Successful Treatment of Post-Traumatic Elbow Scar Contracture Using Combined Approach of Surgical Release & Early Fractional Laser Resurfacing
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Scarring is mostly fibrous formation that arises from the regeneration of tissue after a traumatic injury or inflammation. One of the most common and most important morbidities of scar is contracture, particularly when located in the nearby joints. Many surgical techniques, including tissue expansion, skin grafting, local and distant flaps, and Z- or W-plasty can be applied to scar contracture. Currently, non-surgical methods play an important role in scar treatment methods with ablative fractional resurfacing being one of the most effective and promising methods for correcting various types of scar. This paper reports the combined approach of surgical and non-surgical methods of scar treatment to release scar contracture successfully. A nine-year-old male patient with a 30 cm-sized posttraumatic scar on his right arm was treated with an ablative fractional laser device after Z-plasty. The patient received a total of four sessions of laser treatment with a one month interval between sessions. The results were evaluated before the procedure and 2 years after the last fractional laser resurfacing treatment. The mean vancouver scar scale score of the scar rated by two physicians decreased from 9.5 to 3.0. The patient also noted significant improvement in aesthetics and function and was quite satisfied with the results. No complications, such as wound disruption, post-inflammatory hyper pigmentation, or dyspigmentation were noted. The combined approach of surgical release and early fractional laser resurfacing for scar treatment can produce significant aesthetic and functional improvements of scar contracture.
Abstract
Scarring is mostly fibrous formation that arises from the regeneration of tissue after a traumatic injury or inflammation. One of the most common and most important morbidities of scar is contracture, particularly when located in the nearby joints. Many surgical techniques, including tissue expansion, skin grafting, local and distant flaps, and Z- or W-plasty can be applied to scar contracture. Currently, non-surgical methods play an important role in scar treatment methods with ablative fractional resurfacing being one of the most effective and promising methods for correcting various types of scar. This paper reports the combined approach of surgical and non-surgical methods of scar treatment to release scar contracture successfully. A nine-year-old male patient with a 30 cm-sized posttraumatic scar on his right arm was treated with an ablative fractional laser device after Z-plasty. The patient received a total of four sessions of laser treatment with a one month interval between sessions. The results were evaluated before the procedure and 2 years after the last fractional laser resurfacing treatment. The mean vancouver scar scale score of the scar rated by two physicians decreased from 9.5 to 3.0. The patient also noted significant improvement in aesthetics and function and was quite satisfied with the results. No complications, such as wound disruption, post-inflammatory hyper pigmentation, or dyspigmentation were noted. The combined approach of surgical release and early fractional laser resurfacing for scar treatment can produce significant aesthetic and functional improvements of scar contracture.
참고문헌 (22)
- Gauglitz GG, "Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies", Mol Med, 17, pp.113~125 (2011)
- Iwuagwu FC, "The use of skin grafts in postburn contracture release: a 10-year review", Plast Reconstr Surg, 103, pp.1198~1204 (1999)
- Zhang L, "Reversed Z-plasty and its variations to release wide-scar contraction", Burns, 40, pp.1185~1188 (2014)
- Yotsuyanagi T, "Double combined Z-plasty for wide-scar contracture release", J Plast Reconstr Aesthet Surg, 66, pp.629~633 (2013)
- Stekelenburg CM, "Perforator-based interposition flaps perform better than full-thickness grafts for the release of burn scar contractures: a multicenter randomized controlled trial", Plast Reconstr Surg, 139, pp.501e~509e (2017)
- Stekelenburg CM, "A systematic review on burn scar contracture treatment: searching for evidence", J Burn Care Res, 36, pp.e153~e161 (2015)
- Waibel J, "Ablative fractional laser resurfacing for the treatment of a third-degree burn", J Drugs Dermatol, 8, pp.294~297 (2009)
- Weiss ET, "Successful treatment of atrophic postoperative and traumatic scarring with carbon dioxide ablative fractional resurfacing: quantitative volumetric scar improvement", Arch Dermatol, 146, pp.133~140 (2010)
- Cervelli V, "Ultrapulsed fractional CO2 laser for the treatment of post-traumatic and pathological scars", J Drugs Dermatol, 9, pp.1328~1331 (2010)
- Anderson RR, "Laser treatment of traumatic scars with an emphasis on ablative fractional laser resurfacing: consensus report", JAMA Dermatol, 150, pp.187~193 (2014)
- Baryza MJ, "The Vancouver Scar Scale: an administration tool and its interrater reliability", J Burn Care Rehabil, 16, pp.535~538 (1995)
- Kroonen L, "Treatment of split-thickness skin graft-related forearm scar contractures with a carbon dioxide laser protocol: 3 case reports", J Hand Surg Am, 38, pp.2164~2168 (2013)
- Donelan MB, "Pulsed dye laser therapy and z-plasty for facial burn scars: the alternative to excision", Ann Plast Surg, 60, pp.480~486 (2008)
- Hantash BM, "In vivo histological evaluation of a novel ablative fractional resurfacing device", Lasers Surg Med, 39, pp.96~107 (2007)
- Ozog DM, "Evaluation of clinical results, histological architecture, and collagen expression following treatment of mature burn scars with a fractional carbon dioxide laser", JAMA Dermatol, 149, pp.50~57 (2013)
- Connolly KL, "Vascular patterns in mature hypertrophic burn scars treated with fractional CO2 laser", Lasers Surg Med, 46, pp.597~600 (2014)
- Krakowski AC, "Ablative fractional laser resurfacing helps treat restrictive pediatric scar contractures", Pediatrics, 134, pp.e1700~e1705 (2014)
- 조성은, "Local Flap Surgical Scar Management Caused by Skin Cancer Using Fractional CO2 Laser Treatment", Archives of Aesthetic Plastic Surgery, 21(1), pp.18~22 (2015), 대한미용성형외과학회
- Shumaker PR, "Rapid healing of scar-associated chronic wounds after ablative fractional resurfacing", Arch Dermatol, 148, pp.1289~1293 (2012)
- Shumaker PR, "Functional improvements in traumatic scars and scar contractures using an ablative fractional laser protocol", J Trauma Acute Care Surg, 73(s), pp.S116~S121 (2012)
- 홍수정, "Effects of Minimizing Scar Formation by Early Fractional CO2 Laser Resurfacing", Archives of Aesthetic Plastic Surgery, 20(2), pp.109~113 (2014), 대한미용성형외과학회
- Lee SH, "Early postoperative treatment of surgical scars using a fractional carbon dioxide laser: a splitscar, evaluator-blinded study", Dermatol Surg, 39, pp.1190~1196 (2013)