done using the POSAS  (Patient and Observer Scar Assessment Scale).Results: The results showed that the POSAS score decreased after the essential oil combination administration for six months, 14.40±6.08 vs. 22.67±8.31 (p<0.001).Conclusion: the combination of essential oil oils used in this study reduces hypertrophic scars based on the POSAS assessment.

scholarly journals PENGARUH PROPOLIS TERHADAP KOLAGENISASIPADA PROSES PENYEMBUHAN LUKA SUBKUTAN PUNGGUNG MENCIT YANG DIINDUKSI BAKTERI ACTINOBACILLUS ACTINOMYCETEMCOMITANS

2016 ◽  
Vol 1 (1) ◽  
pp. 11
Author(s):  
Asdar Asdar
Keyword(s):  
Wound Healing ◽  
Body Weight ◽  
Collagen Synthesis ◽  
Collagen Fiber ◽  
Healing Process ◽  
Actinobacillus Actinomycetemcomitans ◽  
Special Treatment ◽  
Wound Healing Process ◽  
Pharmacological Activities ◽  
The Third

Propolis, the resinous hive product by bees, is important in the defence of the hive. It is know that extract of propolisexhibits such pharmacological activities as antimicrobia,antiviral, antifungal, anti-inflamatory, immunostimulatoryand promote wound healing. The objective of this studywas to investigate the influence of the propolis on theformation of collagen in the wound healing process of thesubcutan injury of mice that were induced withActinobacillus actinomyctemcomitans (A.actinomyctemcomitans)Thisstudyapplied 24 female BALB/c mice of 2 - 3 monthsof age with the weight of 20 -30 grams. On the first day thewhole population were injected withA.actinomyctemcomitans subcutanly. The second day micewere randomly devided into two groups that was the groupwith special treatment and the controlled ones. The groupunder treatment were given the extract of propolis 100mg/kg body weight every day. While the controlled oneswere only given aquades.Histological observation was conducted upon each groupon the third, seventh and fourteenth days after A.actinomyctemcomitans injection. There-suits of theobservation was based on the density collagen fiber. Thedata obtained then analyzed by using Mann-Whitney U test.The results of the present study indicated that theadministration of 100 mg/kg BWpropolis peroral maystimulate collagen synthesis.

scholarly journals Haruan Extract (Channa striatus) as an Effective Mediator in Promoting Wound Healing

2021 ◽  
Author(s):  
Ahmad Farouk Musa ◽  
Cheang Jia Min
Keyword(s):  
Fatty Acids ◽  
Extracellular Matrix ◽  
Wound Healing ◽  
Granulation Tissue ◽  
Healing Process ◽  
Skin Grafting ◽  
Treatment Modalities ◽  
Wound Healing Process ◽  
Channa Striatus ◽  
The Government

Wound healing remains a major issue in surgery. None of the existing treatment modalities in caring for wounds can yet claim to be the holy grail of wound management. Channa striatus, locally known in Malaysia as Haruan, is a freshwater air-breathing carnivorous fish that is proven to influence the different phases of wound healing. As a medicinal fish, not only does Haruan have a high content of amino and fatty acids, which are essential in collagen fibre synthesis during wound recovery, it also abounds in arachidonic acid and polyunsaturated fatty acids that promote prostaglandin synthesis, a vital component of the healing process. Moreover, its antinociceptive effects could potentially reduce wound pain, an important factor in wound healing. Proteomic studies show that a quarter of the total protein detected in freeze- and spray-dried C. striatus extract are actin, myosin and tropomyosin – all molecules that play a role in the wound healing process. Proteomic profiling also reveals that Haruan possesses two types of collagen namely collagen type-I and type-II that confer tensile strength during the healing process. It is proven that collagen along with other components of the extracellular matrix form the granulation tissue which, when contracted, closes the wound and concomitantly aligns the collagen fibres in the extracellular matrix. Hence, it is inferred that Haruan promotes the maturation of granulation tissue, thereby expediting the wound healing process itself. Consequently, it could mediate a faster recovery from surgical wound coupled with a lower incidence of wound infection due to an improved and accelerated wound healing process. Additionally, Haruan has demonstrated its ability in promoting angiogenesis and cell proliferation in wound bed preparation for skin grafting. Furthermore, a Haruan aerosol concentrate can act as a wound dressing at the donor site thereby enhancing the healing process while simultaneously exhibiting some antinociceptive properties. Haruan’s exceptional ability in promoting wound healing together with its potential use in skin grafting would be instrumental in the field of surgery. In essence, the cumulated benefits from all the processes involved would translate into a significant reduction of hospitalisation cost; that would immensely benefit not only the patient, but also the government.

scholarly journals Intralesional injection treatment of hypertrophic scars and keloids: a systematic review regarding outcomes

2015 ◽  
Vol 3 ◽  
pp. 1-10 ◽  
Author(s):  
Aurelia Trisliana Perdanasari ◽  
Matteo Torresetti ◽  
Luca Grassetti ◽  
Fabio Nicoli ◽  
Yi Xin Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Treatment Options ◽  
Intralesional Injection ◽  
Hypertrophic Scars ◽  
Level Of Evidence ◽  
Search Terms ◽  
Injection Treatment ◽  
Full Text Review ◽  
On Line

Abstract Background The aim of this review was to explore the existing body of literature focusing on the intralesional treatments of keloids and hypertrophic scars. Methods A comprehensive systematic review of related articles was conducted across multiple databases. Article selection was limited to those published in the English language between 1950 and 2014. Search terms for the on-line research were “scar(s),” “keloid(s),” “hypertrophic,” “injection,” “intralesional,” and “treatment”. Results The initial search returned 2548 published articles. After full text review, the final search yielded 11 articles that met inclusion criteria. A total of 14 patient samples in 11 articles were collected. The most frequent intralesional injection treatment studied was triamcinolone (n = 5), followed by bleomycin (n = 3), 5-fluorouracil (n = 2), verapamil (n = 2), cryosurgery, and collagenase. The scar height reduction for all but one study was demonstrated, with acceptable complication and recurrence rate. Only three articles reported a follow-up period longer than 18 months, and only two studies used standardized outcome criteria with a quantitative scale. Conclusions Although many treatment options have already been described in the literature, there is no universally accepted treatment resulting in permanent hypertrophic or keloid scar ablation. The lack of adequately long-term powered randomized controlled trials does not permit to establish definitive conclusions with implications for routine clinical practice. Level of evidence III/Therapeutic

scholarly journals Advances of Stem Cell Therapeutics in Cutaneous Wound Healing and Regeneration

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Suman Kanji ◽  
Hiranmoy Das
Keyword(s):  
Stem Cells ◽  
Wound Healing ◽  
Stem Cell ◽  
Wound Repair ◽  
Chronic Wounds ◽  
Healing Process ◽  
Treatment Modalities ◽  
Wound Healing Process ◽  
Cutaneous Wound Healing ◽  
Cutaneous Wound

Cutaneous wound healing is a complex multiple phase process, which overlaps each other, where several growth factors, cytokines, chemokines, and various cells interact in a well-orchestrated manner. However, an imbalance in any of these phases and factors may lead to disruption in harmony of normal wound healing process, resulting in transformation towards chronic nonhealing wounds and abnormal scar formation. Although various therapeutic interventions are available to treat chronic wounds, current wound-care has met with limited success. Progenitor stem cells possess potential therapeutic ability to overcome limitations of the present treatments as it offers accelerated wound repair with tissue regeneration. A substantial number of stem cell therapies for cutaneous wounds are currently under development as a result of encouraging preliminary findings in both preclinical and clinical studies. However, the mechanisms by which these stem cells contribute to the healing process have yet to be elucidated. In this review, we emphasize on the major treatment modalities currently available for the treatment of the wound, role of various interstitial stem cells and exogenous adult stem cells in cutaneous wound healing, and possible mechanisms involved in the healing process.

scholarly journals Profile of Working-Age Patients with Keloid and Hypertrophic Scar at Dr. Soetomo General Hospital Surabaya in 2014-2017

2021 ◽  
Vol 12 (2) ◽  
pp. 84
Author(s):  
Fania Ayu Wardani ◽  
David Sontani Perdanakusuma ◽  
Diah Mira Indramaya
Keyword(s):  
Hypertrophic Scar ◽  
Burn Injury ◽  
Corticosteroid Injection ◽  
Healing Process ◽  
Wound Healing Process ◽  
Hypertrophic Scars ◽  
Process Data ◽  
Traumatic Lesion ◽  
Working Age ◽  
The Face

Introduction: Keloid and hypertrophic scar are pathological scars resulting from excessive accumulation of collagen in wound healing process. Data about profiles of keloid and hypertrophic scar are rarely found in Indonesia. Therefore, it is necessary to conduct research related to keloid and hypertrophic scar. This study aimed to provide valuable data for further research.Methods: This was descriptive retrospective study evaluating 105 patients treated for keloid and hypertrophic scar from 2014 to 2017 using medical records of working-age patients.Results: Mostly in patients between 17-25 years old (40%). Comparison between male and female patients were 1.07:1 (keloid) and 1.09:1 (hypertrophic scar). As many as 10.71% of patients of keloid and 17.39% patients of hypertrophic scar were private employees. 23.21% patients with keloid and 23.91% patients of hypertrophic scar were Javanese. 14.29% patients of keloid and 19.57% patients of hypertrophic scar tend to have daily indoor activities. 17.86% patients of keloid and 26.09% patients of hypertrophic scar felt dark-skinned toned. Most keloid scars were caused by traumatic lesions (32.14%), located on the chest (19.54%), and treated by corticosteroid injection. Hypertrophic scar mostly caused by burn injury (54.35%), located on the face (29.55%), and treated by excision surgery.Conclusion: Both keloid and hypertrophic scars were mostly developed in 17-25 years old, male, private employees, Javanese ethnic, dark skin tone patients, with daily indoor activities, caused by traumatic lesion and located on the chest, earlobe, and hand, treated by corticosteroid injection (keloid). Meanwhile, hypertrophic scars are mostly caused by a burn injury on the face and treated by excision surgery.

scholarly journals Effect of Adjuvant Imiquimod 5% Cream on Sustained Clearance of Anogenital Warts Following Laser Treatment

2001 ◽  
Vol 10 (2) ◽  
pp. 79-88 ◽  
Author(s):  
U. B. Hoyme ◽  
M. Hagedorn ◽  
A.-E. Schindler ◽  
P. Schneede ◽  
W. Hopfenmüller ◽  
...  
Keyword(s):  
Wound Healing ◽  
Laser Treatment ◽  
Laser Therapy ◽  
Healing Process ◽  
Primary Objective ◽  
Treatment Modalities ◽  
Wound Healing Process ◽  
Anogenital Warts ◽  
Open Label ◽  
Number Of Patients

Objectives:Imiquimod is an immune response modifier that has demonstrated a good efficacy and relatively low recurrencerates in comparison to other genitalwart treatment modalities. The primary objective of this open-label study was to evaluate the effect on sustained clearance of treated lesions and the safety of patient-applied topical imiquimod after laser therapy of external anogenital warts.Methods:After laser treatment of visible external anogenital warts the ablated region(s) were treated with imiquimod 5% cream three times/week over 12 weeks beginningwhen the wound healing process was completed, followed by a six-month treatment-free observation period for the assessment of sustained clearance of treated lesions.Results:A total of 211 male and female patients was enrolled in the study. After 12 weeks of treatment, 65.4% of all patients showed sustained clearance. During the treatment period, 15 patients (7.1% of 211 patients) presented with recurrent warts in the treated areas, and 58 (27.5%) patients were excluded for other reasons. During the six-month follow-up period, ten additional patients (7.3% of 138 patients) developed wart recurrences. The application of imiquimod 5% cream was well tolerated. The number of patients with adverse events related to studymedication declined fromthe first month of treatment until the end of the third month.Most frequently, mild to moderate itching, burning, pain and erythema were reported.Conclusions:After laser therapy and sufficient wound healing, administration of imiquimod 5% cream three times/week appears to be safe and to reduce the incidence of wart recurrences.

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