Hypertrophic scars and keloids: a review of the current literature on the aetio-pathogenesis and management strategy..

Abstract

Background: Hypertrophic scars and keloids result from an abnormal fibrous wound healing process in which tissue repair and regeneration-regulating mechanism control is lost. Patients typically present with cosmetic concerns, although they can also cause pruritus, pain, and pressure. They present a major therapeutic challenge to the plastic surgeon. This article reviews various treatment modalities for these abnormal scars and the updated findings of molecular scar biology.
Method: A computerized literature search using MEDLINE was conducted for review articles in the English language on hypertrophic scars and keloids. The medical subject headings of "hypertrophic scar" or "keloid" were combined with “aetio-pathogenesis” or "therapy" using the Boolean operator "AND" to narrow the searches. Two hundred and fifty seven articles were brought up out of which less than one half were found relevant and reviewed. Conclusion: The growing understanding of the molecular processes of normal and abnormal wound healing is promising for discovery of novel approaches for the management of hypertrophic scars and keloids. Although optimal treatment of these lesions remains undefined, successful healing can be achieved only with combined therapeutic regimens.

Keywords: Hypertrophic scar, keloid, pathogenesis, management