scar treatment


A Chihuahua protecting its bone. Photographer'...

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We’ve dealt with dog bites and dog bite scars before.

Now, four organizations have joined forces to raise awareness during National Dog Bite Prevention Week, May 15-21. It’s estimated that 4. 7 million people are bitten by dogs every year. Yet most dog bites are entirely preventable through training, proper control of dogs, and education.

The American Academy of Pediatrics (AAP), the American Society of Plastic Surgeons (ASPS), the American Society for Reconstructive Microsurgery (ASRM), and the American Society of Maxillofacial Surgeons (ASMS) are concerned about dog bite injuries among patients of all ages. Children are the most common victims, followed by seniors and mail carriers. Every year about 600,000 children require medical attention for dog bites.

“Half of all children will be bitten by a dog by the time they are high school seniors,” said John Fraser, MD, FAAP, an injury prevention specialist who will represent the Texas Chapter of the American Academy of Pediatrics at the Houston event. “Every year about 600,000 children require medical attention for dog bites. As a pediatrician who has treated some of these kids, I want to do everything I can to prevent these injuries.”

Plastic surgeons, including reconstructive microsurgeons and maxillofacial surgeons, often treat victims of dog attacks and see firsthand how devastating these injuries can be. According to ASPS statistics, nearly 33,000 reconstructive procedures on dog bites were performed in 2010, up eight percent from 2009.

For more information and a brochure on dog bite prevention visit American Veterinary Medical Association web site.

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Renovo, a UK company, announced on February 11 that Phase III trials of its lead scar reduction treatment, Juvista (human TGF-beta3) had failed on its primary endpoint (assessment of the scars by independent experts) and on its secondary endpoint (assessment by the patients themselves). The news was even worse as the company is now trying figure out why in some patients, the half of the scar treated with placebo seemed to heal better than the Juvista-treated half.

The REVISE Trial was a double blind, within patient, placebo controlled trial to assess the efficacy of two dose levels of Juvista (200ng and 500ng/100ul/linear cm of wound margin) given twice, following wound closure and 24 hours later, on the appearance of scars following scar revision surgery. Over 350 patients were recruited from 56 centres in UK France, Hungary, Germany, Italy, Poland, Spain, Denmark, Latvia and USA. The EMA agreed primary endpoint for efficacy was a photographic based assessment at 12 months following surgery by an independent panel of experts using the Global Scar Comparison Scale. Secondary endpoints included an assessment of the scars using the Global Scar Comparison Scale by the patients themselves and by the clinical trial investigator. None of the primary or secondary endpoints were met for either dose.

For some additional analysis visit IN VIVO blog.

Surgeon doing a surgical breast biopsy.

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PharmEcosse, a Scottish company, is starting clinical trials to explore the use of insulin (PE001) for the reduction or prevention of surgical scars in patients undergoing non-cancer bilateral breast surgery. The trial will commence in January 2011 and is expected to report in the first quarter of 2013.

Insulin was found to control the activity of the key cells involved in wound closure and subsequent scar formation which apparently slows down or stops the build up of scar tissue.

For more information about taking part in clinical trials, please go to pharmecosse.com

We occasionally receive questions by email or in the comments section. Let us know if you have any questions related to scars, scar treatment or scar prevention and we will try to answer them. You can ask the questions anonymously via the comments section below. And remember, the only stupid question is the one you don’t ask.

 

In a recent interview with Life & Style, the former star of “The Hills” described a variety of post-surgery scars ranging from a two-inch long blemish under her chin to lumpy legs, uneven breasts and bald spots left from a brow lift.

“People have fewer scars from car accidents than I have on my body,” Montag told the magazine.

All plastic surgery but especially major surgeries like tummy tucks and breast reductions, can involve scarring. Ask your doctor to show you a picture of what the scar looks like beforehand. Another important question is what sort of treatments they offer to minimize scarring, for example silicone gel (e.g. Strataderm), silicone sheeting or laser procedures. It’s not always easy to know in advance whether or not you’re likely to scar. Some people are more prone to scarring than others. People heal differently, and patients with a poor history of wound healing or keloid scars are at high risk of scarring.

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The number of Americans hospitalized for dog bites almost doubled over a 15-year-period, increasing to 9,500 in 2008 from 5,100 in 1993, a new government study reports (Emergency Department Visits and Inpatient Stays Involving Dog Bites, 2008). The increase vastly exceeded population growth, and pet ownership increased only slightly during the same period, said the report’s author, Anne Elixhauser, a senior research scientist with the Agency for Healthcare Research and Quality.

Common principal diagnoses for dog bite-related hospitalizations included skin and subcutaneous tissue infections; open wounds of extremities; open wounds of head, neck, and trunk; and fractures of upper limbs.

About 866 people a day went to the emergency room with dog bites in 2008, and about 26 people were admitted each day.

Children under 5 and adults 65 and older were most likely to be hospitalized after a bite, and residents of rural areas made four times as many emergency room visits and had three times as many hospital admissions for dog bites than those from nonrural areas, the report said.

Dog bite wounds are difficult to treat and can leave nasty scars. It is important to immediately contact a doctor who can provide the dog bite treatment needed to minimize infection and scarring.

When your wound starts to heal the body produces more collagen which gathers around the damaged tissue and seals it. However, in keloid scars the collagen production doesn’t stop and the scar extends beyond the borders of the original wound in the form of dense fibrous tissue.

Keloid scars are raised and range in consistency from soft and doughy to hard and rubbery. They can appear anywhere on the body although they usually form in the area of shoulders, cheeks, earlobes and neck area. Burn scars or infected lesions, including acne, are more likely to form keloids. Keloid scars sometimes itch and may be painful. Keloid scars are 15 times more likely to occur in darker-skinned individuals, may be familial, and tend to develop more readily during and after puberty.

While keloid scars are difficult to treat, combination treatments seem to be the most effective. International Clinical Recommendations on Scar Management highlight a primary role for silicone and intralesional corticosteroids in the management of a wide variety of abnormal scars including keloids. Silicone is also recommended as first-line prophylaxis for keloid scars. Other options include surgery (high risk of recurrence), radiotherapy, cryotherapy, and laser.

If your skin is keloid prone, you should avoid piercings, tattoo and any unnecessary incisions, such as plastic surgery. You should treat acne thoroughly to reduce lesions and potential for scarring or, if surgery is necessary, silicone may be combined with intralesional steroids or other treatments (above) to reduce the likelihood or size of keloid scarring.

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