Hypertrophic scars and keloids: a recurrent problem revisited

Excess scarring caused by pathologically overabundant collagen deposition is a problem known by all surgeons. Such complications to wound healing known as hypertrophic scars and keloids might turn out aesthetically unacceptable to the patient and some scars might even cause anatomic dysfunction. Reviewing the literature in planning a strategy of treatment the surgeon encounters an overwhelming amount of hypotheses on the topic. There seems to be no absolutely effective treatment for hypertrophic scars and keloids and the number of treatment modalities illustrate the lack of understanding concerning this kind of pathologic scarhealing. Most studies have not been well controlled and have produced conflicting results. This review outlines the nature of hypertrophic scars and keloid. Based on a critical assessment of current treatment modalities some guidelines for the choice of treatment is proposed.