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

Pathophysiological Consideration
A variety of operative and non-operative procedures are performed to
improve post burn scar quality. These include various topical therapies that
all share a similar mechanism of action, ablating the skin in an attempt to
yield a more homogenous surface. Such approaches destroy the epidermis
and the basement membrane. Ablating the epidermis of already scarred
skin with subsequent protracted reepithelialization may possibly cause
additional dermal fibrosis by initiating a prolonged inflammatory response.
The ideal scar improvement modality would leave the epidermis intact and
rather improve epidermal thickness via the subsequent release of cell and
tissue derived factors that modulate dermal structure and collagen
deposition
(Rennekampff et al. 2010).