Morphometric analysis of the intercellular substance of hypertrophic scars after anti-scar treatment

Abstract

AIM: This study aimed to assess the formation of scar tissue after burns under the influence of an anti-scar gel. Understanding of the processes involving scars and the morphofunctional features of the tissue at different stages of development allows targeted selection of therapy and prevention of scars.

MATERIALS AND METHODS: We conducted a comparative prospective analysis from 2005 to 2020. Of which two groups were identified. In group 1 (n = 47), burns were treated according to the standard scheme without the use of modern wound coverings. In group 2 (n = 41), early primary prevention of pathological scarring was performed, where the Contractubex gel was applied to the area of burn injury from the moment of epithelialization. Histological examination included the analysis of skin biopsies in the area of damage before and after conservative treatment.

RESULTS: Histological examination showed quantitative changes in the cellular composition of the scar tissue in all groups. The average quantitative index of the fibroblast activity was significantly reduced in group 2 using Contractubex gel. Thickness of collagen fibers, according to the morphometric analysis, is most reduced in all layers of the dermis in group 2 (p < 0.05). In group 1, collagen fibers are represented as nodular clusters; in some areas of the reticular layer of the dermis, fibers have a more fragmented appearance. In group 2, the use of Contractubex leads to a significant decrease in the level of tumor growth factor-β in the papillary and reticular layers of the dermis.

CONCLUSION: The use of Contractubex gel in the early prevention of pathological scarring significantly reduces the need for subsequent reconstructive surgical interventions

Keywords

pathological scars / hypertrophic scars / targeted therapy selection / early prevention / compression / wound dressings / wound healing / punch biopsy / inflammation

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RIGHTS & PERMISSIONS

Minaev S.V., Grigorova A.N., Vladimirova O.V., Ivchenko A.A., Lavreshin P.M., Vladimirov V.I., Timofeev S.I., Gobedzhishvili V.V.