ABSTRACT
OBJECTIVE: After burn injuries, scarred skin lacks elasticity, especially in hypertrophic scars. Topical treatment with tretinoin can improve the appearance and quality of the skin (i.e., texture, distensibility, color, and hydration). The objective of this prospective study was to examine the effects of treatment with 0.05 percent tretinoin for one year on the biomechanical behavior and histological changes undergone by facial skin with post-burn scarring. Setting: Tertiary, Institutional. METHOD: Fifteen female patients who had suffered partial thickness burns with more than two years of evolution were selected. Skin biopsies were obtained initially and after one year of treatment. The resistance and elastance of these skin biopsies were measured using a mechanical oscillation analysis system. The density of collagen fibers, elastic fibers, and versican were determined using immunohistochemical analysis. RESULTS: Tretinoin treatment significantly lowered skin resistance and elastance, which is a result that indicates higher distensibility of the skin. However, tretinoin treatment did not significantly affect the density of collagen fibers, elastic fibers, or versican. CONCLUSION: Topical tretinoin treatment alters the mechanical behavior of post-burn scarred skin by improving its distensibility and thus leads to improved quality of life for patients.
Subject(s)
Adolescent , Adult , Female , Humans , Young Adult , Burns/complications , Cicatrix, Hypertrophic/drug therapy , Elasticity/drug effects , Facial Injuries/drug therapy , Keratolytic Agents/therapeutic use , Tretinoin/therapeutic use , Administration, Topical , Biomechanical Phenomena/drug effects , Cicatrix, Hypertrophic/pathology , Cicatrix, Hypertrophic/physiopathology , Facial Injuries/pathology , Facial Injuries/physiopathology , Prospective Studies , Skin/drug effects , Skin/pathology , Skin/physiopathology , Treatment OutcomeABSTRACT
Os autores apresentam uma revisão sobre a etiologia do quelóide e da cicatriz hipertrófica, bem como sobre as atuais alternativas de tratamento. Essas cicatrizes são resultado de um processo cicatricial alterado e apresentam-se frequentemente na prática clínica. Não existe atualmente um consenso sobre a etiologia e o melhor tratamento. Entre as terapêuticas propostas, a cirurgia, aplicação intralesional de corticóides, pressoterapia, crioterapia podem ser utilizados isoladamente ou associadas
Subject(s)
Humans , Keloid/therapy , Keloid/physiopathology , Cicatrix, Hypertrophic/physiopathology , Cicatrix, Hypertrophic/therapy , Homeopathic Therapeutic Approaches , Clinical ProtocolsABSTRACT
Wound healing is a natural response to injury. The process takes place in all body tissues. Its normal development in a given tissue, organ or system is of pivotal importance for surgery. This review describes the advances made during this century in regard to better knowledge and understanding of woud healing. Recent developments such a growth factors, electric techniques, and hyperbaricoxygen therapy are minutely descussed.