Objectives: This presentation serves to present our study investigating local alterations in hypertrophic scars. Attendees shall understand the differences between pathologic and non-pathologic scars as well as get insight into currently known scientific pathways of scar pathology.
Introduction: One of the long-term complications after every surgical procedure is the occurrence of hypertrophic scars. Depending on the available literature, they form in 30 to 70% of cases. Especially after elective aesthetic procedures these unwanted and disturbing scars present a major psychological and physical burden. Treatment modalities lack evidence not last because of the lack of standardized scar models.
Materials / method: Twenty-two standardized burn and 22 full-thickness skin wounds were placed on the backs of 6 Duroc pigs, whereas half of both had a prolonged inflammation with resiquimod induced. A modified Vancouver Scar Scale, hyperspectral photography and qPCR, and histology from biopsies were performed at defined time points to examine the different processes in the resulting wounds and scars.
Results: Native burn wounds as well as resiquimod-induced full-thickness and burn wounds resulted in more hypertrophic scars than full-thickness wounds. These three wound types also showed relative hypoxia compared with uninduced full-thickness wounds in hyperspectral imaging and increased genetic expression of hypoxia marker HIF1a. The highest number of inflammatory cells was detected in resiquimod-induced full-thickness wounds with histologic features of hypertrophic scars in burn and resiquimod-induced wounds.
Conclusion: According to our experiments, the use of resiquimod is suitable for provoking an earlier-occurring hypertrophic scar. The results suggest that hypoxia is the driving factor in promoting inflammation and thus the appearance of hypertrophic scars. This model allows for the generation of solid hypertrophic scars that can be used to further investigate and define working points in scar treatment, one of which should be the early oxygenation of wounds.
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