Hypertrophic scars

Hypertrophic skin scars (HTS) remain a challenging problem in burn wounds as well as surgical wounds. Hypertrophic scars are thickened and stiff scars, defined as raised above skin level, but, in general, confined to the boundaries of the original wound. In addition to a modified inflammatory response and increased neoangiogenesis, there is a disturbed balance of extracellular matrix (ECM) deposition and degradation in HTS formation. In some individuals HTS seem to be a physiological process in wound healing, since they have a temporary character and regresses within several months. But in other patients HTS is not transient and the scar remains thickened and rigid, which can cause significant morbidity because of the unaesthetic appearance, symptoms such as pain and itch and mechanical problems such as impaired limb mobility when the scar is situated over a joint. To date, there is no optimal therapy available for HTS and many aspects of the mechanism of hypertrophic scar formation still need to be elucidated. Also, a reliable and easily manageable clinical tool to predict HTS formation in patients prior to surgery is lacking.