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

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Clinical presentation

Expanded dermis

comprises flatter and

less clearly demarcated,

loosely arrayed wavy

collagen bundles that

are somewhat

fragmented and

shortened and display

prominent vertically

oriented blood vessels

Hard, usually linear,

slightly-raised scar with

well demarcated

epidermal borders (do

not extend beyond the

general geographic

wound margins)

Appears red or pink in

color

Commonly pruritic

*Keloidal collagen is not always detectable in KSs.

collagen swirls and

whorls that vary in

length

Numerous, thickened

fibrocollagenous

fascicles

Horizontal fibrous

bands in the upper

reticular dermis and

the presence of

prominent fascia-like

bands

Firm, mildly tender,

bosselated & more

raised than HSs, with

a shiny surface &

occasional

telangiectasia,

infiltrates the

surrounding tissue,

well demarcated,

irregular borders

Thinned epithelium is

prone to ulceration,

hyperpigmentation

and discoloration

(pink/purple – initially

erythematous, turning

brownish, may pale as

the scar ages)

Scar margins tend to

exhibit considerable

peripheral tension

whereas center of the

scar less so

Can cause significant

pain and

hyperesthesia

Raised above skin surface

Discoloration

Pain, pruritus, adherences

and contractures can affect

quality of life: physically,

physiologically and

psychologically

Disfigurements present

biopsychosocial

considerations

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