Gojenie się ran z bliznowaceniem – metody terapeutyczne

*Janusz Fornalski

Streszczenie
Hypertrophic scars and keloids are mostly an aestethic problems. In some cases they can impair function of affected region and therefore need treatment. Although the basis for keloid and hypertrophic scar formation has not been fully delineated, an imbalance of matrix degradation and collagen biosynthesis resulting in excess accumulation of collagen in the wound has been postulated to be the primary biochemical features of these skin lesions. Fibroblasts construct new extracellular matrix components, initiate collagen synthesis, and provide wound edge tension through contractile proteins, actin, and desmin. Keloid and hypertrophic scar-derived fibroblasts produce increased amounts of collagen per cell compared with normal fibroblasts. Thus, suppression of the overwhelming and uncontrolled fibroblast activity in keloids and hypertrophic scars may be essential in therapeutic approaches to this abnormal wound response.
Choosing a treatment modality depends upon careful clinical evaluation of the scar and knowledge of the healing properties of the patient.
Hypertrophic scars and keloids can be treated with either surgical or non surgical techniques. Most popular nonoperative treatment techniques of scar management are application of silicone gell, pressure, intralesional triamcinolone acetonide injections, cryosurgery, radiotherapy. Additional treatment modalities are intralesional injections 5-FU, Mo or Verapamil.

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