Tag Archive 'Cicatrización patológica'

Viernes 16 / marzo / 2012

Treatment of keloids and hypertrophic scars: a meta-analysis and review of the literature.

Filed under: Temas de meses anteriores — Dr. Pável Reyes Rodríguez — marzo 16th, 2012 — 1:53 PM

Treatment of keloids and hypertrophic scars: a meta-analysis and review of the literature
Leventhal D, Furr M, Reiter D.
Arch Facial Plast Surg. 2006 Nov-Dec;8(6):362-8.

archives-facial-of-plastic-surgeryManagement of hypertrophic scars and keloids has advanced from crude, invasive methods such as gross excision and radiation to intralesional or topical agents that act on a cellular level. There is no universally accepted treatment regimen and no evidence-based literature to guide management. Our objectives are to present a list of available treatment regimens, their proposed mechanisms of action, and supporting evidence and to perform a meta-analysis of clinical trials to identify treatments with a better-than-even likelihood of improvement. We conducted a PubMed search through October 2005, identifying clinical studies of various treatments for hypertrophic scars and keloids. We graded the quality of each study, delineated the results into favorable vs nonfavorable, and calculated the statistical significance of the findings. The meta-analysis of 70 treatment series for various clinical measures showed a 70% chance of improvement with treatment; however, the mean amount of improvement to be expected was around 60%. There was no statistically significant difference between treatments. Most treatments for keloidal and hypertrophic scarring offer minimal likelihood of improvement. The magnitude of likely permanent improvement in any sign or symptom may be clinically meaningful but far short of cure. Novel therapies deserve further investigation but remain without proven benefit to date.

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Viernes 16 / marzo / 2012

Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies.

Filed under: Temas de meses anteriores — Dr. Pável Reyes Rodríguez — marzo 16th, 2012 — 1:47 PM

Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies
Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG.
Mol Med. 2011 Jan-Feb;17(1-2):113-25.

Excessive scars form as a result of aberrations of physiologic wound healing and may arise following any insult to the deep dermis. By causing pain, pruritus and contractures, excessive scarring significantly affects the patient’s quality of life, both physically and psychologically. Multiple studies on hypertrophic scar and keloid formation have been conducted for decades and have led to a plethora of therapeutic strategies to prevent or attenuate excessive scar formation. However, most therapeutic approaches remain clinically unsatisfactory, most likely owing to poor understanding of the complex mechanisms underlying the processes of scarring and wound contraction. In this review we summarize the current understanding of the pathophysiology underlying keloid and hypertrophic scar formation and discuss established treatments and novel therapeutic strategies.

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Viernes 16 / marzo / 2012

The emerging role of antineoplastic agents in the treatment of keloids and hypertrophic scars: a review.

Filed under: Temas de meses anteriores — Dr. Pável Reyes Rodríguez — marzo 16th, 2012 — 1:23 PM

The emerging role of antineoplastic agents in the treatment of keloids and hypertrophic scars: a review
Shridharani SM, Magarakis M, Manson PN, Singh NK, Basdag B, Rosson GD.
Ann Plast Surg. 2010 Mar;64(3):355-61.

ovidwebcgi2The management of keloids and hypertrophic scars continues to challenge health-care providers. Though both forms of pathologic scarring are distinct entities at the macro and microscopic level, their etiologies and treatment are often similar. Potential treatment approaches are progressing, and combinations of treatment options have been proposed in the literature with promising outcomes. The treatment evolution has reached a level where molecular therapeutic modalities are being investigated. Currently, no gold standard treatment exists. Overall success rates and patient satisfaction seem to be slowly climbing, but additional investigational studies must continue to be performed. Several studies have investigated antineoplastic agents, and there seems to be a marked improvement in rates of recurrence, patient satisfaction, and overall quality of scar when these agents are used. Intralesional injection and/or wound irrigation with interferon-a2b, interferon-g, mitomycin-C, bleomycin, or 5-fluorouracil seems to have a positive effect on the reduction of pathologic scars. There is mounting evidence that these drugs used alone or in combination therapy, have the potential to be an integral part of the treatment paradigm for hypertrophic scars and keloids.

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