Mechanical Receptor–Related Mechanisms in Scar Management: A Review and Hypothesis

@article{Yamur2010MechanicalRM,
  title={Mechanical Receptor–Related Mechanisms in Scar Management: A Review and Hypothesis},
  author={Çağlayan Yağmur and Satoshi Akaishi and Rei Ogawa and Ethem Guneren},
  journal={Plastic and Reconstructive Surgery},
  year={2010},
  volume={126},
  pages={426-434}
}
Background: The physiopathogenesis of proliferative scarring in human skin is not well understood. Furthermore, knowledge of the precise mechanisms of action for physical treatment modalities is limited. Compression garments, occlusive/adhesive skin taping, and silicone gel sheets are applied to form an occlusion on the scar surface, reduce tension, and/or increase pressure on the scar itself. The mechanisms by which the external or superficial actions of these treatments cause remission of a… 
Evidence-Based Scar Management: How to Improve Results with Technique and Technology
TLDR
Although scars can never be completely eliminated in an adult, this article presents the most commonly used, evidence-based methods to improve the quality and symptoms of hypertrophic scars, as well as keloid scars and striae distensae.
Current concepts related to hypertrophic scarring in burn injuries
TLDR
Exposure of the fat domes in the deep dermis is associated with increased HTS, possibly on the basis of altered interaction of adipose‐derived stem cells and the deep burn exudate.
Updated scar management practical guidelines: non-invasive and invasive measures.
Pressure garment therapy (PGT) of burn scars: evidence-based efficacy.
TLDR
This review attempts to summarize and analyze evidence-based literature on PGT and its efficacy in burn hypertrophic scars published in English language in the past 15 years.
Keloids and Hypertrophic Scarring
TLDR
Because complete removal of keloids with current treatment options is difficult, prevention is critical in high-risk patients and hinges on minimization of trauma, including piercing and tattooing, and aggressive acne management.
New insights into the roles of myofibroblasts and innervation during skin healing and innovative therapies to improve scar innervation
TLDR
The mechanisms leading to normal or excessive scarring are discussed and the roles of innervation during wound healing are presented, as well as the latest therapeutic strategies to help wound repair and reinnervation after skin damage.
Hypertrophic burn scar evolution and management : review
TLDR
A composite device for scar control in burn injuries should involve a multimodal approach that incorporates strategies for control of contributing factors including the exposed nerve endings, stimulation of neuropeptide mediators, neurogenic inflammation, pruritis, mechanotension signaling and hydration.
Effectiveness of topical silicone gel and pressure garment therapy for burn scar prevention and management in children: a randomized controlled trial
TLDR
No benefit to a combined silicone and pressure intervention was identified for the prevention and management of abnormal scarring in children at six months post-burn injury, compared to the silicone or pressure interventions alone.
Hypertrophic Burn Scar Evolution
  • Medicine
  • 2013
TLDR
A composite device for scar control in burn injuries should involve a multimodal approach that incorporates strategies for control of contributing factors, including the exposed nerve endings, stimulation of neuropeptide mediators, neurogenic inflammation, pruritis and mechanotension signaling.
...
...

References

SHOWING 1-10 OF 87 REFERENCES
Nonsurgical Management of Hypertrophic Scars: Evidence-Based Therapies, Standard Practices, and Emerging Methods
  • B. Atiyeh
  • Medicine
    Aesthetic Plastic Surgery
  • 2006
TLDR
This review explores the various treatment methods for hypertrophic scarring described in the literature including evidence-based therapies, standard practices, and emerging methods, attempting to distinguish those with clearly proven efficiency from anecdotal reports about therapies of doubtful benefits while trying to differentiate between prophylactic measures and actual treatment methods.
Hypertrophic Scars and Keloids—A Review of Their Pathophysiology, Risk Factors, and Therapeutic Management
TLDR
The growing understanding of the molecular processes of normal and abnormal wound healing is promising for discovery of novel approaches for the management of hypertrophic scars and keloids.
Effects of mechanical compression on hypertrophic scars: prostaglandin E2 release.
[International clinical recommendations on scar management].
TLDR
A qualitative overview of the available clinical literature by an international panel of experts using standard methods of appraisal highlights a primary role for silicon gel sheeting and intralesional corticosteroids in the management of a wide variety of abnormal scars.
Evolution of Silicone Therapy and Mechanism of Action in Scar Management
TLDR
Results from clinical trials and clinical experience suggest that silicone gel is equivalent in efficacy to traditional silicone gel sheeting but easier to use.
Making sense of hypertrophic scar: a role for nerves
TLDR
Observations about the role of neuropeptides in cutaneous repair, neuronal modulation of repair processes at two extremes of abnormal wound healing, chronic non‐healing ulcers in type II diabetes mellitus and hypertrophic scars in deep partial thickness wounds, may provide therapeutic targets.
In vitro mechanical compression induces apoptosis and regulates cytokines release in hypertrophic scars
  • F. Renò, M. Sabbatini, M. Cannas
  • Medicine, Biology
    Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society
  • 2003
TLDR
In the in vitro model, mechanical compression resembling the clinical use of elastocompression was able to strongly increase apoptosis in the hypertrophic scar derma as observed during granulation tissue regression in normal wound healing.
The effect of silicone gel sheets on perfusion of hypertrophic burn scars.
TLDR
Application of silicone sheeting gel did not significantly alter perfusion in either the hypertrophic scar or normal tissue from the baseline measurements, however, application of silicone gel sheeting did significantly increase the mean baseline surface temperature of the hypertension scar from 29 +/- 0.8 degrees C to 30.6 degrees C (P < 0.001).
...
...