Burn injuries, trauma, and surgical procedures can give rise to exuberant scarring, which can lead to physical disability and to patients being stigmatized by their disfigurement. In a review article in this week's PLoS Medicine, Geoffrey Gurtner (Department of Surgery, Stanford University School of Medicine) and colleagues examine the process of such hypertrophic scar formation, the results of current treatments, and the research areas that are likely to lead to advances in the field.
Annually, over 1 million people require treatment for burns in the United States, 2 million are injured in motor vehicle accidents, and over 34 million related surgical procedures are performed. Although the incidence of hypertrophic scarring following these types of injuries is not known, say the authors, "it is a common outcome that creates a problem of enormous magnitude. Treatment of these cases is estimated to cost at least $4 billion per annum in the US alone." And the incidence of burns and traumatic injuries is even greater in the developing world.
Citation: Aarabi S, Longaker MT, Gurtner GC (2007) Hypertrophic scar formation following burns and trauma: New approaches to treatment. PLoS Med 4(9): e234.
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- Caption:Complications of Hypertrophic Scarring
(A) Hypertrophic scars begin as small cutaneous fibrotic regions (arrowheads), which develop into gross scars (arrows) over time. Scarring phenotypes vary widely between different parts of the body for reasons that are at present unclear.
(B) Following burn injury, a patient shows severe joint contracture. (C) Radiograph of the same patient shows erosion of the bone secondary to disuse and contracture. After years of treatment and physical therapy, this patient will only regain minimal hand function.
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