Scar Treatments: Preclintcal and Clinical Studies

摘要

Despite advancements in knowledge of the mechanisms of wound healing and scar formation, both normal and hy-pertrophic scars remain difficult to treat and impossible to prevent. Numerous therapeutic strategies have been described for the reduction and prevention of scars, yet there is no universal consensus in the literature about optimal treatment. Therapeutic approaches fall into three broad categories: alteration of the inflammatory response, modification of collagen metabolism, and surgical and physical manipulation of the shape of the scar. Current management of normal and hypertrophic scars encompasses a wide range of techniques, from traditional invasive methods such as gross excision and radiation to intralesional and topical application of agents designed to take effect on a cellular level. In this review, we present and evaluate pre-clinical and clinical studies of the treatment and prevention of scars using evidence-based literature to assess therapeutic strategy. Preclinical studies of emerging treatment strategies cover the transforming growth factor (TGF)-beta super-family, NSAIDs, gene therapy, and several other novel modalities. Current clinical studies of scar reduction and prevention to be assessed in this review include topical and intralesional corticosteroids, 5-fluorouracil, bleomycin, pressure therapy, silicone gel sheeting, laser therapy, surgical treatment, radiation, and combinations of techniques