Need Details On Keloids And Hypertrophic Scars
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Hypertrophic scars are a bit different from keloids, in the sense that keloids have a tendency to grow over a period of time, thereby causing distress in the form of itching and redness. This is because of a lack of feedback mechanism to stop more scar production. They seem to occur in certain areas more than in others and also in certain races. Hypertrophic scars are just overgrown scars.
Shoulders (deltoid area), front of the chest (over the sternum), ears are some common areas of keloid formation. Also, it is more common in the African races. Hypertrophy can occur when there is tension in the scar or it is across joints or against 'tension lines' of the skin.
Abdomen per se' doesn't form keloid except in unfavourable conditions and in susceptible individuals. Upper abdomen rarely may form keloid if it intrudes onto the lower chest as mentioned above.
The way to prevent or minimise chances of a keloid or hypertrophic scar is to place it in skin creases and along the lines of least tension. If you find that you have a tendency to form bigger scars then after the procedure the surgeon might advise a short course of intra scar steroids or use of silicone gel sheets or creams, which will prevent chances of the scar changing to a hypertrophic scar or a keloid.
Hope this gives you a bird’s eye view of scars and their types. If you have a specific question regarding the same on your person please feel free to write back to me.
Dr.Surindher
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1)Will incision in right hypochondrium be more prone to hypertrophic scar than incision in right iliac fossa?
2)IS skin tension more in upper abdominal area than lower abdominal area?
Thank you for your response.
Right hypochondrium incisons and iliac fossa incisions are not usually prone to form hypertrophic scars or keloids, unless you have a severe keloidal tendency. So you can relax and I don't think you need to be worried about them forming keloids.
But, just to help the scars mature better, you can apply a "Silicon Gel sheet" or a Silicon Gel cream on the scar once daily after your shower for about three months post surgery. That should help the scar heal better.
Wishing you a speedy recovery. You can resume your normal activities and not worry about the scars for now.
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Dr.Surindher
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1)Is skin tension more in hypochondrium and epigastric areas than iliac fossa areas(lower abdomen)?
2)Are hypochondrium areas slightly more prone to hypertrophic scars as compare to other ares of abdomen?
1.Yes skin tension is more in the upper abdomen as compared to the lower abdomen.
2. No, hypochondrium scars are not more prone to hypertrophic scars as compared to other areas of the abdomen, though they are more prone to stretch especially subcostal incisions.
Thank you
Dr.Surindher