Written by ◆Chen Qiulei and compiled by ◆Liang Yingxiu
Scar hyperplasia is mainly divided into two types: hypertrophic scars and keloid scars. Causes include genetics, skin infections, friction and allergies.
There are two forms of silicone gel, namely silicone gel tablets and silicone gel. Both are highly safe, and relevant benefit data have been obtained through systematic reviews. The former is relatively rare, and most people Choose the latter.
(Kuala Lumpur News) If there is a scar on the body, no matter how big or small, although it will not cause life-threatening, for women who love beauty, this long, centipede-like scar will still be irritating even if it is hidden under clothes.
However, some surgeries are unavoidable. For example, in gynecological surgeries, the most common surgeries are caesarean section, uterine fibroids, ovarian cysts or ovarian cysts, etc., whether it is childbirth or In some cases, surgery may be necessary to solve the disease.
Skin infection causing scars to thicken
Dr. Tan Cheng, consultant obstetrics and gynecology, pointed out that scar hyperplasia is mainly divided into two types, namely hypertrophic scars and keloids. The size of the scar formed by the former is similar to that of the resection wound, while the part involved by the latter is larger than the wound. The formation of both is due to excessive proliferation of fibroblasts and excessive expression of growth factors.
So, what causes the above-mentioned scar hyperplasia to form? “First of all, it is closely related to genetics. Generally, Africans and Asians are most likely to develop keloids, especially Africans; any skin infection problem can also cause scars to become thicker; other factors such as tight suture tension and foreign objects Friction, foreign body reaction, such as suture allergy and inflammation, leading to scar enlargement.”
“It is worth noting that some people are suitable to use medical glue to suture wounds, which can avoid accidents in which the wound reacts to foreign matter. However, this depends on the individual’s skin type. This method is more suitable for those with softer skin. And patients whose wounds are not prone to bleeding, otherwise medical glue cannot effectively bond the wounds.”
“It seems that it is not easy to reduce or eliminate scars. In fact, you only need to choose the right method and have a little more patience, and you will definitely achieve the desired results.” Despite this, before scars form, he believes that enough can be done prevention work. First of all, during the operation, if the situation permits, the incision will be made along the skin folds, and the wound repair will be faster. However, this depends on whether the surgical method is suitable for transverse or vertical incision, and transverse incision is more ideal. Furthermore, avoid tension and pulling. Allergy issues such as suture methods, foreign object friction and foreign body reaction.
Postoperative wound repair is divided into 4 stages
In addition, any skin infection should be treated as soon as possible. Once medical treatment is delayed, it will be almost impossible to improve or eliminate scars.
“Regardless of any form of surgery, including obstetrics and gynecology surgery, postoperative wound repair is divided into four stages, namely the hemostasis stage (haemostasis), inflammation stage (inflammation), proliferation stage (proliferation) and remodeling stage (remodelling).
The process of each stage is different, and as time goes by, the final stage will be entered step by step. First of all, in the hemostasis stage of post-operative wound repair, it means hemostasis of the post-operative wound, contraction of blood vessels at the wound site, platelets beginning to gather here, and fibrin formation. This stage usually takes 24 hours. . “
“In the second stage of inflammation, the wound will begin to become inflammatory. At this time, multiple cells infiltrate at the same time, namely neutrophils that invade bacteria, and monocytes infiltrate and differentiate into macrophages and lymphocytes, collectively known as White blood cells, each with different functions, such as antibacterial and antiviral effects. This stage begins to form within 24 to 48 hours and generally lasts for 4 to 6 days.”
“After the inflammatory stage is over, about 4 to 24 days later, the wound epidermis forms, which means it begins to enter the proliferative stage. The so-called proliferative stage means that the wound is re-epithelialized, and new blood vessels, collagen synthesis, and extracellular matrix are formed one by one. .”
Finally, in the remodeling stage of wound repair, the wound will continue to respond and change, including repeated remodeling of collagen, and repeated maturation and retraction of blood vessels. This reaction will last from two to three weeks to one year.
Silicone gel is safer
He said that the above-mentioned inflammation stage and remodeling stage play a key role in improving and fading postoperative scars. After entering the third stage of the repair process, when the epidermis is formed, you can start using silicone gel; when entering the remodeling stage, due to repetitive changes in the reaction of the wound, good results will be achieved if the relevant treatments are continued at this time. .
“How to improve or even eliminate postoperative scars? I believe many women are deeply troubled by it and have been looking for a cure. Currently, the most common home treatment method that can reduce scars is the use of silicone gel. Silicone resin Gel is mainly divided into two forms of use, namely silicone gel tablets and silicone gel. Both are highly safe and have relevant benefit data obtained through systematic reviews. The former is relatively rare and most people Choose the latter.”
The use of silicone gel can maintain moisture in the wound, thereby reducing the production of mast cells, inhibiting allergic reactions, and reducing the chance of inflammation; reducing capillary activity and collagen precipitation, and temperature-mediated activation of collagen decomposition. Helps relieve pain and itching.
However, it must be noted that these two treatment methods also have their shortcomings. If “overdosed”, it will also cause other problems, such as water accumulation, which can lead to skin maceration, persistent itching, rashes, and odor, especially when using silicone gel tablets are more likely to cause the above problems.
He said that as mentioned above, if you want to achieve good results, you must follow the doctor’s instructions. Patients can only start applying silicone gel during the hyperplasia stage (after epidermis is formed). This gel does not feel strange after application. It should be applied once in the morning and evening for at least 3 months. To achieve better results, it can be continued continuously. Use for 6 months to a year.
“Although silicone gel is effective, some people do not follow the instructions or only adhere to it for a few weeks, and the results are not as good as expected. In addition to silicone gel, other treatments that can reduce scars include pressure earrings (a form of pressure earrings). Treatments include pressure earring, radiation therapy, interferon alpha, intralesional fluorouracil and imiquimod.”
Radiation therapy improves effectiveness by 90%
The above treatment methods are suitable for different situations, and each has its own effectiveness and disadvantages. Compression therapy, for example, refers to the use of compression to restrict the input of blood, oxygen and nutrients to scar tissue to inhibit growth. Studies have shown that it is not very effective. In addition, there is no substantial data on whether the drugs interferon alpha and imiquimod are effective in treating scars.
“Using radioactive treatment, the improvement effect can reach 70% to 90%.
However, the sequelae include the risk of cancer, skin darkening and ulcers.
In addition, topical fluorouracil is a chemotherapy that can be used together with steroids.
It can improve scars and reduce recurrence rate by 50%.
But it can also cause skin darkening and ulcers. In one study,
Skin ulcers occurred in 21% of patients.
It is worth mentioning that the above two treatments are relatively powerful methods and are only suitable for severe scars. “
lifestyle habits eating style Impact on improving scars
Although there are various scar removal methods on the market, silicone gel is still the first choice for home treatment.
On the other hand, many people may have overlooked that correct living habits and dietary patterns can also help improve scars.
In addition to reducing scars, some treatments can also eliminate scars. If the scar is irreversible, it can be removed with the safest and most effective local injection of corticosteroids. The only disadvantage is that the injection is more painful.
Chen Zhen reminded that it should be noted that the drug must be injected into the scar during injection, otherwise it will cause the skin and subcutaneous fat to atrophy, resulting in uneven skin surfaces.
Other scar removal methods include cryosurgery. Studies show that 51% to 75% of patients experience improvement. However, after treatment, the skin will “fading” and become edema, and the scars may even become numb and insensitive. Another common and effective method is pulse dye laser treatment.
Patients should avoid contact with water
In terms of lifestyle, some cultures believe that patients should avoid contact with water, which is especially common in postpartum women who are in confinement. In fact, mothers with caesarean section wounds must shower and clean the wound every day to keep the wound hygienic to reduce wound infection; avoid scrubbing the wound area when cleaning, and remember to dry the wound by gently pressing it.
Protein aids wound recovery
As for diet, the general public has a common understanding of dietary taboos after surgery. In fact, protein is a key nutrient that helps in wound recovery. Chicken, eggs and meat are all sources of protein, and patients should consume more of them. The only things you need to avoid are foods that cause allergies.
It is worth noting that you need to be cautious when choosing to consume Chinese medicinal materials with blood-activating effects. It is recommended that you first seek the advice of a Chinese medicine practitioner.