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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.

An informative article on the subject of post-laser wound care was recently published on Plastic Surgery Practice web site.

The author, Joseph Niamtu III, DMD, FAACS, discusses recent trends in laser treatments and focuses on post-treatment care:

Inducing an intentional and controlled second-degree facial burn removes the entire epithelium and part of the dermis. This is obviously a giant insult to the normally intact integument. Patients who undergo fully ablative, high-fluence, high-density, multipass CO2 laser resurfacing have to understand in the preop period that this treatment will be their hobby for 4 to 6 weeks. I am very blunt with my patients who are considering this type of laser treatment, and I do not sugarcoat the recovery.

Read more of his discussion here.

Stratpharma AG, Swiss based specialty pharmaceutical company has developed Stratamed, the first silicone-based scar management product that may be applied to open wounds and compromised skin after procedures discussed in Dr Niamtu’s article, such as laser skin resurfacing. The new product helps with rapid epithelialization, reduces down-time, and is the only silicone gel treatment that improves the outcome of scarring by up to 78%.

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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.

 

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.

British biopharmaceutical company Renovo announced that its Phase I dose ranging clinical trials designed to establish the safety of Juvista® following the surgical excision of bilateral earlobe keloids met all primary safety objectives. However, due to the insufficient sample size there is no data about efficacy of the product.

Juvista (INN: Avotermin) is a therapeutic application of human recombinant Transforming Growth Factor Beta 3 (TGFβ3). Clinical trials are investigating the effects of intradermal injection of Juvista applied to skin wounds created either by surgical incision or excision, at or shortly after the time of surgery on the appearance of the subsequent scar.

In a cesarean birth (C-section), the baby is delivered through an incision in the mother’s abdomen and uterus (womb). C-Section births exceed 30% in USA, Brazil, Italy, Mexico, Turkey, Korea, Portugal, Australia, Thailand, and other countries. China is the only country where C-section births exceed 40%. The number of cesarean sections in the U.S. has risen nearly 46% since 1996.

Every C-Section is a major abdominal surgery that leaves a scar. The size of your C-section scar will depend on several factors: the size and position of the baby, whether the C-section was planned or not, etc. Generally, the C-section scar is around 4-6 inches (10-15 cm) long and 1/8 inch (0.3 cm) wide.

Usually the “bikini cut” incision is used but sometimes the “classical” incision will be made vertically from just below the belly button (naval) to just above the pubic bone. To close the wound, some surgeons prefer to use staples whereas others still use suture; there is little statistical evidence to show that one way or another will increase or decrease the size or the appearance of the scar.

Treatment. Initially, the C-section scar will be red, raised and could itch. After the wound is closed you should start using a silicone based product like Strataderm to make the scar softer, flatter and smoother and to relieve itching. The majority of women will develop “mature” C-section scars by the sixth month after delivery. If you have darker skin and/or are prone to keloids you should consult a physician before the C-Section.

Acne is the most common skin disorder, affecting around 15% of the adult population and up to 80% of adolescents. Facial scarring because of acne occurs to some degree in most cases. The majority of acne scars are flat and depressed below the surrounding skin (atrophic), generally small and often round with an indented or inverted centre. To prevent acne scars, do not pop, squeeze, or pick at acne; do not pull scabs of acne; seek treatment early for acne that does not respond to OTC medications.

Types of Acne Scars:

–          red and/or hyperpigmented marks: a post-inflammatory change that usually disappears in 6-12 months

–          acne scars – icepick: depressed scars, deep, narrow and sharp; usually too deep for dermabrasion or laser skin resurfacing

–          acne scars – boxcar: depressed scars, round with sharp edges

–          rolling acne scars: depressed scars, wavy texture in the skin

–          keloids and hypertrophic scars are raised acne scars that may become larger and more noticeable, sometimes painful and itchy.  

Silicone gel like Strataderm is effective for treatment of acne scars and prevention of keloids and hypertrophic scars. Other effective treatments for depressed acne scars include laser skin resurfacing, dermabrasion, scar surgery (punch excision, punch elevation, punch graft, subcutaneous incision), fillers, chemical peel, microdermabrasion and similar procedures that you should discuss with your dermatologist. For raised acne scars, like keloid and hypertrophic scars, your doctor might consider options like intralesional injections, cryotherapy, surgery, laser and light therapy. Your dermatologist will be able to create a treatment plan based on the type of your acne acne scars, results you can expect, and your medical history.

Acne Scars: