Heterotopic Ossification and Hypertrophic Scars.
Heterotopic Ossification and Hypertrophic Scars.
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DOI：
10.1016/j.cps.2017.05.006
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发表时间：
2017-10
影响因子：
2.3
通讯作者：
Levi B
中科院分区：
文献类型：
--
作者：
Agarwal S;Sorkin M;Levi B
烧伤和创伤导致广泛的浅表和深部软组织创面，无法完全愈合到伤前状态。通常，伤口愈合需要能够分化为受损组织类型的细胞的增殖。作为组织结构要求的一部分，这些细胞铺设细胞外基质(ECM)，通常以胶原蛋白的形式存在。然而，细胞增殖和胶原沉积的失调往往会导致伤口的病理改变。两种情况-异位骨化(HO)和肥厚性瘢痕形成-给大面积烧伤患者的治疗带来了巨大的挑战。HO是异位骨性病变的病理形态，导致剧烈疼痛、伤口无法愈合和活动范围受限。目前针对HO的治疗策略包括预防性放射治疗、非类固醇抗炎药(NSAIDs)和双膦酸类药物；最终，发生HO的患者可能需要手术切除，然后采取预防性措施以降低复发风险。相比之下，肥厚性瘢痕是由过度的胶原沉积引起的非骨性病变。与HO相似，增生性瘢痕通常是疼痛的、功能受限的，并且在审美上令人不快。治疗策略包括应用二氧化碳激光、注射类固醇和切除植皮。在这里，我们回顾了与这两种形式的病理性伤口愈合相关的生物学、诊断、治疗和结果。
Burns and trauma lead to extensive superficial and deep soft tissue wounds which are unable to heal perfectly to the pre-injury state. Typically wound healing requires proliferation of cells capable of differentiating into the injured tissue type. As part of the structural requirements for tissue, these cells lay down extracellular matrix (ECM) often in the form of collagens. However, dysregulated cellular proliferation and collagen deposition often leads to wound pathology. Two conditions – heterotopic ossification (HO) and hypertrophic scarring – present a substantial challenge in the management of patients with large surface-area burns. HO is the pathologic formation of ectopic osseous lesions causing severe pain, non-healing wounds, and restricted range of motion. Current treatment strategies aimed at HO include prophylactic radiation therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and bisphosphonates; ultimately patients who have developed HO may require surgical excision followed by prophylactic measures to reduce recurrence risk. Hypertrophic scars in contrast are non-osseous lesions caused by excessive collagen deposition. Similar to HO, hypertrophic scars are often painful, functionally limiting, and aesthetically displeasing. Treatment strategies include CO2 laser application, steroid injections, and excision with skin grafting. Here we review the biology, diagnosis, and treatment and outcomes associated with both forms of pathologic wound healing.
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影响因子：
2.2
作者：
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通讯作者：
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影响因子：
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