[libribook.com] Traumatic Scar Tissue Management 1st Edition
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[libribook.com] Traumatic Scar Tissue Management 1st Edition

hongchingyee
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Table 5.2Important pathophysiological scar-related terms

Figure 5.2Keloid scar example.Pathophysiological Scar Formation – What can go WrongMultiple factors can contribute to impaired wound healing. To generalize, thesefactors can be categorized as local and systemic:• Local: directly influence the characteristics of the wound itself, for exampleoxygenation, infection and the various aspects of the inflammatory cascade.• Systemic: encompass the individual general state of health – in particular,factors which may affect his or her ability to heal. Some systemic factorsinclude: genetic predisposition, age, stress levels, existing pathologies, neuroinflammatoryand neurogenic issues (covered in greater detail in Chapter 4),medications, nutritional and lifestyle practices (e.g. sedentary tendencies,smoking and exposure to other pollutants). Research shows that smoking(nicotine) has a detrimental impact on all stages of wound healing resulting indelayed healing and a higher incidence of scar complications. Smokingcessation reverses some but not all of the mechanisms involved as many of thepathologic processes induced by smoking appear to be prolonged or evenirreversible despite abstinence from smoking (Avery & Bailey 2008, Sorenson2012).Essentially the primary presentation seen with pathological scars is excessivecollagen proliferation. Normally, the body stops collagen production whenadequate strength of the scar is obtained. When collagen production does notshut down, pathological scars will form (Box 5.1).Scartype/termCicatricContractureDescription and other important informationGeneralized term used to describe a scar left by the formation of new connective tissue over ahealing sore or wound. This type of scar may have considerable contraction. It may be necessary todivide the scar and then graft on new skin, as is done for burnsCommon post-burn injury crossing joints or skin creases at right angles. Contractures are oftendisabling or result in dysfunction as they prevent or limit normal mobility. Contracture occursbefore the scar fully matures and often presents as hypertrophic

Table 5.2

Important pathophysiological scar-related terms

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