Soft-tissue dermal loss does not regenerate; instead, it is replaced with
scar. The extent of
scarring is directly related to the severity of tissue loss (in terms of volume and depth). Commonly, an acute dermal loss will heal with excessive
scar, hypertrophic scar. A
hypertrophic scar is elevated but is contained within the boundaries of the initial injury.
Hypertrophic scars have a reddish appearance, indicating an elevated local circulation. A
laser Doppler blood flow monitor was employed to measure blood flow changes in healed
wounds. It was speculated that local circulation in a developing
hypertrophic scar would be elevated. Patients with recently healed
wound sites were monitored and exhibited an average blood flow reading of 365 +/- 325 mV (n = 131). This average value, ranging from 98 to 1450 mV, was 18 times greater than the average reading from normal skin, which was 43 +/- 13 mV (n = 212). Blood flow declined to 32 +/- 21 mV (n = 7) at 16 to 18 weeks (74 percent of normal skin values) in healed
wounds that developed normal
scar. However, a closed
wound that developed into a
hypertrophic scar had a blood flow reading of 148 +/- 78 mV (n = 59) at 16 to 18 weeks. This value was three times greater than in normal skin and four times greater than in normal
scar. At 38 to 50 weeks postinjury,
hypertrophic scar remained elevated (102 +/- 34 mV; n = 10).
Hypertrophic scars sustain an elevated blood flow.(ABSTRACT TRUNCATED AT 250 WORDS)