Currently, the exact pathomechanisms which lead to hypertrophic scarring are not yet completely understood. Various studies, like from Butzelaar et al. [1] or Sarrazy et al. [3]investigating the background of pathological scarring, observed several differences in the genesis of HS compared to the normal wound healing process. To summarize study results briefly, hypertrophic scarring is related to an prolonged inflammatory phase followed by pathological modifications of wound healing process such as hypercellularity, augmented neovascularization and excessive collagen production.Specific hypertrophic scar fibroblasts found in HS tissue show a greater expression of TGF-β1, causing an overproduction of collagen. Furthermore, an imbalance of collagen production and collagenases (like matrix metalloproteinases, MMP) also occurs, leading to a dysfunctional remodeling of granulation tissue and resultant hypertrophic scarring[1–4]. The complexity of the wound healing process may explain the current This article is protected by copyright. All rights reserved. 5variety of treatment methods for hypertrophic scarring. Silicone products are an early treatment modality which have been used since 1980 [2]. Silicone products may influence hypertrophic scarring by enabling constant hydration of the scar tissue as a consequence of the applied silicone membrane. Another treatment method is the application of mechanical pressure to the scar surface via pressure garments to decrease blood and oxygen flow into the scar tissue, which may reduce cellularproliferation and prevent excessive scarring[4–6]. Other studies recommend the use ofmore invasive methods such as intralesional injections of corticosteroids,
Currently, the exact pathomechanisms which lead to hypertrophic scarring are not yet completely understood. Various studies, like from Butzelaar et al. [1] or Sarrazy et al. [3]<br>investigating the background of pathological scarring, observed several differences in the genesis of HS compared to the normal wound healing process. To summarize study results briefly, hypertrophic scarring is related to an prolonged inflammatory phase followed by pathological modifications of wound healing process such as hypercellularity, augmented neovascularization and excessive collagen production.Specific hypertrophic scar fibroblasts found in HS tissue show a greater expression of TGF-β1, causing an overproduction of collagen. Furthermore, an imbalance of collagen production and collagenases (like matrix metalloproteinases, MMP) also occurs, leading to a dysfunctional remodeling of granulation tissue and resultant hypertrophic scarring[1–4]. The complexity of the wound healing process may explain the current <br>This article is protected by copyright. All rights reserved. 5variety of treatment methods for hypertrophic scarring. Silicone products are an early treatment modality which have been used since 1980 [2]. Silicone products may influence hypertrophic scarring by enabling constant hydration of the scar tissue as a consequence of the applied silicone membrane. Another treatment method is the application of mechanical pressure to the scar surface via pressure garments to decrease blood and oxygen flow into the scar tissue, which may reduce cellular<br>proliferation and prevent excessive scarring[4–6]. Other studies recommend the use of<br>more invasive methods such as intralesional injections of corticosteroids,
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