In response to damage to the skin, neuro-humoral mechanisms come into play that aim to restore the body's homeostasis through the closure of a wound defect. And the faster is the restoration of the integrity of the skin (there is epithelization of the wound), the greater the likelihood of obtaining either an abruptly healing or healing with the formation of aesthetically acceptable scars.
In response to trauma with damage to the vasculature, the skin develops an inflammatory process, which is a natural protective reaction of the body. The purpose of the inflammatory reaction is to remove fragments of the destroyed skin and, ultimately, to close the skin defect with a newly formed tissue in order to maintain homeostasis.
The lack of any components necessary for the implementation of "protective", physiological inflammation, can prolong this process and transfer it to an "inadequate" level.
Basal keratinocyte is not only the mother cell of the epidermis, which gives rise to all overlying cells, but is a mobile and powerful bioenergetic system.
Depending on the location and depth of destructive changes, scars can have different clinical manifestations. So the scar, located flush with the skin, not causing deformation of the skin and underlying tissues is called normotrophic.
The name keloid comes from the Greek word keleis - tumor and eidos-type, similarity. Keloids are divided into two groups - true or spontaneous and cicatricial or false.
Hypertrophic scars often combine a group of pathological scars in common with keloid scars in connection with that. That both species are characterized by excessive formation of fibrous tissue and arise as a result of prolonged inflammation, hypoxia, attachment of secondary infection, reduction of local immunological reactions. In a history of such patients, endocrinopathies are sometimes found.
It is known that the skin is a multifunctional organ that performs respiratory, nutritional, thermoregulatory, detoxifying, excretory, barrier-protective, vitamin-forming and other functions.
Speaking of local reactions, various authors agree that it is necessary to distinguish 3 main stages of the wound process. So Chernuk AM (1979) distinguished the stage of damage, the stage of inflammation and the stage of recovery.
It is necessary to begin procedures almost immediately after the operation to help the body cope with lymphostasis, ischemia, edema, hematomas and avoid inflammation.