scarless surgery in treating scars
TRANSCRIPT
What is a scar?
Scar is the visible final state of the natural skin healing process.
Besides scratches, every wound results in some degree of scarring.
Causes of scars
wound scars (trauma)surgical scars acne scars (inflammation)burn scars (contracture)
There are several different kinds of scarring, each caused by differing amounts of collagen over
expression.
BADBAD things about scars
For physicians, scars are a source of frustration
Patients regard scars as stigma!Substantial physical, psychological, emotional & financial costs.
• Burn them
• Melt them
How do we treat scars until now
• Grind them
Actually destructively with ablative procedures
(NO ablative procedure can meet these requirements! )
How we SHOULD treat scars?
Both are physiological requirements to be fulfilled
A Non-Traumatic micro-needle(Ø = 0,25 mm) compared with a 27G injection needle
(Ø = 0,4 mm)
Non-traumatic micro needles and penetrate the dermis without cutting it, they just part skin cells!
Micro-needling: How it works?
How it works:
Injury stimulus on dermisAlarming signal for stem cell attractionRelease of NATURAL growth factorsVertical scar perforation“Nothing to repair” Filling of the old scar bed
Typical Micro-Needlingapplications
Acne scars Facelift scars, Parotidectomy, Thyroidectomy, Oncologic
Surgery Surgical abdominal scars (appendectomy, Cesarean
section, abdominoplasty etc) Thoracic scars Breast augmentation, breast reduction, breast
reconstruction scars Orthopedic scars (Knee, femoral, upper arm, vertebral) Hair transplantation scars (Strip procedure scars, scalp
reduction or scalp extension scars) Burn contractures Striae
Microneedles and atrophic scars
“Too Little” is complemented (collagen addition).Microneedles stimulate skin stem cells and cause skin cells to proliferate new fibroblasts migrate into the scar-bed and fill it with new collagen layers.
Microneedles and hypertrophic scars
“Too Much” is decomposed (Scar degradation)•Different cells are stimulated to degrade old collagen strands.Most probably microneedling stimulates enzymes (proteinases) to degrade scar tissue
Still ELUSIVE
Example of stained skin cross-section from a
biopsy Collagen fibers stained
purple are increased up to
1000% and to a depth of
0.5 to 0.6 mm
Procedure
gentle pressure, roll the roller over each area in
each direction, vertically, horizontally and in both
diagonalsuntil you get an even pattern of petaechie
Improvement after 1 treatment,
3 months post-op.
Burn scars on forearm
Source: Med. Hochschule Hannover
A 3 years old post-burn hypertrophic, hyper pigmented scar on the posterior surface of the left calf. Before and 8 months after 1 procedure of micro-needle session.
Micro-Needling Advantages
NO post-op pain. NO side-effects. Minimal social down time. Any area of skin can treated (around the
eyes, neck, dorsum of hands) Even areas previously LASER-(mal)treated. No damage on skin. No use of xenobiotics (Collagen Fillers etc.)