Keywords
Hypertrophic Scar
Wound Healing
Silicone Elastomers
Pressure
Skin Graft
Wound Healing
Silicone Elastomers
Pressure
Skin Graft
How to Cite
Rueda-Gutiérrez, J. A., Rodríguez- Franco, K., Quintero – Moya, S. Y., Gutiérrez – Solano, M., & Meléndez – Flórez, G. L. (2020). Silicone coated thermoplastic mask for management of hypertrophic facial scars. Médicas UIS, 33(3), 49–58. https://doi.org/10.18273/revmed.v33n3-2020006
Abstract
Burns secondary to physical aggression with the intention of disfiguring, torturing or even murdering, have become a common reason for consultation in the 21st century, with Bangladesh being the country with the highest incidence in the world. Colombia is one of the countries with the highest incidence in Latin America. Most injuries occur in exposed areas such as the face and are accompanied by serious physical, aesthetic and functional sequelae. We present the case of a 35-year-old patient with third degree burns in the frontal, periocular, bilateral malar, nasal, upper labial and right ear region, managed with skin grafts, who later developed a hypertrophic scar. The treatment with a thermoplastic mask made by the treating professionals is described, with an internal silicone cover, made on a custom mold and adjusted with elastic bands; integrating in a single removable, comfortable and low-cost device, different therapeutic alternatives that manage to effectively modulate the healing process and, due to their simplicity, favor adherence to treatment, which is essential to obtain satisfactory results. MED.UIS.2020;33(3): 49-58.
References
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2. Acid Survivors Foundation (ASF). Annual Progress Status of ASF [Internet]. Mirpur: Acid Survivors Foundation; 2017. Disponible
en: http://old.acidsurvivors.org/images/frontImages/Annual_ Report_2016_24.07.2017.pdf
3. Welsh J. “It was like burning in hell”: a comparative exploration of acid attack violence [tesis de maestría]. Chapel Hill: Carolina papers on international health, Universidad de Carolina del Norte; 2009.
4. Guerrero L. Burns due to acid assaults in Bogotá, Colombia. Burns. 2013;39(5):1018-23.
5. Ley por medio de la cual se crea el artículo 116A, se modifican los artículos 68A, 104, 113, 359 y 374 de la ley 599 de 2000 y se modifica el artículo 351 de la ley 906 de 2003. (Diario oficial N. 49747.6, número 1773, 6 de enero de 2016)
6. Gaviria JL, Santamaria N, Velandia C, Balanta C, Quintero A. Georreferenciación de las quemaduras en Bogotá, Colombia. Rev Colomb Cir Plást Reconstr. 2019;25(2):61-71.
7. Bombaro KM, Engrav LH, Carrougher GJ, Wiechman SA, Faucher L, Costa BA et al. What is the prevalence of hypertrophic scarring following burns?. Burns. 2003;29(4):299-302.
8. Kwan P, Desmoulière A, Tredget EE. Molecular and Cellular Basis of Hypertrophic Scarring. En: Herndon DN, editores. Total Burn Care. 4ª ed. Edinburgh: Elsevier; 2018. p. 455-465.
9. Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG. Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med. 2011;17(1- 2):113-125.
10. Ogawa R, Akaishi S. Endothelial dysfunction may play a key role in keloid and hypertrophic scar pathogenesis – keloids and hypertrophic scars maybe vascular disorders. Med Hypotheses. 2016;96:51-60.
11. Ferguson MJ, Duncan J, Bond J, Bush J, Durani P, So K, et al. Prophylactic administration of avotermin for improvement of skin scarring: three double-blind, placebo-controlled, phase I/II studies. Lancet. 2009;373(9671):1264–74.
12. Villegas Alzate F. Cirugía plástica para el médico general, estudiantes de la salud y otros profesionales. 2ª ed. Bogotá, Colombia: Ecoe Ediciones;2019.
13. Micallef L, Vedrenne N, Billet F, Coulomb B, Darby IA, Desmoulière A. The myofibroblast, multiple origins for major
roles in normal and pathological tissue repair. Fibrogenesis Tissue Repair. 2012;5(Suppl 1):S5.
14. Lee KC, Bamford A, Gardiner F, Agovino A, Ter Horst B, BishopJ, et al. Burns objective scar scale (BOSS): Validation of an
objective measurement devices based burn scar scale panel. Burns. 2020;46(1):110-20.
15. Xue M, Jackson CJ. Extracellular Matrix Reorganization During Wound Healing and Its Impact on Abnormal Scarring. Adv Wound Care (New Rochelle). 2015;4(3):119-36.
16. Hinz B. The role of myofibroblasts in wound healing. Curr Res Transl Med. 2016;64(4):171-7. 17. To WS, Midwood KS. Plasma and cellular fibronectin: distinct and independent functions during tissue repair. Fibrogenesis Tissue Repair. 2011;4:21.
18. Cubison TC, Pape SA, Parkhouse N. Evidence for the link between healing time and the development of hypertrophic scars (HTS) in
paediatric burns due to scald injury. Burns. 2006;32(8):992–9.
19. Herranz P, Santos X. Cicatrices, guía de valoración y tratamiento. Madrid: Meda Pharma; 2013. 20. Hospital San Vicente Fundación de Medellín y Physician for Peace. Experiencias Tercer Encuentro Unidades de Quemados de Colombia. Medellín: 2018.
21. Thompson CM, Sood RF, Honari S, Carrougher GJ, Gibran NS. What score on the Vancouver Scar Scale constitutes a hypertrophic scar? Results from a survey of North American burn-care providers. Burns. 2015;41(7):1442-1448.
22. Tsuge T, Aoki M, Akaishi S, Dohi T, Yamamoto H, Ogawa R. Geometric modeling and a retrospective cohort study on the usefulness of fascial tensile reductions in severe keloid surgery. Surgery. 2020;167(2):504-509.
23. Gee Kee EL, Kimble RM, Cuttle L, Stockton KA. Scar outcome of children with partial thickness burns: A 3 and 6 month follow up. Burns. 2016;42(1):97-103.
24. Bao Y, Xu S, Pan Z, Deng J, Li X, Pan F, et al. Comparative Efficacy and Safety of Common Therapies in Keloids and Hypertrophic Scars: A Systematic Review and Meta-analysis. Aesthetic Plast Surg. 2019;44(1):207-218.
25. Colla C, Kant SB, Van den Kerckhove E, Van der Hulst RR, Piatkowski de Grzymala AA. Manual fabrication of a specialized transparent facial pressure mask: A technical note. Prosthet Orthot Int. 2019;43(3):356-360.
26. Kant S, Colla C, Kerckhove E, Piatkowski de Grzymala A. Clinical effects of transparent facial pressure masks: A literature review.
Prosthet Orthot Int. 2019;43(3):349–55.
27. Grabowski G, Pacana MJ, Chen E. Keloid and Hypertrophic Scar Formation, Prevention, and Management: Standard Review of
Abnormal Scarring in Orthopaedic Surgery. J Am Acad Orthop Surg. 2020;28(10):e408-e414.
28. Nedelec B, Carter A, Forbes L, Chen Hsu SC, McMahon M, Parry I, et al. Practice guidelines for the application of nonsilicone or
silicone gels and gel sheets after burn injury. J Burn Care Res. 2015;36(3):345-374.
29. Hu MS, Zielins ER, Longaker MT, Lorenz HP. Scar prevention, treatment, and revision. En: Gurtner GC, Neligan PC, editors. Plastic Surgery. Philadelphia: Elsevier; 2018. p. 196–213.
30. O’Brien L, Jones DJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database Syst
Rev. 2013(9):CD003826.
31. Hernandez C, Toro A. Approach and management of hypertrophic scars and keloids. Rev Asoc Colomb Dermatol. 2011;19: 218-28.
32. Mokos ZB, Jović A, Grgurević L, Dumić-Čule I, Kostović K, Čeović R, et al. Current Therapeutic Approach to Hypertrophic Scars. Front. Med. 2017;4(83).
33. Kant SB, Colla C, Van den Kerckhove E, Van der Hulst RRWJ, Piatkowski de Grzymala A. Satisfaction with Facial Appearance
and Quality of Life after Treatment of Face Scars with a Transparet Facial Pressure Mask. Facial Plast Surg. 2018;34(4):394–9.
34. Eming SA. Biology of wound healing. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4a ed. Philadelphia, PA: Elsevier; 2018. p. 2413–24.
35. Park TH. New pressure device, “Magsil,” as an adjuvant pressure therapy for ear keloids. Arch Facial Plast Surg. 2012;14(4):298‐9.
36. Oliveira GV, Chinkes D, Mitchell C, Oliveras G, Hawkins HK, Herndon DN. Objective assessment of burn scar vascularity,
erythema, pliability, thickness, and planimetry. Dermatol Surg. 2005;31(1):48-58.
37. Esselman P, Kowalske K. Burn Rehabilitation, An Issue of Physical Medicine and Rehabilitation Clinics, Volume 22-1. En: Physical Medicine
nd Rehabilitation Clinics of North America. 1a ed. 2011. p. 201-357.
38. Shirakami E, Yamakawa S, Hayashida K. Strategies to prevent hypertrophic scar formation: a review of therapeutic interventions based on
olecular evidence. Burns Trauma. 2020 Jan 2;8:tkz003.
39. El Ayadi A, Jay JW, Prasai A. Current Approaches Targeting the Wound Healing Phases to Attenuate Fibrosis and Scarring. Int J Mol Sci. 020
eb 7;21(3):1105
40. Villafuerte-Vélez CK, Castro-Cabrera AC, Restrepo-Villafuerte C. Trans-surgery prophylactic corticotherapy of cicatricial hyperplasia. Clinic- tadistic prospective study. Cir. plást. Iberolatinoam. 2017;43(1):33-9.
492.
2. Acid Survivors Foundation (ASF). Annual Progress Status of ASF [Internet]. Mirpur: Acid Survivors Foundation; 2017. Disponible
en: http://old.acidsurvivors.org/images/frontImages/Annual_ Report_2016_24.07.2017.pdf
3. Welsh J. “It was like burning in hell”: a comparative exploration of acid attack violence [tesis de maestría]. Chapel Hill: Carolina papers on international health, Universidad de Carolina del Norte; 2009.
4. Guerrero L. Burns due to acid assaults in Bogotá, Colombia. Burns. 2013;39(5):1018-23.
5. Ley por medio de la cual se crea el artículo 116A, se modifican los artículos 68A, 104, 113, 359 y 374 de la ley 599 de 2000 y se modifica el artículo 351 de la ley 906 de 2003. (Diario oficial N. 49747.6, número 1773, 6 de enero de 2016)
6. Gaviria JL, Santamaria N, Velandia C, Balanta C, Quintero A. Georreferenciación de las quemaduras en Bogotá, Colombia. Rev Colomb Cir Plást Reconstr. 2019;25(2):61-71.
7. Bombaro KM, Engrav LH, Carrougher GJ, Wiechman SA, Faucher L, Costa BA et al. What is the prevalence of hypertrophic scarring following burns?. Burns. 2003;29(4):299-302.
8. Kwan P, Desmoulière A, Tredget EE. Molecular and Cellular Basis of Hypertrophic Scarring. En: Herndon DN, editores. Total Burn Care. 4ª ed. Edinburgh: Elsevier; 2018. p. 455-465.
9. Gauglitz GG, Korting HC, Pavicic T, Ruzicka T, Jeschke MG. Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. Mol Med. 2011;17(1- 2):113-125.
10. Ogawa R, Akaishi S. Endothelial dysfunction may play a key role in keloid and hypertrophic scar pathogenesis – keloids and hypertrophic scars maybe vascular disorders. Med Hypotheses. 2016;96:51-60.
11. Ferguson MJ, Duncan J, Bond J, Bush J, Durani P, So K, et al. Prophylactic administration of avotermin for improvement of skin scarring: three double-blind, placebo-controlled, phase I/II studies. Lancet. 2009;373(9671):1264–74.
12. Villegas Alzate F. Cirugía plástica para el médico general, estudiantes de la salud y otros profesionales. 2ª ed. Bogotá, Colombia: Ecoe Ediciones;2019.
13. Micallef L, Vedrenne N, Billet F, Coulomb B, Darby IA, Desmoulière A. The myofibroblast, multiple origins for major
roles in normal and pathological tissue repair. Fibrogenesis Tissue Repair. 2012;5(Suppl 1):S5.
14. Lee KC, Bamford A, Gardiner F, Agovino A, Ter Horst B, BishopJ, et al. Burns objective scar scale (BOSS): Validation of an
objective measurement devices based burn scar scale panel. Burns. 2020;46(1):110-20.
15. Xue M, Jackson CJ. Extracellular Matrix Reorganization During Wound Healing and Its Impact on Abnormal Scarring. Adv Wound Care (New Rochelle). 2015;4(3):119-36.
16. Hinz B. The role of myofibroblasts in wound healing. Curr Res Transl Med. 2016;64(4):171-7. 17. To WS, Midwood KS. Plasma and cellular fibronectin: distinct and independent functions during tissue repair. Fibrogenesis Tissue Repair. 2011;4:21.
18. Cubison TC, Pape SA, Parkhouse N. Evidence for the link between healing time and the development of hypertrophic scars (HTS) in
paediatric burns due to scald injury. Burns. 2006;32(8):992–9.
19. Herranz P, Santos X. Cicatrices, guía de valoración y tratamiento. Madrid: Meda Pharma; 2013. 20. Hospital San Vicente Fundación de Medellín y Physician for Peace. Experiencias Tercer Encuentro Unidades de Quemados de Colombia. Medellín: 2018.
21. Thompson CM, Sood RF, Honari S, Carrougher GJ, Gibran NS. What score on the Vancouver Scar Scale constitutes a hypertrophic scar? Results from a survey of North American burn-care providers. Burns. 2015;41(7):1442-1448.
22. Tsuge T, Aoki M, Akaishi S, Dohi T, Yamamoto H, Ogawa R. Geometric modeling and a retrospective cohort study on the usefulness of fascial tensile reductions in severe keloid surgery. Surgery. 2020;167(2):504-509.
23. Gee Kee EL, Kimble RM, Cuttle L, Stockton KA. Scar outcome of children with partial thickness burns: A 3 and 6 month follow up. Burns. 2016;42(1):97-103.
24. Bao Y, Xu S, Pan Z, Deng J, Li X, Pan F, et al. Comparative Efficacy and Safety of Common Therapies in Keloids and Hypertrophic Scars: A Systematic Review and Meta-analysis. Aesthetic Plast Surg. 2019;44(1):207-218.
25. Colla C, Kant SB, Van den Kerckhove E, Van der Hulst RR, Piatkowski de Grzymala AA. Manual fabrication of a specialized transparent facial pressure mask: A technical note. Prosthet Orthot Int. 2019;43(3):356-360.
26. Kant S, Colla C, Kerckhove E, Piatkowski de Grzymala A. Clinical effects of transparent facial pressure masks: A literature review.
Prosthet Orthot Int. 2019;43(3):349–55.
27. Grabowski G, Pacana MJ, Chen E. Keloid and Hypertrophic Scar Formation, Prevention, and Management: Standard Review of
Abnormal Scarring in Orthopaedic Surgery. J Am Acad Orthop Surg. 2020;28(10):e408-e414.
28. Nedelec B, Carter A, Forbes L, Chen Hsu SC, McMahon M, Parry I, et al. Practice guidelines for the application of nonsilicone or
silicone gels and gel sheets after burn injury. J Burn Care Res. 2015;36(3):345-374.
29. Hu MS, Zielins ER, Longaker MT, Lorenz HP. Scar prevention, treatment, and revision. En: Gurtner GC, Neligan PC, editors. Plastic Surgery. Philadelphia: Elsevier; 2018. p. 196–213.
30. O’Brien L, Jones DJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database Syst
Rev. 2013(9):CD003826.
31. Hernandez C, Toro A. Approach and management of hypertrophic scars and keloids. Rev Asoc Colomb Dermatol. 2011;19: 218-28.
32. Mokos ZB, Jović A, Grgurević L, Dumić-Čule I, Kostović K, Čeović R, et al. Current Therapeutic Approach to Hypertrophic Scars. Front. Med. 2017;4(83).
33. Kant SB, Colla C, Van den Kerckhove E, Van der Hulst RRWJ, Piatkowski de Grzymala A. Satisfaction with Facial Appearance
and Quality of Life after Treatment of Face Scars with a Transparet Facial Pressure Mask. Facial Plast Surg. 2018;34(4):394–9.
34. Eming SA. Biology of wound healing. In: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatology. 4a ed. Philadelphia, PA: Elsevier; 2018. p. 2413–24.
35. Park TH. New pressure device, “Magsil,” as an adjuvant pressure therapy for ear keloids. Arch Facial Plast Surg. 2012;14(4):298‐9.
36. Oliveira GV, Chinkes D, Mitchell C, Oliveras G, Hawkins HK, Herndon DN. Objective assessment of burn scar vascularity,
erythema, pliability, thickness, and planimetry. Dermatol Surg. 2005;31(1):48-58.
37. Esselman P, Kowalske K. Burn Rehabilitation, An Issue of Physical Medicine and Rehabilitation Clinics, Volume 22-1. En: Physical Medicine
nd Rehabilitation Clinics of North America. 1a ed. 2011. p. 201-357.
38. Shirakami E, Yamakawa S, Hayashida K. Strategies to prevent hypertrophic scar formation: a review of therapeutic interventions based on
olecular evidence. Burns Trauma. 2020 Jan 2;8:tkz003.
39. El Ayadi A, Jay JW, Prasai A. Current Approaches Targeting the Wound Healing Phases to Attenuate Fibrosis and Scarring. Int J Mol Sci. 020
eb 7;21(3):1105
40. Villafuerte-Vélez CK, Castro-Cabrera AC, Restrepo-Villafuerte C. Trans-surgery prophylactic corticotherapy of cicatricial hyperplasia. Clinic- tadistic prospective study. Cir. plást. Iberolatinoam. 2017;43(1):33-9.
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