title: Management of scars: updated practical guidelines and use of silicones.
abstract: Hypertrophic scars and keloids resulting from surgery, burns, trauma and infection can be associated with substantial physical and psychological distress. Various non-invasive and invasive options are currently available for the prevention and treatment of these scars. Recently, an international multidisciplinary group of 24 experts on scar management (dermatologists; plastic and reconstructive surgeons; general surgeons; physical medicine, rehabilitation and burns specialists; psychosocial and behavioural researchers; epidemiologists; beauticians) convened to update a set of practical guidelines for the prevention and treatment of hypertrophic and keloid scars on the basis of the latest published clinical evidence on existing scar management options. Silicone-based products such as sheets and gels are recommended as the gold standard, first-line, non-invasive option for both the prevention and treatment of scars. Other general scar preventative measures include avoiding sun exposure, compression therapy, taping and the use of moisturisers. Invasive treatment options include intralesional injections of corticosteroids and/or 5-fluorouracil, cryotherapy, radiotherapy, laser therapy and surgical excision. All of these options may be used alone or as part of combination therapy. Of utmost importance is the regular re-evaluation of patients every four to eight weeks to evaluate whether additional treatment is warranted. The amount of scar management measures that are applied to each wound depends on the patient's risk of developing a scar and their level of concern about the scar's appearance. The practical advice presented in the current guidelines should be combined with clinical judgement when deciding on the most appropriate scar management measures for an individual patient.
authors.affiliation: APHP, Hôpital Rothschild, Service de Gériatrie - Plaies et Cicatrisation, 75012 Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Meaume
authors.affiliation: Dermatology Department, Private Hospital Clairval, 13009 Marseille, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Le Pillouer-Prost
authors.affiliation: Dermatology Department, University Hospitals Brugmann - Saint Pierre - Queen Fabiola Children's Hospitals Université Libre de Bruxelles 1020 Brussels, Belgium.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Richert
authors.affiliation: Dermatology Department, UZ Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium.
authors.forename: Diane
authors.initials: D
authors.lastname: Roseeuw
authors.affiliation: Dermatology Department, Clinique du Parc Léopold, Rue Froissart 38, 1040 Brussels, Belgium.
authors.forename: Javid
authors.initials: J
authors.lastname: Vadoud
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002921:Cicatrix / Q000517:prevention & control / Q000628:therapy*; D017439:Cicatrix, Hypertrophic / Q000517:prevention & control / Q000628:therapy; D058128:Compression Bandages; D017679:Cryotherapy; D006801:Humans; D007627:Keloid / Q000517:prevention & control / Q000628:therapy; D053685:Laser Therapy; D026741:Physical Therapy Modalities; D017410:Practice Guidelines as Topic; D018714:Radiotherapy, Adjuvant; D012828:Silicones / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D012828:Silicones
keywords: Guidelines; Prevention; Scar; Silicone gel; Silicone sheet; Treatment