[Specificities in children wound healing].
Children have specific characteristics of wound healing. The aim of this study was to describe the specific clinical characteristics of wounds healing in children and to present the current knowledge on the specific mechanisms with regard to infant age. The tissue insult or injury in fetus can heal without scar, mainly due to reduced granulation tissue associated to diminished or even no inflammatory phase, modified extracellular matrix such as the concentration of hyaluronic acid in amniotic liquid, expression and arrangement of collagen and tenascin. Thickness of children skin is a serious negative factor in case of trauma, whereas poor co-morbidities and efficient growth tissue mechanisms are beneficial to good evolution, even in cases of extensive damage and loss of tissue. The subsequent tissue mechanical forces, wound healing during childhood, spanning from the age of 2 until the end of puberty, is associated with more hypertrophic scars, both in duration and in intensity. Consequently, unnecessary surgery has to be avoided during this period when possible, and children with abnormal or pathologic wound healing should benefit from complementary treatments (hydration, massage, brace, silicone, hydrotherapy…), which represent efficient factors to minimize tissue scarring. After wound healing, the growth body rate can be responsible for specific complications, such as contractures, alopecia, and scar intussusceptions. Its evolutionary character implies the need of an attentive follow-up until adult age. Psychologic repercussions, as a consequence of pathologic scars, must be prevented and investigated by the surgeon.
Chirurgie plastique reconstructrice et esthétique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France; EA 7319 Derm-I-C, laboratoire de dermatologie, UFR médecine, 41, rue Cognacq-Jay, 51095 Reims cedex, France.
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J
Sanchez
EA 7319 Derm-I-C, laboratoire de dermatologie, UFR médecine, 41, rue Cognacq-Jay, 51095 Reims cedex, France.
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F
Antonicelli
Chirurgie pédiatrique, American Memorial Hospital, CHU de Reims, 47, rue Cognacq-Jay, 51100 Reims, France.
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D
Tuton
Chirurgie plastique reconstructrice et esthétique, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
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Mazouz Dorval
Chirurgie plastique reconstructrice et esthétique, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France; Chirurgie pédiatrique, American Memorial Hospital, CHU de Reims, 47, rue Cognacq-Jay, 51100 Reims, France; EA 3801, université de Champagne-Ardenne, 41, rue Cognacq-Jay, 51095 Reims cedex, France. Electronic address: caroline_francois@icloud.com.
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C
François
D002648:Child; D017439:Cicatrix, Hypertrophic / Q000473:pathology / Q000503:physiopathology; D003286:Contracture / Q000503:physiopathology; D006801:Humans; D012867:Skin / Q000254:growth & development; D014945:Wound Healing / Q000502:physiology*
Amniotic bands; Brides amniotiques; Brides cicatricielles; Children; Chirurgie plastique pédiatrique; Cicatrice; Cicatrice chéloïde; Cicatrice hypertrophique; Cicatrisation; Enfant; Hypertrophic scar; Keloid scar; Pediatric plastic surgery; Scar flanges; Wound; Wound healing