scholarly journals Burn Hypertrophic Scar in Pediatric Patients: Clinical Case

2020 ◽  
pp. 517-521
Author(s):  
Roohi Vinaik ◽  
Joel Fish ◽  
Marc G. Jeschke
Keyword(s):  
Laser Therapy ◽  
Hypertrophic Scar ◽  
Clinical Case ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Symptomatic Relief ◽  
Treatment Options ◽  
Healing Process ◽  
Hypertrophic Scars ◽  
Limited Mobility

AbstractRecent improvements in burn care have resulted in greater patient survival of severe burns. With improved survival, treatment of the resulting permanent burn hypertrophic scars requires extensive care. Hypertrophic scarring occurs due to aberrations in the normal healing process, resulting in excessive inflammation and collagen deposition at the site of injury. These scars are accompanied by symptoms such as pain, pruritus, erythema, and limited mobility. The high scar prevalence in pediatric patients and accompanying physical, psychological, and social burden warrant a better understanding of the possible treatment options. Currently, several therapeutic strategies exist for hypertrophic scar management in the pediatric patient, although none are completely effective. Recently, laser therapy has emerged as a potential therapy for symptomatic relief and scar modulation. Here, we provide an up-to-date review of treatment options for hypertrophic scars in the pediatric population. In addition, we discuss a clinical case, outlining the potential merits of addition of laser therapy and surgical revision for the treatment of hypertrophic scars.

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.

The Effectiveness of Laser Therapy for Hypertrophic Burn Scars in Pediatric Patients: A Prospective Investigation

2021 ◽  
Author(s):  
Jennifer Zuccaro ◽  
Charis Kelly ◽  
Manuela Perez ◽  
Andrea Doria ◽  
Joel S Fish
Keyword(s):  
Carbon Dioxide ◽  
Laser Therapy ◽  
Carbon Dioxide Laser ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Dye Laser ◽  
Pulsed Dye Laser ◽  
Assessment Protocol ◽  
Scar Assessment ◽  
Fractional Carbon Dioxide Laser

Abstract Laser therapy has become a valuable treatment option for hypertrophic burn scars. Improvements in scar symptoms have been achieved using the ablative fractional carbon dioxide laser as well as the pulsed dye laser. However, research regarding the use of laser therapy among pediatric patients remains limited. Thus, the aim of this study was to investigate the effectiveness of using laser therapy to improve hypertrophic burn scars in a pediatric population using a comprehensive scar assessment protocol. A pragmatic, single-center, prospective observational study was conducted at a tertiary pediatric hospital. Twenty participants with hypertrophic burn scars were included. Laser procedures were administered at approximately two month intervals and scars were evaluated at five time-points over one year using the Vancouver Scar Scale, the Patient and Observer Scar Assessment Scale, conventional ultrasound, ultrasound elastography, and a multi-probe skin analysis device. Seventy-one laser procedures were performed with most participants receiving treatment with both the ablative fractional carbon dioxide laser and the pulsed dye laser at the same session (83%). From baseline to study completion, significant improvements in all scar measures were observed (p &lt; 0.05). In particular, improvements in overall scarring and in specific scar properties including thickness, stiffness, and colour were found (p &lt; 0.05). To our knowledge, this is the most comprehensive study to date to evaluate the effect of laser treatment on hypertrophic burn scars in a pediatric population. Our findings suggest that laser therapy is a beneficial treatment for burn-injured children as evidenced by the improvements in subjective and objective scar assessment measures.

scholarly journals Overactive bladder in children

2017 ◽  
Vol 11 (1-2S) ◽  
pp. 74 ◽  
Author(s):  
Sophie Ramsay ◽  
Stéphane Bolduc
Keyword(s):  
Quality Of Life ◽  
Overactive Bladder ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Treatment Options ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Stepwise Approach ◽  
Pediatric Use

Overactive bladder (OAB) is a highly prevalent disorder in the pediatric population. This condition is especially troublesome for pediatric patients and their families when associated with incontinence, since it negatively affects self-esteem and impairs children’s development. From the patient’s perspective, urgency and urge incontinence can have a significant impact, negatively affecting their quality of life. For a therapy to have true benefit, changes must not only be statistically significant, but must also be perceived as meaningful by the patient. A stepwise approach is favoured to treat this pathology, starting with behavioural therapy, followed by medical management, and eventually more invasive procedures.Antimuscarinic agents are the mainstay of medical treatment for OAB. Oxybutynin is the most commonly used antimuscarinic in the pediatric population. However, some patients have a suboptimal response to antimuscarinics and many experience bothersome side effects, which have been documented with all antimuscarinics to a significantly higher degree than placebo. Although there have been reports about the use of tolterodine, fesoterodine, trospium, propiverine, and solifenacin in children, to date, only oxybutynin has been officially approved for pediatric use by medical authorities in North America.This review will address alternative treatment options for pediatric patients presenting with OAB, from conservative measures to more invasive therapies.

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 Treatment of recurrent aphthous stomatitis by laser therapy: A systematic review of the literature

2015 ◽  
Vol 72 (8) ◽  
pp. 722-728 ◽  
Author(s):  
Verica Pavlic ◽  
Vesna Vujic-Aleksic ◽  
Akira Aoki ◽  
Lana Nezic
Keyword(s):  
Laser Therapy ◽  
Treatment Options ◽  
Healing Process ◽  
Cochrane Collaboration ◽  
Recurrent Aphthous Stomatitis ◽  
Aphthous Stomatitis ◽  
Cochrane Library ◽  
Original Research ◽  
Treatment Protocols ◽  
Efficient Treatment

Background/Aim. Recurrent aphthous stomatitis (RAS) is defined as multifactor immunologic inflammatory lesions in the oral cavity, characterized by painful, recurrent single/multiple, shallow, round or ovoid ulcerations of mucosal tissues. To date, a considerable number of RAS treatment protocols have been suggested, but since the etiology of RAS is idiopathic, these treatment options have symptomatic rather than curative or preventive effect. Recently, it has been suggested that laser therapy could be successfully used as an efficient treatment approach in therapy of RAS. Therefore, the aim of this review was to estimate the effects of laser therapy in treatment of RAS analyzing results of clinical studies published in peer reviewed journals. Methods. The studies published until 31 December 2013 were obtained from the Medline/PubMed, Science Direct and Cochrane Library of the Cochrane Collaboration (CENTRAL) online databases, using following search terms and key words: ?laser? AND ?recurrent aphthous stomatitis?, ?laser? AND ?aphthous?, and ?laser? AND ?aphthae?. In total 4 original research articles met the all required inclusion/exclusion criteria, and were used for this review. The main outcome measures assessed were: a reduction of pain associated with RAS and a reduction in episode duration (faster RAS healing). Results. The assessed literature demonstrates the benefits of laser therapy mainly due to immediate analgesia and ability to speed up a RAS healing process. Conclusion. Even though the assessed literature suggests beneficial outcomes of laser therapy in treatment of RAS, these results should be interpreted with caution. The issues related to the study designs and different sets of laser irradiation parameters of a limited number of available studies with the same treatment outcomes prevent us from making definite conclusions.

scholarly journals Incidental durotomy in the pediatric spine population

2018 ◽  
Vol 22 (5) ◽  
pp. 591-594
Author(s):  
James L. West ◽  
Madison Arnel ◽  
Atilio E. Palma ◽  
John Frino ◽  
Alexander K. Powers ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Primary Repair ◽  
Pediatric Population ◽  
Treatment Options ◽  
Spinal Cord Tumor ◽  
Tumor Resection ◽  
Pedicle Screws ◽  
Tethered Cord ◽  
Csf Leak ◽  
Incidental Durotomy

OBJECTIVESpine surgery is less common in children than adults. These surgeries, like all others, are subject to complications such as bleeding, infection, and CSF leak. The rate of incidental durotomy in the pediatric population, and its associated complications, has scarcely been reported in the literature.METHODSThis is a retrospective chart review of all pediatric patients operated on at Wake Forest Baptist Health from 2012 to 2017 who underwent spine surgeries. The authors excluded any procedures with intended durotomy, such as tethered cord release or spinal cord tumor resection.RESULTSFrom 2012 to 2017, 318 pediatric patients underwent surgery for a variety of indications, including adolescent idiopathic scoliosis (51.9%), neuromuscular scoliosis (27.4%), thoracolumbar fracture (2.83%), and other non–fusion-related indications (3.77%). Of these patients, the average age was 14.1 years, and 71.0% were female. There were 6 total incidental durotomies, resulting in an overall incidence of 1.9%. The incidence was 18.5% in revision operations, compared to 0.34% for index surgeries. Comparison of the revision cohort to the durotomy cohort revealed a trend toward increased length of stay, operative time, and blood loss; however, the trends were not statistically significant. The pedicle probe was implicated in 3 cases and the exact cause was not ascertained in the remaining 3 cases. The 3 durotomies caused by pedicle probe were treated with bone wax; 1 was treated with dry Gelfoam application and 2 were treated with primary repair. Only 1 patient had a persistent leak postoperatively that eventually required wound revision.CONCLUSIONSIncidental durotomy is an uncommon occurrence in the pediatric spinal surgery population. The majority occurred during placement of pedicle screws, and they were easily treated with bone wax at the time of surgery. Awareness of the incidence, predisposing factors, and treatment options is important in preventing complications and disability.

scholarly journals Pulse dye laser therapy and superficial cryotherapy as a novel combination treatment for hypertrophic scars and keloids

2022 ◽  
Vol 13 (1) ◽  
pp. 28-31
Author(s):  
Iqbal A. Bukhari
Keyword(s):  
Laser Therapy ◽  
Combination Treatment ◽  
Treatment Options ◽  
Fibrous Tissue ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Dye Laser ◽  
Hypertrophic Scars ◽  
Pressure Therapy ◽  
One Year

Background: Hypertrophic scars are benign and fibrotic skin lesions caused by defects in the regulation of cellularity during the wound-healingprocess, in which there is higher collagen production and less degradation. Genetic predisposing factors and different skin injuries may play a role in developing these types of lesions. On the other hand, keloids are overgrowths of fibrous tissue outside the original boundaries of trauma, yet these may also occur spontaneously. There are numerous treatment options for both conditions, including silicone gel sheeting, pressure therapy, intralesional triamcinolone acetonide, radiation, laser therapy, cryosurgery, interferon, 5-fluorouracil, and surgical excision as well as a multitude of extracts and topical agents. Objective: The objective was to evaluate the effectiveness of pulse dye laser (PDL) therapy and superficial cryotherapy as a combination treatment for hypertrophic scars and keloids. Method: Four Arabic female patients were seen at the outpatient clinic of the Department of Dermatology at the King Fahd Hospital of the University in Khobar, Saudi Arabia. The patients had keloids and hypertrophic scars. Treatment with cryotherapy every week for three weeks followed by one session of pulsed dye laser was administered rotationally for three to six months until the lesions displayed remarkable physical improvement or complete resolution. Results: All patients experienced significant improvement, showing a reduction in the size, erythema, pliability, and pruritus. None of the hypertrophic scars or keloids deteriorated during the one year of treatment. No complications were noted during the treatment period. Conclusion: Sequential PDL therapy combined with superficial cryotherapy may be an option for treating hypertrophic scars and keloids.

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 What are the scientific facts about the symptoms and treatment of COVID-19 in the pediatric population? A systematic review with overview

2021 ◽  
Vol 10 (10) ◽  
pp. e24101018386
Author(s):  
Vitória Monteiro Monte Oliveira ◽  
Paulo Francisco de Almeida-Neto ◽  
Francisca Dalila Paiva Damasceno de Lima ◽  
Stefanny Karla Ferreira de Sousa ◽  
André Carvalho de Sousa ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Health Professionals ◽  
Web Application ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Healing Process ◽  
Scientific Data ◽  
Intestinal Infection ◽  
Antiviral Therapies ◽  
Scientific Facts

Considering the lower prevalence of pediatric patients with COVID-19, health professionals are more familiar with interventions aimed at adults; thus, understanding the symptoms and which approaches can be useful for pediatric patients with COVID-19 is of great importance for health professionals. The study aimed to aggregate scientific data on procedures and treatments performed on pediatric patients (aged 6 to 17 years) with COVID-19. A systematic literature search was performed in five electronic databases (i.e., PubMed, CINAHL, Google Scholar, and LILACS). Literature analyses were performed in English and Chinese, between November 2019 and December 2020. For data classification, the web application Rayyan® was used. Studies have shown that in most cases, children are asymptomatic. However, when symptomatic, they present fever, cough, intestinal infection, and vomiting. It is noteworthy that the respiratory rate and stool tests were significant indicators of the disease. Regarding treatment, oxygen support is essential during the hospitalization of patients and, antiviral therapy with Lopinavir and Ritonavir has shown significant results in a few isolated cases. It is concluded that the main symptoms of SARS-CoV-2 in pediatric patients are mild symptoms similar to those of common flu. In addition, respiratory rate and examinations based on fecal samples are good indicators of the disease in children of both sexes, as well as antiviral therapies and early isolation at the beginning of the disease are significant for the healing process.

MINIMAL INVASIVE MANAGEMENT OF PEDIATRIC CROHN’S ANORECTAL STRICTURE, LESS IS MORE

2021 ◽  
Vol 27 (Supplement_1) ◽  
pp. S16-S16
Author(s):  
Dorothy Rocourt ◽  
Travis Hoover
Keyword(s):  
Disease Control ◽  
Crohn Disease ◽  
Pediatric Patients ◽  
Biologic Therapy ◽  
Case Reports ◽  
Pediatric Population ◽  
Treatment Options ◽  
Ileocecal Resection ◽  
Rectal Stricture ◽  
Less Is More

Abstract Background Anorectal stricture (ARS) is an uncommon but potentially disabling manifestation of perianal Crohn disease (CD) in pediatric patients. Various treatment options are available but there is little data regarding their efficacy, particularly in the pediatric population. We present three case reports of patients with symptomatic ARS treated with serial dilation and biologic therapy. Methods An institutional review board-approved retrospective review was performed using electronic health records. Three patients with ileocolonic CD and perianal involvement with symptomatic ARS were identified. All patients were treated with serial rectal dilations under general anesthesia using Hegar dilators. Results All patients are currently asymptomatic at follow-ups ranging from 1 to 3.5 years since the last dilation. Patient demographics and details of ARS management are presented in Table 1. All patients tolerated the procedures well and did not experience complications such as perforation, sepsis, or fecal incontinence. Rectal biopsy in each patient showed active inflammation, suggesting type 1 stricture according to the Hughes-Cardiff Classification (vs. type 2 fibrotic stricture). Patient 1 experienced 6 recurrences, each managed with an average of 2 dilations until disease control was established with ustekinumab (USK) and eventually vedolizumab (VDZ). She underwent ileocecal resection three years after the final dilation. Patient 2 underwent ileocecal resection immediately following the first series of dilations. He later experienced one stricture recurrence at 2 years, which was managed with one dilation and increased USK dosing frequency. Patient 3 received steroid suppositories prior to dilation and has been self-dilating at home. He has had no recurrences requiring operative dilation. Self-dilation was not feasible in patients 1 and 2. Conclusion Inflammatory anorectal stricture associated with perianal Crohn disease in pediatric patients can be managed successfully with dilation until disease control with biologic therapy. Recurrences of stricture can also be managed with dilation and modification of biologic therapy. If tolerated, self-dilation may reduce recurrence. Background Anorectal stricture (ARS) is an uncommon but potentially disabling manifestation of perianal Crohn disease (CD) in pediatric patients. Various treatment options are available but there is little data regarding their efficacy, particularly in the pediatric population. We present three case reports of patients with symptomatic ARS treated with serial dilation and biologic therapy. Crohn’s rectal stricture pre and post dilation

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