Overview about the keloid scars and the elaboration of a non-invasive, unconventional treatment

Abstract

Although the healing means 2 types of biological mechanisms that seem to be "pathologic", the swell and the granulations are a normal process in the biology of the human being, representing two systemic functions: the adaptation and the morphogenesis. There is a pathological healing in which the fundamental healing phenomenon is deviated from the normal. There are three variable parameters responsible for the pathological evolution of a scar: the cellular population, the fundamental matrix and the fibers. The healing evolution can be deviated to an intense maturation with an "old", atrophic scar, or to an incomplete maturation and the result is a hypertrophic or a keloid scar. For the hypertrophic scars, the excision and the skin graft lead to good results and the relapses are rare; the keloid relapse is always at the border between the graft and the wound edge, or between the two skin grafts. These are the considerations for which the treatments are mixed, combined (surgical, drugs, physiotherapy) both in our country and abroad, but the results are still frustrating. That is why new, modern methods of treatment are used today: criotherapy, laser, ultrasounds. However, even those treatments are not very successful: tissue expander, external press therapy, corticosteroids injections, other pharmacological agents (retinoic acid, colchicines, antineoplasics). We propose a regenerative, alternative, non-invasive treatment starting from the results we obtained in a research work 4 years ago, when we irradiated the fibroblasts in an electromagnetic high frequency millimeter waves field, and we obtained the fibroblasts apoptosis and the reorganization of the collagen fibers by changing the piezoelectric emission.

Figure 1

Granulation tissue with inflammatory cells and congested blood vessels; hematoxylin–eosin color (objective 40x)

Figure 2

Keloid with abnormally large collagen fibers and large fibroblasts; hematoxylin–eosin color (objective 40x).The healing evolution can be deviated to an intense maturation with an ‘old’, atrophic scar, or to an incomplete maturation and the result is a hypertrophic or a keloid scar.

Figure 3

Atrophic scar in a 28–year–old man, after losing 20 kg

Figure 4

Retractile scar after a hypertrophic scar, in a 19–year–old girl, operated at 4 years old

Figure 5

Keloid scar after acneea vulgaris

Figure 6

Fascicles of collagen fibers (keloid scar); Philips 206 S electron microscope

Figure 7

Keloid scar–hematoxylin–eosin color, optical microscopy [Novex Holland optical microscope, Carfem Electronic Ltd]