Application of interventional tissue remodeling strategy in scar prevention and treatment

Liu Wei

doi:10.3760/cma.j.cn501225-20250102-00004

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > > Accepted Manuscript

Zhang QR,Chen CY,Xu N,et al.Effect of P311 microspheres-loaded thermosensitive chitosan hydrogel on the wound healing of full-thickness skin defects in rats[J].Chin J Burns Wounds,2022,38(10):914-922.DOI: 10.3760/cma.j.cn501225-20220414-00135.

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Liu Wei.Application of interventional tissue remodeling strategy in scar prevention and treatment[J].Chin J Burns Wounds,2025,41(4):1-8.DOI: 10.3760/cma.j.cn501225-20250102-00004.

Citation:

Liu Wei.Application of interventional tissue remodeling strategy in scar prevention and treatment[J].Chin J Burns Wounds,2025,41(4):1-8.DOI: 10.3760/cma.j.cn501225-20250102-00004.

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Application of interventional tissue remodeling strategy in scar prevention and treatment

doi: 10.3760/cma.j.cn501225-20250102-00004

Liu Wei^,

Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering Research, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China Email: liuwei_md@126.com

Funds:

General Program of National Natural Science Foundation of China 81671921

Received Date: 2025-01-02
Available Online: 2025-04-01

Abstract

Abstract

Effective scar prevention and treatment remains a clinical challenge in the field of surgery, while concept innovation and technological progress will be the key to make the breakthrough. Although tissue remodeling is an important part of wound healing process, natural healing process often results in scar formation. This can be attributed to the fact that natural tissue remodeling is often insufficient. The author proposes that the strategy of interventional tissue remodeling can be used for scar prevention and treatment. This strategy involves artificially interfering the healing process using various feasible means such as laser, drugs, bioactive molecules as well as tissue regenerative methods. Therefore, the natural wound healing process can be transformed towards the process of tissue regeneration to a certain extent. As a result, it is likely to achieve better tissue remodeling effect that is not possible by the natural remodeling process. Based on reported literature and the author's own clinical experience, this article presents the potential application area of interventional tissue remodeling strategy for scar prevention and treatment along with clinical evidence of case report, and hopes to draw attention from peer colleagues to this clinical challenge in order to establish such an effective strategy with further clinical validation by additional evidence.
- Cicatrix,
- Laser therapy,
- Wound healing,
- Tissue remodeling,
- Cicatrix remodeling,
- Tissue regeneration,
- Wound interference

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[1]	SpielmanAF, GriffinMF, ParkerJ, et al. Beyond the scar: a basic science review of wound remodeling[J]. Adv Wound Care (New Rochelle), 2023,12(2):57-67. DOI: 10.1089/wound.2022.0049.
[2]	GurtnerGC,WernerS,BarrandonY,et al.Wound repair and regeneration[J].Nature,2008,453(7193):314-321.DOI: 10.1038/nature07039.
[3]	HardyMA.The biology of scar formation[J].Phys Ther,1989,69(12):1014-1024.DOI: 10.1093/ptj/69.12.1014.
[4]	KerwinLY,El TalAK,StiffMA,et al.Scar prevention and remodeling: a review of the medical, surgical, topical and light treatment approaches[J].Int J Dermatol,2014,53(8):922-936.DOI: 10.1111/ijd.12436.
[5]	中国整形美容协会瘢痕医学分会.瘢痕早期治疗全国专家共识(2020版)[J].中华烧伤杂志,2021,37(2):113-125.DOI: 10.3760/cma.j.cn501120-20200609-00300.
[6]	中国临床瘢痕防治专家共识制定小组.中国临床瘢痕防治专家共识[J/CD].中华损伤与修复杂志(电子版),2017,12(6):401-406.DOI: 10.3877/cma.j.issn.1673-9450.2017.06.001.
[7]	章一新, 李洁.瘢痕光电治疗之我见[J]. 中华烧伤与创面修复杂志, 2023, 39(6): 501-506. DOI: 10.3760/cma.j.cn501225-20220821-00353.
[8]	董继英,姚敏.光电声技术治疗创伤性瘢痕的研究进展[J].中华烧伤杂志,2018,34(6):418-421.DOI: 10.3760/cma.j.issn.1009-2587.2018.06.025.
[9]	KuehlmannB, Stern-BuchbinderZ, WanDC, et al. Beneath the surface: a review of laser remodeling of hypertrophic scars and burns[J]. Adv Wound Care (New Rochelle), 2019,8(4):168-176. DOI: 10.1089/wound.2018.0857.
[10]	KauvarANB, KubickiSL, SuggsAK, et al. Laser therapy of traumatic and surgical scars and an algorithm for their treatment[J]. Lasers Surg Med, 2020,52(2):125-136. DOI: 10.1002/lsm.23171.
[11]	雷颖,欧阳华伟,谭军.脉冲染料激光联合超脉冲点阵二氧化碳激光治疗小儿早期烧伤瘢痕的效果[J].中华烧伤杂志,2020,36(5):357-362.DOI: 10.3760/cma.j.cn501120-20200224-00084.
[12]	DeBrulerDM, BlackstoneBN, BaumannME, et al. Inflammatory responses, matrix remodeling, and re-epithelialization after fractional CO₂ laser treatment of scars[J]. Lasers Surg Med, 2017,49(7):675-685. DOI: 10.1002/lsm.22666.
[13]	HultmanCS,FriedstatJS,EdkinsRE,et al.Laser resurfacing and remodeling of hypertrophic burn scars: the results of a large, prospective, before-after cohort study, with long-term follow-up[J].Ann Surg,2014,260(3):519-529; discussion 529-532.DOI: 10.1097/SLA.0000000000000893.
[14]	JinR,HuangX,LiH,et al.Laser therapy for prevention and treatment of pathologic excessive scars[J].Plast Reconstr Surg,2013,132(6):1747-1758.DOI: 10.1097/PRS.0b013e3182a97e43.
[15]	BaiY, ZhangY, NiW, et al. Laser, intense pulsed light, and radiofrequency for the treatment of burn scarring: a systematic review and meta-analysis[J]. Eur Burn J, 2023,4(2):142-162. DOI: 10.3390/ebj4020013.
[16]	LiuW. Emerging technologies in scar management: remodeling of post-surgical linear scar using microplasma radiofrequency[M]//Téot L, Mustoe TA, Middelkoop E, et al.Textbook on scar management: state of the art management and emerging technologies. Cham (CH): Springer, 2020.
[17]	WangS, MiJ, LiQ, et al. Fractional microplasma radiofrequency technology for non-hypertrophic post-burn scars in Asians: a prospective study of 95 patients[J]. Lasers Surg Med, 2017,49(6):563-569. DOI: 10.1002/lsm.22640.
[18]	WangF, LiX, WangX, et al. Efficacy of topical silicone gel in scar management: a systematic review and meta-analysis of randomised controlled trials[J]. Int Wound J, 2020,17(3): 765-773. DOI: 10.1111/iwj.13337.
[19]	ChowL, YickKL, SunY, et al. A novel bespoke hypertrophic scar treatment: actualizing hybrid pressure and silicone therapies with 3D printing and scanning[J]. Int J Bioprint, 2021,25,7(1):327. DOI: 10.18063/ijb.v7i1.327.
[20]	张玉婷,李攀,罗伦,等.烧伤患者瘢痕重塑期增生性瘢痕机械信号转导分子与伤后时间的相关性研究[J].中华烧伤杂志,2018,34(10):690-695.DOI: 10.3760/cma.j.issn.1009-2587.2018.10.008.
[21]	De DeckerI,BeeckmanA,HoeksemaH,et al.Pressure therapy for scars: myth or reality? A systematic review[J].Burns,2023,49(4):741-756.DOI: 10.1016/j.burns.2023.03.007.
[22]	AiJW, LiuJT, PeiSD, et al. The effectiveness of pressure therapy (15-25 mmHg) for hypertrophic burn scars: a systematic review and meta-analysis[J]. Sci Rep, 2017,7:40185. DOI: 10.1038/srep40185.
[23]	CostaAM,PeyrolS,PôrtoLC,et al.Mechanical forces induce scar remodeling. Study in non-pressure-treated versus pressure-treated hypertrophic scars[J].Am J Pathol,1999,155(5):1671-1679.DOI: 10.1016/S0002-9440(10)65482-X.
[24]	NicolettiG, PeruginiP, BellinoS, et al. Scar remodeling with the association of monopolar capacitive radiofrequency, electric stimulation, and negative pressure[J]. Photomed Laser Surg, 2017,35(5):246-258. DOI: 10.1089/pho.2016.4180.
[25]	Van DaeleU, MeirteJ, AnthonissenM, et al. Mechanomodulation: physical treatment modalities employ mechanotransduction to improve scarring[J]. Eur Burn J,2022,3(2):241-255. DOI: 10.3390/ebj3020021.
[26]	CaoG, YeM, WangH, et al. The role of biomechanical forces in the formation and treatment of pathological scars[J]. Clin Cosmet Investig Dermatol,2024,17:2565-2571. DOI: 10.2147/CCID.S496253.
[27]	GurtnerGC,DauskardtRH,WongVW,et al.Improving cutaneous scar formation by controlling the mechanical environment: large animal and phase Ⅰ studies[J].Ann Surg,2011,254(2):217-225.DOI: 10.1097/SLA.0b013e318220b159.
[28]	DaiW, ZhouB, YiB, et al. A novel TCR hydrogel wound dressing loaded with UC-SMC extract enhances skin regeneration and prevents wound scarring[J]. App Mat Today, 2023, 32: 101785.
[29]	LiH,HeJ,YuH,et al.Bioglass promotes wound healing by affecting gap junction connexin 43 mediated endothelial cell behavior[J].Biomaterials,2016,84:64-75.DOI: 10.1016/j.biomaterials.2016.01.033.
[30]	FernandesMG,da SilvaLP,CerqueiraMT,et al.Mechanomodulatory biomaterials prospects in scar prevention and treatment[J].Acta Biomater,2022,150:22-33.DOI: 10.1016/j.actbio.2022.07.042.
[31]	LiuW,WuX,GaoZ,et al.Remodelling of keloid tissue into normal-looking skin[J].J Plast Reconstr Aesthet Surg,2008,61(12):1553-1554.DOI: 10.1016/j.bjps.2008.08.003.
[32]	WernerS,GroseR.Regulation of wound healing by growth factors and cytokines[J].Physiol Rev,2003,83(3):835-870.DOI: 10.1152/physrev.2003.83.3.835.
[33]	KanjiS,DasH.Advances of stem cell therapeutics in cutaneous wound healing and regeneration[J].Mediators Inflamm,2017,2017:5217967.DOI: 10.1155/2017/5217967.
[34]	YunIS,JeonYR,LeeWJ,et al.Effect of human adipose derived stem cells on scar formation and remodeling in a pig model: a pilot study[J].Dermatol Surg,2012,38(10):1678-1688.DOI: 10.1111/j.1524-4725.2012.02495.x.
[35]	DomergueS, BonyC, MaumusM, et al. Comparison between stromal vascular fraction and adipose mesenchymal stem cells in remodeling hypertrophic scars[J]. PLoS One, 2016,11(5):e0156161. DOI: 10.1371/journal.pone.0156161.
[36]	JacksonWM,NestiLJ,TuanRS.Mesenchymal stem cell therapy for attenuation of scar formation during wound healing[J].Stem Cell Res Ther,2012,3(3):20.DOI: 10.1186/scrt111.
[37]	SavantSS.Modified acne scar revision - punch excision, punch-in-subcision with shoulder dermabrasion followed by dermal grafting[J].Indian J Dermatol Venereol Leprol,2025,91(1):139-141.DOI: 10.25259/IJDVL_914_2023.
[38]	LiY, DongJ, LiuL, et al. Smart use of skin biopsy punch in treating keloids: a single-center retrospective study[J]. Aesthetic Plast Surg, 2024,48(15):2965-2974. DOI: 10.1007/s00266-024-04000-6.
[39]	刘龙灿,鲜华,敖贤,等.环钻切除术在治疗胸部多发性瘢痕疙瘩中的临床应用[J].中华整形外科杂志,2023,39(12):1277-1283.DOI: 10.3760/cma.j.cn114453-20230301-00044.
[40]	LiuW, WuX, GaoZ. New potential antiscarring approaches[J]. Wound Repair Regen, 2011,19Suppl 1:S22-31. DOI: 10.1111/j.1524-475X.2011.00710.x.

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Application of interventional tissue remodeling strategy in scar prevention and treatment

doi: 10.3760/cma.j.cn501225-20250102-00004

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Application of interventional tissue remodeling strategy in scar prevention and treatment

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