Hypertrophic Scars

Burn scars can sometimes heal in a way that causes them to become thick, raised, and stiff. These scars may itch, feel uncomfortable, limit movement, and affect how the skin looks. Because of this, many burn survivors look for treatments that can help improve both the appearance and the symptoms of their scars. One treatment that has shown promise is fractional CO₂ laser therapy. This laser creates tiny openings in the scar tissue that help soften the scar and stimulate the skin to remodel itself. These openings can also help medications applied to the skin reach deeper into the scar where they may work better. A steroid medication called triamcinolone is commonly used to treat these scars. Another medication, called 5-fluorouracil (5-FU), has been shown in prior studies to work well when combined with steroids, but it is usually given by injection, which can be painful and sometimes causes side effects. In this study, we will look at whether delivering these medications through the laser openings can improve scars more effectively. Each participant's scar will be divided into two halves. One side will receive both medications, and the other side will receive the steroid alone. By comparing the two sides of the same scar, we hope to better understand whether adding 5-FU provides additional benefit.

The goal of this clinical trial is to determine whether the application of brief topical cryotherapy immediately before intralesional corticosteroid injections can reduce pain and injection resistance during routine treatment of keloid and hypertrophic scars in adult patients. The main questions it aims to answer are: Does topical cryotherapy applied before intralesional triamcinolone injection impact pain perceptions for participants with keloids or hypertrophic scars? Does topical cryotherapy affect provider-assessed injection resistance compared with standard injection alone? Researchers will split the keloid/hypertrophic scar into two halves. One half will be treated with cryotherapy followed by steroid injection, while the other half will be treated with steroid injection alone to evaluate differences in pain perception and injection resistance. Participants will rate pain after each injection using a 10-point numeric pain scale. Clinicians will rate the resistance after each injection using a 10-point numeric scale.

This study aims to evaluate the effectiveness of nano-fat grafting in treating hypertrophic scars caused by burns on the chest, shoulders, and back. Burn scars in these specific areas are often difficult to treat because the skin is under constant tension and motion, which can prolong inflammation and worsen the scar. While conventional scar treatments like silicone patches, pressure garments, and steroid injections are widely used, they do not always completely restore normal tissue. Nano-fat grafting is emerging as a promising regenerative option. This procedure involves taking a small amount of the patient's own fat and processing it into a liquid that is rich in healing cells. This liquid is then injected directly into the scar to potentially improve skin texture, color, and flexibility. The study will enroll 55 participants between the ages of 18 and 50. To be eligible, patients must have a post-burn hypertrophic scar on their chest, shoulder, or back that is less than 6 months old. During the study, doctors will harvest a small amount of fat from the patient's abdomen or thighs using a small tube. This fat will be carefully washed, processed, and passed through a special filter to create liquid nano-fat. The liquid is then gently injected into the scar tissue. Researchers will monitor the patients and evaluate the scars at 1, 3, and 6 months after the injection. They will use standard clinical scar assessments (the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale) alongside photographs to measure improvements in scar color, thickness, pliability, and overall appearance, as well as patient-reported symptoms like pain and itching.

The Surgical Care and Recovery with Laser Evaluation Trial (S.C.A.R.L.E.T.) is a prospective, single-center clinical study conducted at AdventHealth Medical Group Plastic and Reconstructive Surgery at Innovation Tower. The study evaluates whether early adjuvant ProFractional laser and/or Broadband Light (BBL) therapy improves the appearance, texture, and patient-reported outcomes of surgical scars following major body-contouring procedures. Participants undergoing qualifying surgeries will be grouped as either cosmetic (receiving three laser/BBL sessions) or non-cosmetic (receiving standard care only). Scar outcomes will be assessed using validated instruments-SCAR-Q and Patient and Observer Scar Assessment Scale (POSAS)-along with standardized photographic analysis at serial follow-ups through six months postoperatively.

The goal of this clinical trial is to compare the efficacy of three different topical applications in preventing hypertrophic scars in adults with scars healed after suturing. The main question it aims to answer is: Is Chitosan cream effective in preventing hypertrophic scars? Researchers will compare Chitosan cream with silicone gel and olive oil to see if there is any difference in their efficacies. Participants will be randomly assigned to three groups, with each group using a different topical application. They will be instructed to: * apply the topical application on their scar twice a day for 8 weeks * attend follow-up visits at 4, 12 and 24 weeks for a doctor to assess their scar and take clinical photographs * immediately inform the researcher if they experience any side effects

Evaluation of the safety and topical efficacy of a scar gel after 90 days of continuous use, comparing it to a benchmark for preventing hypertrophic scars and improving appearance, hydration and pigmentation.

The aim of this study is to determine the effect of microporous taping on improving scar characteristics in post-surgical HTS.

Recent advancements in scar management include the use of Plasma Rich Fibrin (PRF) injections and fractional CO2 laser treatments. Both modalities are considered innovative approaches that offer promising outcomes in scar revision . Plasma Rich Fibrin (PRF) is a newer modality in regenerative medicine derived from the patient's own blood. Unlike platelet-rich plasma (PRP), PRF does not use anticoagulants during processing, leading to a natural fibrin matrix that supports prolonged release of growth factors and cytokines . This matrix has been shown to enhance wound healing and improve scar texture and appearance. Studies have demonstrated PRF's efficacy in treating various skin conditions, including acne scars and general skin rejuvenation, suggesting potential benefits for postburn scar management . Fractional CO2 laser therapy is a well-established technique for scar treatment, including postburn scars. This technology utilizes laser energy to create microthermal zones in the skin, which stimulates collagen production and skin remodeling while minimizing damage to surrounding tissues . Clinical trials have validated the effectiveness of fractional CO2 lasers in reducing scar thickness and improving skin texture, making it a popular choice for scar revision .

In this study 80 patients will be randomly assigned into two equal groups (40 patients for each group): 1. Group A: Experimental: Magnesium Sulphate Iontophoresis for Postburn Hypertrophic Scar The study group includes 40 postburn hypertrophic scar patients will receive Magnesium Sulphate iontophoresis twice a week for 4 weeks; in addition to their traditional physical therapy program (deep friction massage, stretching and pressure therapy). 2. Group B: Control: Traditional physical therapy for postburn hypertrophic scar This group includes 40 patients with postburn hypertrophic scar who will receive only the traditional PT (deep friction massage, stretching and pressure therapy) 2 sessions per week for 4 weeks