Utilizing Topical Therapies and Mitomycin to Reduce Scars

Craig Cupp; Curtis Wesley Gaball

doi:10.1055/s-0032-1325645

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2012; 28(05): 513-517
DOI: 10.1055/s-0032-1325645

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Utilizing Topical Therapies and Mitomycin to Reduce Scars

Craig Cupp

¹Department of Otolaryngology–Head and Neck Surgery, Naval Hospital Bremerton, Bremerton, Washington

,

Curtis Wesley Gaball

²Department of Otolaryngology, Naval Medical Center San Diego, San Diego, California

› Author Affiliations

Abstract

Minimizing scar size, width, and contour of elevation is a common goal for the facial plastic surgeon. Various standard techniques are employed to reduce tension and enhance the rapid and uneventful healing of incisions. In some cases, these routine measures are not judged to be adequate, and additional intraoperative and postsurgical measures are employed to control the body's innate healing processes. Mitomycin C and self-drying silicone gel have been particularity useful in our practice.

Keywords

scar - mitomycin C - keloid

Full Text

References

References
1 Signorini M, Clementoni MT. Clinical evaluation of a new self-drying silicone gel in the treatment of scars: a preliminary report. Aesthetic Plast Surg 2007; 31: 183-187
2 Juckett G, Hartman-Adams H. Management of keloids and hypertrophic scars. Am Fam Physician 2009; 80: 253-260
3 Al-Attar A, Mess S, Thomassen JM, Kauffman CL, Davison SP. Keloid pathogenesis and treatment. Plast Reconstr Surg 2006; 117: 286-300
4 Reish RG, Eriksson E. Scars: a review of emerging and currently available therapies. Plast Reconstr Surg 2008; 122: 1068-1078
5 Shridharani SM, Magarakis M, Manson PN, Singh NK, Basdag B, Rosson GD. The emerging role of antineoplastic agents in the treatment of keloids and hypertrophic scars: a review. Ann Plast Surg 2010; 64: 355-361
6 Rockwell WB, Cohen IK, Ehrlich HP. Keloids and hypertrophic scars: a comprehensive review. Plast Reconstr Surg 1989; 84: 827-837
7 Ramakrishnan KM, Thomas KP, Sundararajan CR. Study of 1,000 patients with keloids in South India. Plast Reconstr Surg 1974; 53: 276-280
8 English RS, Shenefelt PD. Keloids and hypertrophic scars. Dermatol Surg 1999; 25: 631-638
9 Fitzpatrick RE. Treatment of inflamed hypertrophic scars using intralesional 5-FU. Dermatol Surg 1999; 25: 224-232
10 Mustoe TA, Cooter RD, Gold MH , et al; International Advisory Panel on Scar Management. International clinical recommendations on scar management. Plast Reconstr Surg 2002; 110: 560-571
11 Davison SP, Dayan JH, Clemens MW, Sonni S, Wang A, Crane A. Efficacy of intralesional 5-fluorouracil and triamcinolone in the treatment of keloids. Aesthet Surg J 2009; 29: 40-46
12 Ogawa R. The most current algorithms for the treatment and prevention of hypertrophic scars and keloids. Plast Reconstr Surg 2010; 125: 557-568
13 Ketchum LD, Cohen IK, Masters FW. Hypertrophic scars and keloids. A collective review. Plast Reconstr Surg 1974; 53: 140-154
14 Wang XQ, Liu YK, Qing C, Lu SL. A review of the effectiveness of antimitotic drug injections for hypertrophic scars and keloids. Ann Plast Surg 2009; 63: 688-692
15 Mustoe TA. Evolution of silicone therapy and mechanism of action in scar management. Aesthetic Plast Surg 2008; 32: 82-92
16 Mercer NS. Silicone gel in the treatment of keloid scars. Br J Plast Surg 1989; 42: 83-87
17 Gold MH. A controlled clinical trial of topical silicone gel sheeting in the treatment of hypertrophic scars and keloids. J Am Acad Dermatol 1994; 30: 506-507
18 Ahn ST, Monafo WW, Mustoe TA. Topical silicone gel for the prevention and treatment of hypertrophic scar. Arch Surg 1991; 126: 499-504
19 Bianchi FA, Roccia F, Fiorini P, Berrone S. Use of Patient and Observer Scar Assessment Scale for evaluation of facial scars treated with self-drying silicone gel. J Craniofac Surg 2010; 21: 719-723
20 Chang CC, Kuo YF, Chiu HC, Lee JL, Wong TW, Jee SH. Hydration, not silicone, modulates the effects of keratinocytes on fibroblasts. J Surg Res 1995; 59: 705-711
21 Ueda K, Furuya E, Yasuda Y, Oba S, Tajima S. Keloids have continuous high metabolic activity. Plast Reconstr Surg 1999; 104: 694-698
22 Wang XQ, Liu YK, Wang ZY , et al. Antimitotic drug injections and radiotherapy: a review of the effectiveness of treatment for hypertrophic scars and keloids. Int J Low Extrem Wounds 2008; 7: 151-159
23 Segev F, Jaeger-Roshu S, Gefen-Carmi N, Assia EI. Combined mitomycin C application and free flap conjunctival autograft in pterygium surgery. Cornea 2003; 22: 598-603
24 McLeod IK, Brooks DB, Mair EA. Revision chonal atresia repair. Int J Pediatr Otorhinol 2003; 67: 517-524
25 Ingrams DR, Volk MS, Biesman BS, Pankratov MM, Shapshay SM. Sinus surgery: does mitomycin C reduce stenosis?. Laryngoscope 1998; 108: 883-886
26 Simman R, Alani H, Williams F. Effect of mitomycin C on keloid fibroblasts: an in vitro study. Ann Plast Surg 2003; 50: 71-76
27 Stewart IV CE, Kim JY. Application of mitomycin-C for head and neck keloids. Otolaryngol Head Neck Surg 2006; 135: 946-950
28 Talmi YP, Orenstein A, Wolf M, Kronenberg J. Use of mitomycin C for treatment of keloid: a preliminary report. Otolaryngol Head Neck Surg 2005; 132: 598-601
29 Bailey JN, Waite AE, Clayton WJ, Rustin MH. Application of topical mitomycin C to the base of shave-removed keloid scars to prevent their recurrence. Br J Dermatol 2007; 156: 682-686
30 Sanders KW, Gage-White L, Stucker FJ. Topical mitomycin C in the prevention of keloid scar recurrence. Arch Facial Plast Surg 2005; 7: 172-175
31 Sanni A, Ikponmwosa S, Golio D, Tehrani K. The use of mitomycin C and keloid scar recurrence. Plast Reconstr Surg 2010; 126: 3
32 Uppal RS, Khan U, Kakar S, Talas G, Chapman P, McGrouther AD. The effects of a single dose of 5-fluorouracil on keloid scars: a clinical trial of timed wound irrigation after extralesional excision. Plast Reconstr Surg 2001; 108: 1218-1224
33 Bulstrode NW, Mudera V, McGrouther DA, Grobbelaar AO, Cambrey AD. 5-fluorouracil selectively inhibits collagen synthesis. Plast Reconstr Surg 2005; 116: 209-221 ; discussion 222–223
34 Haurani MJ, Foreman K, Yang JJ, Siddiqui A. 5-Fluorouracil treatment of problematic scars. Plast Reconstr Surg 2009; 123: 139-148 ; discussion 149–151