Scars: general information

It is well-known how widespread the scars of the skin are - an organ that performs a variety of functions, but whose main role is to protect the body from aggressive external influences that can disrupt homeostasis and harm the biological system. As a result of surgical interventions or other traumatic factors (mechanical, temperature, chemical, ionizing radiation, destructive cutaneous pathology), skin integrity is violated, in response to which general and local neurohumoral mechanisms are incorporated, the purpose of which is to restore homeostasis.

When the integrity of the skin is broken, the body reacts with a protective inflammatory reaction, as a result of which a new tissue appears. Depending on the depth of damage, the inflammatory process ends either by complete repair of the normal structure of the skin, or by replacing the defect with a connective tissue. With destruction below the papillary layer, the restoration of the integrity of the skin always occurs through the formation of a "patch" of coarse-fibrous connective tissue - scar. For the first time this newly formed tissue called cicatricial Dupuytren.

It is known that the scar is a secondary morphological element of the skin, resulting from pathophysiological processes. I.V. Davydovsky in 1952 called the scar a product of pathological tissue regeneration. However, academician AMChernukh in 1982 wrote: "The inflammatory reaction that led to a beneficial effect for the body should be qualified, as a completely normal, adequate, and adequate inflammation, is characterized as a protective reaction of the organism. The result of such an adequate inflammation are normal physiological scars. Inadequate inflammation does not limit itself, has a prolonged course and ends with the formation of pathological scars. "

O. Braun-Falco (1984) called scarring permanent fibrosis as a result of skin damage, O.D. The owner, V.V. Saffronov. II.G. Short, consider skin scars, as a compensatory reaction of the organism in the form of cellular regeneration and tissue hyperplasia. But no matter how doctors treat scars, they are "patches" on the skin of a recovered person, who remains with them for the rest of their lives.

Scars on the face, open areas of the body for young people, especially women - a great spiritual drama. So. A very common disease of young people - acne. According to the literature, approximately 50% of cases leave after itself hypotrophic scars, of different depth and size. On the skin with such scars, it is impossible to apply make-up or somehow to encode them - their visibility is even greater. Teenagers who suffer from such skin defects are often mocked by their classmates. Which leads to a reluctance to learn, psychological frustration and even suicidal attempts.

The greatest problem is keloid scars, since they tend to proliferate scar tissue in all directions and disturb patients not only with their non-aesthetic appearance, but with itching and paresthesias in the scar area. The problem of keloid scars is extremely relevant even in connection with that. That the percentage of patients treated with keloid scars is steadily increasing. So, according to different authors. - from 12% to 19% of the total number of those who applied to medical institutions with scars, suffer keloid scars. Women account for about 85%. These people feel defective, hence their lack of consistency. Mental imbalance.

A special contingent of patients with scars are patients after plastic aesthetic operations. Patients go to surgery to improve their appearance, and instead, or along with it, often get disfiguring scars. The emergence of keloids after plastic surgery is a particularly serious problem and a trauma not only for patients, but also for surgeons, since such scars practically negate the fruits of their skill, sometimes causing litigation with patients.

Of great importance is the problem of skin scarring due to the fact that it suffers from them - the youngest, active and socially promising part of the population. Experiencing its unaesthetic appearance. Patients with scars are locked in themselves; go to their "problem", they try to be treated, just not knowing which specialists to contact. More often to improve the type of scars, patients turn to doctors of three specialties - surgeons. Dermatologists and cosmetologists. Extensive scars and scar deformity - this pathology belongs to the sphere of activity of plasgic surgeons and without a scalpel it is impossible to improve the appearance of such scars. However, after a surgical correction there are scars that disturb the patient and which can be improved by dermatocosmetological means and methods. Dermatologists do not deal with this problem, many cosmeticians do not want to bother with these patients, because the work requires a long, diverse and results are not very comforting. Surgeons tell patients that they can no longer do anything or even that it is not a surgical pathology. Thus, patients turn out to be homeless, left to themselves and in the endless search for a place or center where they could be helped. They turn to beauty salons or centers that advertise about the treatment of scars or even "removal of scars." Doctors understand that to remove the scar from the skin with that. That in its place was normal healthy skin can not be, according to patients who hope to heal this do not understand. As a result, they spend time, money and ... Lose hope for getting an aesthetically acceptable kind of their scars. In fact, with a systematic, strictly individualized approach to each patient and specifically to his scar pathology, it is possible to help these people. Not to remove the scar, but to significantly improve its appearance is a very real task for any scar pathology.

To determine the correct approach tactics for the treatment of scars, dermatologists, surgeons and dermatocosmetologists should be able to classify scars, conduct differential diagnosis between them, depending on their clinical and morphological characteristics, the means, methods and technologies used, and, accordingly, the results of treatment .

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