Alteration of hypertrophic scars induced by mechanical pressure

Hypertrophic scars and contractures may be rapidly resolved through application of pressure and forced extension. Examination of pressure-treated scars by scanning and transmission electron microscopy demonstrates a reduction in intercollagen cohesiveness and increasing numbers of vesicular fibroblasts. Assays of chrondroitin sulfate A show a decrease from the excessive levels found in untreated hypertrophic scars. It is suggested that the application of pressure increases an already present condition of hypoxia, which results in degeneration of many fibroblasts. The ratio of collagen synthesis to degradation would, then, be altered in favor of the latter, resulting in resolution of the scar.