Scar Management
Scars may cause functional, cosmetic and psychological problems for patients. [3]
- Up to 94% of Asian patients develop hypertrophic scars following a median sternotomy incision.[1]
- 41% of women develop a hypertrophic scar within 12 weeks of caesarean delivery.[2]
- Reducing pain and visibility of scars improves function, appearance and self-esteem.
2002 International Clinical Recommendations on Scar Management[4]
Abnormal scar prevention and treatment techniques have been reviewed by an international panel of experts.
Only silicone and intralesional steroids have sufficient clinical evidence to be endorsed by scar experts.
Silicone is recommended as first line therapy in the treatment of:
- Linear hypertrophic scars
- Keloids
- Widespread burn hypertrophic scars
| Scar type |
| Immature hypertrophic |
Linear hypertrophic (surgical/traumatic) scar |
Minor keloid |
Major high risk keloid |
Widespread burn hypertrophic scar |
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| Initial management |
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Apply prevention algorithm.
Treat as a hypertrophic scar if erythema continues for >1 month |
Silicone (eg. Dermatix®)
(2 months) Monthly steroid injections |
Speciality
burns unit |
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Localised pressure therapy
if possible (3–12 months) |
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Secondary management |
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Pressure therapy |
Laser therapy
Surgery with adjunctive silicone gel sheeting (2 months) |
Pressure garments
+/- silicone gel sheeting (6–12 months) |
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Unit specialising in scar therapy
Combination/monotherapy:
Primary: steroids, silicones, pressure therapy, surgery/grafting
Occasionally: cryotherapy, radiotherapy, laser, other therapies |
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