Both accident, surgery and injury; Skin inflammations, burns and skin wounds caused by different reasons carry scars for a while during the healing process and leave scars on the skin. This tissue, called a scar, can be a simple scar and can also be seen in the form of contractions and hardening that affect the patient's movement and function.
Wound-related causes: It occurs in different forms depending on the severity, depth and inflammation of the wounds. Large and deep wounds leave more and long-lasting scars. Wounds that are dirty, tense, and whose blood supply is impaired cause great difficulty for the patient in the healing process.
Patient-related reasons: These are wounds directly related to the patient's attitude towards wounds. Less scars remain in light-skinned people and the elderly. In dark-skinned individuals, rough scars may remain. Despite all methods, the scars of raised wounds in some people may be genetic. It should not be forgotten that insomnia and stress can cause pressure on the wound and cause bad results from wounds and scars.
Surgery-related causes: These are the scars formed during surgical interventions. Wounds, cuts and scars made in invisible areas in proportion to body lines can be easily hidden. Sutures should not reduce wound strength or increase tension. Removing them as early as possible will prevent the formation of scars.
Systemic factors: Since wound healing may be delayed due to Vitamin A and Vitamin C deficiencies, scars are possible. The use of steroids and immunosuppressive drugs also delays the healing of wounds.
Factors such as diabetes, collagen synthesis disorders and radiation make it difficult for wounds to heal. Additionally, smoking and alcohol use; Lack of iron, zinc, copper and protein prevents the healing of wounds.
The Healing Process of Wounds
It consists of three interconnected stages.
1- Inflammatory phase: It is the body's first response process for protection against trauma. It takes 3 to 10 days afterwards. Collection of blood platelets in the injured area, contraction of the vessels and thus stopping bleeding Following this, an inflammatory process occurs due to the expansion of the vessels and the inflammatory cells flowing to the injured area. If the wound is not closed immediately with stitches but left open, the injured area will heal on its own and the first phase will continue until the new epithelialization occurs until the skin is covered with the layer on top.
2- Proliferative phase: It will last 3 – 4 weeks and starts on the second day. There is an increase in the cells called fibroblasts under the skin. New vascular formation increases, and in this process, the wound lips contract and try to shrink the wound. Then, red tissue formation begins. In the wound, the tension strength increases and epithelialization begins.
3- Remodeling phase: It is a process that starts from 3 weeks and lasts up to 2 years. Although the wound is stretched and its strength increases, the wound tension force can never reach its original, natural strength. As the wounds become organized, the scar formation process begins.
What is a hypertrophic scar, are there any differences from a keloid?
Unfortunately, although the body reacts similarly to every scar. , some wounds prefer to grow rather than shrink. Even if they grow, they do not exceed the wound limits. Wound types called keloids can also be seen after burns.
About Keloid
It comes from the Greek word “Cheloide”which means crab claw. It is pronounced as keloid. It is the word chosen because of the sideways growth of the tissue. Keloid is a form of wound healing. Trauma is the healing phase of spontaneously inflamed wounds that occur after surgical incisions, accidents, burns, etc. The characteristic of keloid tissue is that it is irregular, limited, pink or darker in color, shiny and swollen from the skin. Itching, discomfort and sensitivity to touch are unbearable. These wounds tend to grow, look like cauliflower, and it is not known when they will stop growing.
What is inside the keloid tissue?
They are extremely large compared to a normal skin structure. There are type 1 collagen, cells called fibroblasts and blocked microvessels. Although there are many claims and hypotheses, the actual reason for its formation is unknown.
It is seen only in humans. Most people with this scar are between the ages of 10 and 30 and are white-skinned women. It is less common in older people. However, it can be seen in people of all ages and skin colors. In some people, it is based on genetic formation.
In which body parts are keloids seen?
The back and shoulders, earlobe and chest area are suitable areas for keloid formation. It is rarely seen in the facial area. However, it has been determined that it may occur in neck and jaw lines.
KELOID TREATMENT:
If the exact treatment method is to be investigated, a negative response may be given. But the method of prevention is more at the forefront. People with this problem should not undergo elective surgery and different treatment methods should be applied. Some of them:
Intralesional corticosteroid injection, Silicone-containing cream and pressure-bearing dressings, Laser treatment, Cryotherapy (freezing treatment with liquid nitrogen), Retinoic acid creams, Radiotherapy application, Mesotherapy application, Surgical intervention…
Prevention of scar formation and wound care?
Rather than correcting, shrinking and eliminating scars, this It is much easier and more important to prevent the formation of scars.
1- Dirty, infected wounds should first be cleaned well, washed with plenty of water, and even infection treatment should be applied with antibiotic treatment.
2- Foreign objects such as stones, soil, glass and especially hair in the wound should be removed from the skin and wound and cleaned thoroughly. Dead tissue should be removed and moisturized.
3- Few and non-reactive stitches should be used in the stitches, and care should be taken not to keep the wound tension high during this process.
5- During the surgery, scars should be made parallel to the body lines and concealable.
6- During the stitching, other healthy tissues should not be damaged and the tissues' nutrition through the vessels should not be prevented.
7- Stitches should be removed as early as possible.
8- Excessive delay Movements that may cause tension should be avoided.
9- The wound should always be kept clean, dressings should never be interrupted, and doctor's recommendations should be taken into account.
10- With the advice of a doctor, the wound should be washed after 48 hours and the tissue should be removed from dirt and similar factors that cause inflammation.
11- Moisturizing and healing cream can be applied to clean wounds during dressing.
12- Scar remover can be used with the doctor's knowledge.
13- It should be kept away from sunlight, and the wound area should be protected from the sun with clothing and hats for 1 year. , sunscreen cream or lotion with at least 30 SPF that does not contain allergenic factors should be used.
14- Healing agents should be used for bodies whose wounds are slow to heal, urgently. Surgery should not be attempted unless there is no such thing.
15- A balanced and regular diet and plenty of vitamin C and protein should be taken.
Do all wounds leave scars?
Every wound leaves a scar, more or less. There is absolutely no surgical method or medication that does not leave a scar.
Do plastic surgery specialists perform stitches with lasers?
There is an interest in beauty and aesthetic branches, as well as this unknown situation. The term continuous laser stitching is used depending on the branch. Laser treatment is a technology that is mostly used for similar purposes such as destroying and peeling the skin layer. Therefore, it does not have a feature such as stitching or joining. What is meant by laser stitching is a type of stitch that is placed under the skin and cannot be seen, and cannot be removed again because it melts. Since there is no scar formation in the interventions performed with this method, there is no possibility of leaving a scar.
Human race, skin color, nutrition and age, as well as other diseases and disorders, can positively or negatively affect the healing of wounds. In some people, blistering or redness may be observed during the wound healing process.
Do plastic surgeries leave scars?
Scarring is never desired after plastic surgery. But there is no such thing as leaving no trace. Gentle stitching, ability to hide stitches, proportion to body lines It requires special skills such as balance balancing. After these procedures, it can be described as plastic surgery without leaving any scars. Examples will be listed; Since nose surgery is performed internally, there is no scar on the skin. Prominent ear surgery is not seen much because it is a behind-the-ear procedure. Breast aesthetics involves stitching the nipple and its surroundings, and the folds between the breast tissue and the rib cage. The remaining scars can be hidden and collected in certain areas and points to make them invisible.
Can existing scars be eliminated?
An existing scar can be completely eliminated. It is impossible to do. The aim is to minimize and hide the scar as much as possible.
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