Hypertrophic scarring: the greatest unmet challenge after burn injury.
Hypertrophic scarring: the greatest unmet challenge after burn injury.
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DOI：
10.1016/s0140-6736(16)31406-4
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发表时间：
2016-10-01
期刊：
影响因子：
--
通讯作者：
Herndon DN
中科院分区：
文献类型：
--
作者：
Finnerty CC;Jeschke MG;Branski LK;Barret JP;Dziewulski P;Herndon DN
急性烧伤护理的改进使患者能够在大面积烧伤中存活下来，而大面积烧伤曾经是致命的。现在，高达70%的患者在烧伤后会出现增生性疤痕。功能和社会心理后遗症仍然是一个主要的康复挑战，降低了生活质量，推迟了重新融入社会。目前的方法是利用有针对性的伤口护理和手术来优化烧伤伤口的愈合潜力，以尽量减少肥厚性疤痕的发展。这种方法经常失败，尽管最佳适应症、时机和治疗组合尚未确定，但对已建立的疤痕的调节仍在继续。对新治疗方法的需求是至关重要的，未来改善预后和生活质量的努力应包括优化伤口愈合以减轻或预防增生性瘢痕形成，精心设计的试验以确认治疗效果，以及进一步阐明分子机制以允许开发新的预防和治疗策略。
Improvements in acute burn care have enabled patients to survive massive burns which would have once been fatal. Now up to 70% of patients develop hypertrophic scars following burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. The current approach is to optimise the healing potential of the burn wound using targeted wound care and surgery in order to minimise the development of hypertrophic scarring. This approach often fails, and modulation of established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventative and therapeutic strategies.