Scars are the body’s response to an intense inflammation or injury. They are distinguished in: postoperative, hypertrophic, keloid, atrophic, post-burn and contracted.
Our goal in every surgical operation is, apart from the general aesthetic and functional result, a good final scar.
The postoperative scar is, at an early stage, red and tense, but then, with the progress of its remodeling and maturation becomes flat, thin, soft, without pain or pruritus.
The ultimate picture of a postoperative scar is not always what is expected, as the most important factor that comes from the patient himself cannot be predicted, and it is about the healing quality he has.
Ultimately, despite careful handling and wound care, we cannot rule out the possibility of the scar being submerged or protruding, having red, blue or white color, causing pain or itching and being hypertrophic or keloid.
Keloids & Hypertrophic Scars
Keloids and hypertrophic scars are due to excessive production of fibrotic tissue, in response to previous injury, to predisposed individuals.
The two sexes are routed with the same frequency. These lesions are usually located on the anterior surface of the chest, shoulders, cervix and earlobe after its piercing.
Hypertrophic scars are red and tense and persist for several months. They are larger in size and more elevated than the expected one for the particular trauma. A part of the scar may look normal, while another may seem hypertrophic. Unlike keloids, hypertrophic scars are limited to the wound area and show a tendency to recede. Pruritus and sensitivity are often observed.
The keloids are even larger, more elevated and often sensitive. They extend beyond the wound site and often disrupt the anatomy of this area. They do not show a tendency to retreat, and usually their size is increasing over time.
Recent lesions respond better than older, less active scars. The treatment of these scars includes topical corticosteroids, laser therapy and surgical correction.
The atrophic scar is caused by tissue loss. They are the most common type of scar after inflammatory acne.
See also: Acne Scars
It is caused by a burn. Post-burn scars are a major aesthetic and functional problem, despite the advances made over the last few decades in the treatment of burns.
It is a hard, hypertrophic, stretched and shrunken scar that results from the prolongation of the contraction period during healing of the wounds.
Predisposing factors for contracted scars appearance are:
- secondary intention healing
- tension on the suture line
- vertical orientation of the trauma in relation to the lines of minimal skin tension
They can cause severe aesthetic problems and are primarily responsible for functional disorders.
They must be prevented, but if they have been created they are dealt with surgery.