Textbook On Scar Management

This text book is open access under a CC BY 4.0 license. Written by a group of international experts in the field and the result of over ten years of collaboration, it allows students and readers to gain to gain a detailed understanding of scar and wound treatment – a topic still dispersed among various disciplines. The content is divided into three parts for easy reference. The first part focuses on the fundamentals of scar management, including assessment and evaluation procedures, classification, tools for accurate measurement of all scar-related elements (volume density, color, vascularization), descriptions of the different evaluation scales. It also features chapters on the best practices in electronic-file storage for clinical reevaluation and telemedicine procedures for safe remote evaluation. The second section offers a comprehensive review of treatment and evidence-based technologies, presenting a consensus of the various available guidelines (silicone, surgery, chemical injections, mechanical tools for scar stabilization, lasers). The third part evaluates the full range of emerging technologies offered to physicians as alternative or complementary solutions for wound healing (mechanical, chemical, anti-proliferation). Textbook on Scar Management will appeal to trainees, fellows, residents and physicians dealing with scar management in plastic surgery, dermatology, surgery and oncology, as well as to nurses and general practitioners

The purpose of this book is to discuss available treatments for “scars” and analyze their mechanisms from an international perspective. “Scars” are now receiving considerably more attention internationally, because the topic of patients’ quality of life (QOL) of patients has gained in importance. Total Scar Management highlights many “new” and “practical” topics related to scars such as various treatments for post-burn scars, traumatic scars, keloids and hypertrophic scars, aesthetic management of scars, reconstructive surgery of scar contractures, basic researches, etc. Written by an international team of prominent experts in their respective fields, the book presents the latest and most helpful advances regarding “scars,” offering a unique resource for all plastic surgeons, dermatologists, aesthetic surgeons, wound surgeons, wound healing specialists, and general surgeons who are interested in the aesthetic outcomes of their work.

This book addresses the management of scars using lasers and light. The authors provide a comprehensive overview of the current laser modalities and the science and evidence behind them. They also present various treatments, including those using carbon dioxide lasers, Erbium:YAG lasers, pulsed dye lasers and Q-switched lasers. The book includes detailed information on the treatment of burn, acne, keloid and hypertrophic scars, as well as discussions of the complications of laser treatments and ethical and medico-legal issues. Scars have many causes, including trauma and burns, but also medical treatments themselves - scars are an inevitable consequence of most surgery. There have been significant advances in laser and light technology over the last decade, and the management of scars with a variety of lasers has been adopted both in traditional healthcare settings and in the cosmetic sector. Edited by a respected burns and plastic surgeon, this book is a valuable resource for a variety of clinicians including dermatologists, laser practitioners, physiotherapists and occupational therapists, burn care professionals, as well as multidisciplinary teams working with patients with scars of all aetiologies.

A number of scar revision techniques can be utilized to treat specific types of scars, in combination with each other or with adjunctive therapies to achieve optimal results. Pathological conditions like hypertrophic scars and keloids are still challenging. Though a number of therapies exist to treat keloids, such as intralesional steroids and anti-metabolites, cryosurgery, to name a few, none are definitive in treatment. Understanding the molecular basis of keloids may lead to development of new therapies. Striae, also known as ‘stretch marks’, are extremely common, disfiguring and a real challenge to treat. Management of striae is a neglected field of research. Except for topical retinoids, the efficacy satisfactorily. Current treatment options include chemical peels, lasers and collagen induction therapy, with a tendency towards active intervention. However, studies are necessary to determine treatment strategies which produce results that are effective with minimal adverse effects. Post-acne scarring is one of the most common causes of facial scars, causing considerable cosmetic disability. Acne is a common skin disorder, unfortunately affecting a large number of teenagers. Usually patients have a combination of different types of scars; hence no single modality is useful. A combination of procedures is generally required for a satisfactory cosmetic outcome. The use of fractional lasers is gaining importance, as it is a minimally invasive procedure as compared to aggressive resurfacing procedures of the past. Collagen induction therapy is another promising technique. Today, patients are also getting up-to-date information about the various modalities available for scar treatment through media, such as magazines, advertisements and internet. However, exaggerated advertisements and information from nonprofessional sources, particularly with regard to lasers can influence patient expectations and result in unrealistic expectations. Patients need to understand that deep scars cannot be eliminated fully and can only be improved. They usually have high expectations from procedural techniques. Proper counseling is extremely important for a happy and satisfactory outcome. Current innovations and techniques in scar prevention and management and increasing use of minimally invasive surgeries are paving the way toward smoother, less noticeable scars. Every surgeon practicing aesthetics should be well versed with modalities of scar management and this is the aim of this clinical update.

Apply cutting-edge expertise to manage your patients’ scarring issues! Scarring and fibrosis affect millions of people worldwide, and can be devastating both physically and psychologically, whether they result from major trauma such as burns or common conditions such as acne. Put today’s most advanced clinical approaches to work for your patients with The Scar Book: Formation, Mitigation, Rehabilitation, and Prevention! A multidisciplinary team of leading world experts presents the state of the art in scar pathophysiology and treatment, breaking down the barriers between medical disciplines to provide unprecedented holistic guidance.

Intro -- Half Title Page -- Title Page -- Copyright Page -- Dedication -- Contributors -- Preface -- Acknowledgments -- Contents -- SECTION I Perspectives -- 1 A Historical Perspective on Scar Management -- 2 The Global Impact of Scars -- 3 Medical Conditions Associated with Scarring and Fibrosis -- 4 Scars and Scar Management: Ethical Considerations -- SECTION II Formation -- 5 Scar Histopathology and Morphologic Classification -- 6 The Cellular and Molecular Basis of Scarring: The Paradigm of Hypertrophic Scarring After Thermal Injury -- 7 The Biomechanics of Scar Formation -- SECTION III Mitigation -- 8 An Approach to Scar Mitigation -- 9 Optimizing Wound Healing and Scar Formation -- SECTION IV Rehabilitation -- 10 Medical Management of Scars -- 11 Neurobiology of Scars: Managing Pain and Itch -- 12 Surgical Scar Revision -- 13 Lasers and Light Devices in Scar Management -- 14 Laser-Assisted Delivery of Therapeutic Agents -- 15 Fat Grafting for Scar Treatment -- 16 Multimodal Scar Management -- 17 Atrophic Scar Management -- 18 Scar Management in Skin of Color -- 19 Rehabilitative Burn Scar Management -- 20 Scar Camouflage -- 21 Medical Tattooing -- 22 A Pediatric Perspective -- 23 A Perspective from Military Medicine -- 24 Recovery and Reintegration After Burn Injury -- 25 Integrating Scar Management into Clinical Practice -- SECTION V Prevention -- 26 Scar Treatment, Restoration, and Prevention-Beyond the Horizon? -- 27 Fetal Wound Healing -- 28 Clinical Scar Research: Quantitative and Qualitative Assessment of Hypertrophic Burn Scars -- Index

The definitive guide to safely and effectively treating scars—and improving the quality of life for every patient From a team of pioneers in dermatology and laser medicine, Treatment of Scars from Burns and Trauma provides the latest, most innovative methods for treating scars. It provides the essential information you need to know about how scarring occurs, how it affects patients, and how to design and implement the best possible treatment plan. This unparalleled resource covers every angle of scar treatment. First, it explains the fundamentals, including all the clinically relevant elements of wound care, pain, range of motion, and patient selection, along with treatment. It then focuses on treatment—both new and traditional techniques. Finally, it provides best practices for pain, infection, and ulceration management. This unique text covers a broad range of topics and treatments, including: Basic science of scars Patient selection and counseling Dermabrasion Laser-assisted drug delivery Fractional resurfacing Vascular lasers and lights Minimally invasive surgical techniques Treating Keloid and Hypertrophic scars Fat grafting Stem cell transfer

Visible scarring may be a daily reminder of disease long after active acne has subsided. Frequently, it is a cause of distress for the patient and a leading cause for visiting medical professionals. This updated and expanded edition of an acclaimed pioneering text will be invaluable for both general and cosmetic dermatologists, plastic surgeons, and primary care physicians with a specialist interest in the skin as an invaluable guide through the complexities of treatment.