An improper connective tissue reaction in some sensitive individuals brings on the fibrous growths known as keloids. Black people develop keloids more frequently than white people. However, it is unknown why this is the case. Much of the keloid disease (KD) understanding is based on anecdotes rather than objective observation and statistical analysis. 


Hypertrophic scarring can cause prolonged inflammation, fibrosis, dermal tissue proliferation, and increased extracellular matrix protein deposition. This study reviews the various treatment techniques to differentiate between preventative measures and real therapy strategies. The review examines accepted procedures and cutting-edge techniques to assess the efficacy of keloid therapies and treatments for hypertrophic scars, which may not always be clear in the research.

Keloid scar measures

Keloid scars cause pain, itching, functional limitation, and disfigurement, leading to psychological distress. Progress in treatment regimens is hindered by the lack of a universally accepted outcome measure. The Patient and Observer Scar Assessment Scale is a tool for assessing scars, incorporating clinician and patient assessments. This study evaluates its application to keloids and compares it to the widely used Vancouver Scar Scale, which is considered the standard mode of assessment for scars.


Dr. Eade started the discussion by stressing the importance of good preoperative planning to avoid unsightly scars. He emphasized controlling the external factors that influence wound healing, such as avoiding incisions over the presternal and shoulder areas, avoiding tight closures, making incisions parallel to the skin crease lines, proper deep suture placement to relieve skin edge tension, the use of tapes or pull-out sutures to approximate skin edges, and the positive effects of pressure dressings during the healing period.


Severe burns can happen in a matter of seconds, but the scars they leave behind can result in permanent incapacity. Nursing practices can lessen scarring and increase function. They include positioning, exercise, bacterial invasion prevention, and knowing how and when to apply pressure garments and splints. If the burn is deep, the healing process will be slow. These burns naturally recover within a few days to two to three weeks without any visible scarring. New cells also advance from the wound edge to resurface the burn. A partial-thickness burn kept clean and free from infection will heal with minimal to no scarring and only a transient discolouration to mark the area of injury.


There is weak evidence of the benefit of silicone gel sheeting to prevent abnormal scarring in highrisk individuals, but the poor quality of research means a great deal of uncertainty prevails. Trials evaluating silicone gel sheeting as a treatment for hypertrophic and keloid scarring showed improved scar thickness and colour but are of poor quality and highly susceptible to bias.

Lindokuhle Mabuza


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