상처회복

SKIN INJURY REPAIR

손상 복구의 기본 개념을 이해하면 미용피부의 거의 전부가 보인다

상처회복 Skin  Injury Repair
원리 조직이 손상되면 일차적으로 지혈과 손상된조직을 제가해 새로운 세포가 증식하여 회복된다.
단계
1. 지혈단계

손상된 혈관이 빨리 수축되며 혈전 기전이 활성화되어 출혈을 멈춘다.
2. 염증단계
 호중구와 대식세포로 불리는 세포가  외부로부터의 감염을 막아주는 역할과 동시에 상처에서 손상되거나 죽은 조직들을 제거한다.
3. 증식단계
지혈단계와 염증단계를 거쳐 창상이 깨끗해지면 다음으로 여러 세포들과 세포외 기질이 증식한다. 혈관들이 새로 생성되기 시작하고 피부의 여러 층의 상피층을 회복하고, 상처복구의 기본 골격이 되는 콜라겐을 합성한다.
4. 성숙단계
상처치유의 가장 마지막 단계이며 가장 긴 단계가 성숙단계로,섬유아세포에 의한 콜라겐 합성의 시작과 함께 상처의 성숙이 수개월에서 수년간 지속되는 동적인 과정이다,

급성기 회복

 

장기 회복

Treatment of scars

Treatment Description Advantages Disadvantages
Pressure therapy Application of elastic bandages or pressure garments to apply pressure to scar sites. Noninvasive. Can be applied at home by the patient. Often cause discomfort to the wearer which affects compliance. To achieve optimum results from pressure therapy require 6–12 months constant wear.
Silicone gel therapy Application of silicone gel sheets or gel formulated in a tube. Noninvasive. Can be applied at home by the patient. To achieve optimum results from silicone gel therapy require 6–12 months constant wear.
Steroid injections Injection of corticosteroids directly into the scar tissue which inhibits fibrosis and reduces the number of contractile myofibroblasts. Can inhibit the formation of hypertrophic scarring. Requires multiple injections over a period of time to be administered by a clinician.
Dermal fillers Fillers such as collagen can be injected at the scar site. Can be used to improve the contours of pitted scars. Must be carried out by a cosmetic/healthcare professional. Results are temporary.
Dermabrasion Controlled abrasion or planing of upper to mid skin layers. This technique has largely been replaced with advanced methods such as laser resurfacing. Can smooth raised scars and reduce shallow/mid-depth acne scars. Invasive procedure which usually requires an anesthetic. The resultant wounds also carry the risk of further scar formation.
Microdermabrasion A cosmetic procedure involving the exfoliation of the skin epidermis. Noninvasive, nonsurgical and usually pain-free technique. Usually only effective on shallow scars such as those caused by acne.
Laser resurfacing The use of intense pulsed light typically with an erbium or CO2 laser. Can reduce the elevation of scars and also soften scar tissue. Must be carried out by a cosmetic/healthcare professional. Depending on the laser used, results can be short or long term.
Skin grafts (punch grafts) Small skin grafts are taken from unscarred skin and used to cover a scar. Most commonly used for deeper acne scarring. An invasive technique which requires additional wounds to be created to harvest skin tissue.
Surgical revision Can be used to improve the appearance of prominent, irregular-shaped scars. An invasive surgical technique that requires often deep wounds to be created and which will form a further scar.
Ablative fractional resurfacing A series of patients who experienced rapid and sustained healing of long-standing erosions and ulcers associated with traumatic scars and split-thickness skin grafts after initiating a course of AFR. Advantages include the novel concept of photomicrodebridement, including biofilm disruption and the stimulation of de novo growth factor secretion and collagen remodeling.