1. Skin tension, including the external tension caused by the degree of skin tissue defect and the inherent tension of skin tissue itself. Hypertrophic scars are prone to occur in areas with high tension and activity, such as mandible, anterior sternum, deltoid muscle, upper back, elbow, hip, knee, ankle joint and instep.
2. Age: Young people are prone to develop hypertrophic scars, especially at the age of 1-2, which is mainly caused by the vigorous growth of adolescent tissues, strong post-traumatic reactivity and high skin tension;
3. Skin pigment: Colored people have more pigment cells and are easily stimulated, and the incidence of keloids in blacks is 9 times that of whites; It is easy to occur in the period of pituitary physiological activity, such as adolescence and pregnancy;
4. Infection: repeated infection, long-term wound exposure, excessive proliferation of granulation tissue, prone to hypertrophic scars or keloids;
5. Foreign bodies fall into the wound surface: dust, talcum powder, fibers, hair follicles, sebaceous glands and sweat glands can all cause tissue reaction, leading to scar hyperplasia;
6. The angle between the incision and the skin: the incision perpendicular to the skin has the thinnest scar after healing; The greater the angle of inclination, the wider the scar of dermis and the more obvious the skin deformity.
Second, how long can the scar recover after operation
The skin can be divided into dermis and epidermis. Generally, a large area of surgical scars are genuine scars that directly hurt the dermis. These scars do great damage to the skin. Generally, there will be a pigment recovery about one year after operation, but it is almost impossible to completely recover to a smooth and smooth state before operation without using artificial means.
Third, how to repair the surgical scar
1. External application of drugs
Scar ointment can be classified into ordinary moisturizing ointment, anti-inflammatory ointment containing steroids, moisturizing and softening ointment containing silica gel, and melanin-removing ointment used to dilute pigmentation. Scar is a normal connective tissue for wound healing, so it will inevitably form and exist at any wound. External ointment applied to the scar can only achieve slight effects such as moisturizing and softening connective tissue and diluting pigment, thus improving and beautifying the appearance of scar.
2. silica gel patch therapy
silica gel patch is externally applied to hypertrophic scar, which has the function of preventing and treating scar hyperplasia. After using self-adhesive silica gel patch on the scar surface, the water evaporation on the scar surface can be reduced, the hydration of scar tissue can be increased, the permeability of water-soluble proteins and various water-soluble inflammatory proteins on the scar surface can be increased, and these water-soluble proteins can spread on the skin surface, the water-soluble proteins and products in the stroma can be reduced, and the fluid pressure can be reduced, thus promoting scar.
3. Laser therapy
Laser therapy is suitable for superficial concave and hypertrophic scars. When laser is applied to the skin, the scar on the skin surface is affected by laser, and other tissues are not affected. However, these parts that are not affected by laser will accumulate more collagen and elastin, which will help the collagen in the dermis to regenerate and rearrange. In addition, after laser irradiation, it will produce photothermal effect, photochemical effect, pressure effect, electromagnetic field effect and biological stimulation effect on skin tissue, so that the damaged and necrotic tissue at the skin scar can be rapidly pyrolyzed, gasified or broken into tiny fragments, which will be excreted after being swallowed by phagocytes in the body, thus achieving the purpose of calming the scar. The cost of laser treatment varies from 8 to 8, yuan.
4. Radiotherapy
Radiotherapy is suitable for superficial hypertrophic scars. When the scar is treated by radiotherapy, both superficial X-rays and β-rays can greatly reduce the number of fibroblasts in scar tissue, damage their functions, reduce the synthesis of collagen fibers and matrix, and increase the decomposition of collagen fibers, thus flattening and softening the scar. The cost of radiotherapy for scars is about 1,-3, yuan.
5. Surgical repair
There are four effective methods to treat scars by surgery:
(1) Scar excision and suture: a commonly used surgical method to treat scars, and smaller scars can also be used.
(2) Skin grinding: a surgical method that grinds the epidermis and dermal papilla to improve the irregular part of the skin surface, making it smooth and similar in color. It is suitable for acne, smallpox, chickenpox, herpes zoster, eczema, trauma, burn or superficial scar left after operation. If necessary, it can be performed at the same time as surgical resection for scar treatment, and the effect is better than simple grinding.
(3) scar release and local plastic surgery: the smaller cord-like and webbed scars with tension can be removed, and then the normal skin tissue around them can be used to form a flap, and the skin defect at the scar site can be repaired by cross transposition.
(4) scar excision and free skin grafting: the larger hyperplastic scar can be surgically excised, and then the free skin graft from the normal part of the body can be transplanted to the scar wound to repair the wound and restore the skin function.
Fourth, what to eat after the operation without leaving scars
1. Auricularia auricula
Eating Auricularia auricula is good for wound healing, and Auricularia auricula is rich in mineral elements such as iron. 1 grams of auricularia auricula per day contains 185 mg of iron, which is 2 times higher than celery with the highest iron content in green leafy vegetables, and is also rich in zinc.
2. Bitter gourd
Bitter gourd juice contains protein components similar to quinine. It can strengthen the phagocytosis of macrophages, and the bitter gourd and bitter bitter bitter in bitter gourd can increase appetite, strengthen spleen and stimulate appetite, which is beneficial to wound recovery.
3. Tomatoes
Tomatoes can prevent blood clots. The yellow colloidal substance around tomato seeds can prevent platelet coagulation in the blood; It is also rich in antioxidant components such as vitamin C, lycopene and carotene, which is beneficial to wound healing.
4, trotters
Eating trotters is good for wound healing, and trotters are rich in zinc and collagen. Zinc deficiency will reduce the function of fibroblasts, and more collagen can promote the healing of wounds.