1/9. The prevention and management of postdermabrasion complications.The complications of keloids, pigment changes, loss of skin texture, and enlarged facial pores remain a problem with dermabrasion patients. Their occurrence can be reduced by proper patient selection, proper dermabrasion technique, proper wound management, and prompt treatment. Keloids are rapidly resolved with the use of flurandrenolide tape covered with positive-pressure chin-strap dressings. Streaks of hyperpigmentation are lightened with a combination of sunscreen, opaque makeup, tretinoin, and hydroquinone lotions. The loss of skin texture can be prevented by not abrading too deeply and avoiding subsequent bacterial contamination during wound healing. However, enlarged skin pores in the central portion of the face and hypopigmentation can be permanent complications.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/9. Failure of carbon dioxide laser excision of keloids.Seven patients with nine keloids have been treated by excision with the carbon dioxide laser. Eight of the nine keloids have recurred to their original or close to original size as early as 10 months following treatment and as late as 22 months. Keloids included in this study were located on the trunk, nuchal region, back, and earlobe. Only one patient (who underwent earlobe keloid excision) has greatly improved keloids after only 9 months follow-up, but this patient needs to wear pressure earrings continuously. The long-term benefits of keloid excision with the carbon dioxide laser is not demonstrated in this case study series.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/9. keloid scar of the face.Although all the consultants agreed that this patient deserved to be treated, they disagreed as to the method. Dr. Wise suggested excision of the scar with postoperative irradiation. Dr. Thomas would excise the scar, inject the lesion with steroids intraoperatively and postoperatively, and apply a pressure dressing. Dr. Cook would not operate at all and favored intralesional injection of steroids. When used, Kenalog was the steroid preparation of choice. Dr. Wise would not use steroids in this situation because of the possible complications of skin atrophy, change in pigmentation, and telangiectasias. Dr. Thomas would avoid low-dose irradiation for fear of inducing a head and neck malignancy. Dr. Cook would avoid all surgical intervention, believing that it would only compound the present problem. All consultants agreed that the patient deserved close follow-up, and that he was at risk for similar scar formation in the future. They also pointed out the genetic predisposition for his offspring to have similar problems.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/9. Effectiveness of silastic sheet coverage in the treatment of scar keloid (hypertrophic scar)Several methods for the treatment of scar keloids have been reported. In this article, use of a 1-mm-thick silastic sheet placed over the scar keloid for 8-12 hours daily is reported. This procedure produced better results than the so-called pressure method.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/9. Postsurgical acrylic ear splints for keloids.It is generally acknowledged that earlobe keloids are best surgically resected and repaired while attempting to leave a residual skeletal cartilaginous soft-tissue framework, oftentimes composed of keloidal tissue itself. Whether grafts, flaps, or primary incision and closure are performed, the success of each procedure may require the adjuvant use of pressure to the involved ear-lobes for at least a year. Where gross deformity has existed, the use of an "oyster splint" seems to act as a pressure remolding device.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
6/9. physical therapists as scar modifiers.Hypertrophic scars, a common sequelae to burn injuries, represent an overgrowth of dermal components like collagen. To the burn-injured patient, the red, raised, rigid scars represent impaired function and distorted appearance. physical therapists modify scars by treating with pressure and stretching to minimize the devastating effects. Healing time, location of the injury, condition of the unhealed and healed areas, and treatment cost influence physical therapy. This article describes scarring and provides practical guidelines for pressure materials and stretching techniques. With an appropriate program, caring for a patient with burns becomes extremely beneficial and rewarding.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
7/9. Corneal keloid in Lowe's syndrome.Bilateral corneal keloids in a boy wih Lowe's syndrome were examined by conventional light and electron microscopy. There were no signs of perforating corneal trauma or iridocorneal incarceration in either eye. The corneal keloids consisted of haphazardly arranged bundles of collagen fibers, fibroblasts, and fenestrated blood vessels. The anterior region of the keloids showed signs of active progression and epithelial epidermalization. The etiology of keloids in Lowe's syndrome remains obscure. Considerations include excessive local delivery of amino acids and unknown noxious substances through the leak corneal vessels, seepage of similar substances across the defective blood-aqueous barrier and the decompensated endothelium, repeated external trauma with associated inflammation, phenytoin (Dilantin) therapy, and congenital predisposition. No data are available on the management of the progressive course of corneal keloids. Possible empirical regimens include local excision, pressure therapy, topical corticosteroids, and cromolyn sodium.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/9. Silicone gel sheeting for the prevention and management of evolving hypertrophic and keloid scars.BACKGROUND. Hypertrophic scars and keloids remain a problem for surgeons. Topical and intralesional corticosteroids, positive pressure dressings, cryotherapy, and laser therapy are helpful but not uniformly successful. OBJECTIVE. To document the effectiveness of silicone gel sheeting in the prevention and/or reduction of evolving hypertrophic scars and keloids. methods. Silicone gel sheeting was placed over evolving scars in 20 cases. The dressing was worn for at least 12 hours a day. Biopsies were examined for the presence of silica in the tissue. RESULTS. Lesions improved during the treatment period in 85% of the cases. The mechanisms of action are unknown. Positive pressure was not necessary. No silica from the dressing was found at the wound site. CONCLUSION. Daily treatments with silicone gel sheeting should begin as soon as an itchy red streak develops in a maturing wound. The dressing is effective in reducing the bulk of these lesions.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
9/9. Penile oedema induced by continuous condom catheter use and mimicking keloid scar.Continuous use of condom catheter for urinary incontinence in a patient with neurogenic bladder gave rise to localized chronic oedema on the dorsum of the penis, mimicking keloid scar, and urethral fistula on the ventral surface. These unusual combined complications on the penile surfaces were due to pressure effect.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |