Treatment, Elimination, and Prevention Strategies for Burn Wounds
In the aftermath of a second-degree burn, proper wound care is crucial in preventing or minimizing the appearance of scars. This article explores various treatment methods for keloid scars, which are raised, shiny, and hairless bumps that can form after a burn.
Keloids do not regress spontaneously and often require active treatment. They may cause discomfort, tenderness, itching, and cosmetic concerns. Treatment success varies, with recurrence rates being a significant issue, especially if surgery is used alone.
The most widely used treatment involves injecting corticosteroids directly into the keloid every 4 to 6 weeks. Steroids reduce inflammation and break down excess collagen, thereby flattening and softening the scar. In adults, combining corticosteroids with other treatments like 5-fluorouracil (5-FU) and pulsed dye laser improves outcomes and reduces side effects.
Silicone gel sheets are used as dressings to keep the wound moist and reduce skin tension, which helps decrease keloid size and may prevent worsening. Though it might not completely prevent keloid formation, it is non-invasive and often used post-injury or post-surgery.
Applying consistent pressure to the scar post-excision has shown promising results, particularly for keloids on ears or earlobes. The exact mechanism is unknown, but it helps reduce recurrence when combined with surgery or other treatments.
Freezing keloid tissue with liquid nitrogen is safe, effective, and simple, particularly for smaller keloids, and has a low recurrence rate when combined with other therapies.
Superficial Radiation Therapy (S.R.T.) uses targeted low-level radiation to destroy keloid cells while sparing deeper healthy skin layers. It is especially useful for recurrent or large keloids and can be considered after other treatments have failed. Benefits include reducing recurrence but risks like skin pigment changes exist.
Pulsed dye laser therapy and interferon treatments are sometimes used to improve scar texture and redness. Emerging therapies such as extracorporeal shock wave therapy (ESWT) have shown promise in modulating inflammatory responses and reducing scar thickness in burn scars, including keloids.
Combination therapies tend to provide the best outcomes. For example, surgical removal followed by corticosteroid injections or radiation therapy significantly lowers recurrence rates compared to single treatments. Early intervention and preventive care, especially in individuals prone to keloids, can also reduce severity.
In conclusion, a multi-modal treatment approach tailored to the scar size, location, and patient age, with steroid injections, silicone gel, pressure therapy, and radiation being cornerstone therapies for improving appearance and reducing recurrence. Emerging options like ESWT may offer additional benefits in the future.
Compression garments support the affected area during healing in third-degree burns. Emotional and psychological distress can result from burn scars, particularly in visible areas like the face. Contracture scars make the skin, muscles, and tendons tighter and restrict normal skin movement. Third-degree burns can take a long time to heal and are likely to produce a scar.
Avoid using creams containing vitamin A or vitamin E on scars, as they can make them more noticeable. Physical therapy can help improve motion in areas affected by contractures.
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