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Hyperplastische Narben und Keloide

Teil I: Grundlagen und Prävention

Hyperplastic scars and keloids

Part I: basics and prevention

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Zusammenfassung

Eine gestörte Wundheilung führt häufig zu hässlichen Narben. Hierunter sind es besonders die hypertrophen Narben und Keloide, welche neben kosmetischen Problemen auch funktionelle Einschränkungen bewirken können. Deshalb ist die Therapie von Narben sowie deren Prävention im besonderen Interesse des plastischen Kopf-, Hals-, und Gesichtschirurgen. Die vorliegende Arbeit beschreibt die Pathogenese der verschiedenen Narbentypen und deren Charakeristika. Die Unterschiede zwischen reifer, unreifer und hypertropher Narbe sowie dem Narbenkeloid zeigen sich im Aussehen, in der Histologie und in der zellulären Reaktion auf die Wirkung von Wachstumsfaktoren. Das Verständnis der molekularen Mechanismen der Wundheilung ermöglicht die Aufklärung der Pathogenese hypertropher Narben und Keloide. Dies ist die Voraussetzung für die Entwicklung effektiver Strategien zur Prävention und Behandlung. In diesem 1. Teil der Arbeit soll ein Überblick über mögliche präventive Maßnahmen geben werden.

Abstract

Aberrant wound healing results in unsightly scarring, hypertrophic scarring, and keloid formation, causing functional and cosmetic deformities, discomfort, psychological stress, and patient dissatisfaction. Scar prevention and management continue to be important issues for the facial plastic surgeon. This article presents an overview on the pathogenesis of a scar and of the different types of scars. Differences between keloids, hypertrophic scars and normal scars include distinct scar appearance, histologic morphology and cellular function in response to growth factors. Recent advances in our understanding of the wound healing process reveal possible causes for hypertrophic scars and keloids. This information might assist in the development of efficacious prevention and treatment for hypertrophic scar and keloid formation. This article also describes the strategies available for scar prevention. Recommendations focus on the management of hypertrophic scars and keloids.

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  1. Universitäts-Hals-Nasen-Ohren-Klinik Mannheim, Klinikum, Theodor-Kutzer-Ufer, 68135, Mannheim, Deutschland

    A. Baisch &  F. Riedel

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Baisch, A., Riedel, F. Hyperplastische Narben und Keloide. HNO 54, 893–905 (2006). https://doi.org/10.1007/s00106-006-1462-z

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