Hypertrophic scars and keloids: Assessment of the effectiveness and outcome of different treatment modalities

Abstract

Hypertrophic scars and keloids occur due to an abnormal wound heal-ing process frequently seen after a surgical procedure or trauma. There has been no general consensus in the management of hypertrophic scars and keloids so far. Our aim was to assess the impact of mono-therapy as well as multimodal treatment in hypertrophic scars and keloids. The study was conducted on 66 patients at an institute based hospital. Classification was made according to the morphologic fea-tures of the scar and the treatments determined by clinical evaluation. Parameters for scar assessment, previous treatment history, complica-tions, recurrences, and clinical photograph were analysed. Assessment was measured using VSS, and POSAS scales and results were statis-tically analysed. Burn was the single most common etiology. The num-ber of hypertrophic scars (40.9%) was higher than keloids (33.3%). We had used intralesional corticosteroid in 41 patients, surgical procedures for 29 patients, cryotherapy in 23 patients and CO2 laser for three pa-tients. Ten (15.2%) recurrences were noted with a higher recurrence rate in keloids patients. Non-operative treatments should remain the first line of treatment for post-operative and preventable scars. Multimodal approaches showed significant benefits in keloids and hypertrophic scars. We found cryotherapy to be effective as a monotherapy or as an adjuvant for small scars. Clinically classifying the scar based on their morphological features aids in choosing the type of treatment. [J Med Allied Sci 2019; 9(1.000): 3-9]

Keywords

• Hypertrophic scars
• Keloids
• Multimodal treatments
• Pathological scars
• Scar assessment scale