Yasuyoshi Tosa
School of Medicine-Showa University, Japan
Keynote: J Univer Surg
Introduction: Hypertrophic scars/keloids are brought on by wounds such as trauma, burns or surgery, and the scar over time becomes a protuberant lesion associated with pain and itching. Because they are conditions that exist only in humans, detailed research proceeds only with difficulty. Clinically, cases of mixed hypertrophic scars and keloids are found occasionally and diagnosis can be a struggle. We present the concept of hypertrophic scars/keloids, as well as our experience in the methods of treatment. Evaluation method: evaluation is done by scoring according to the JSW Scar Scale 2015 of the Japan Scar Workshop, including colour of the scar, protrusion, hardness, size and direction of increase. They have a variety of appearance depending on the stage.
Methods: The method of treatment was selected to be consistent with treatment goals of release of scar contracture, flattening of raised lesions and reduction/disappearance of itching and pain and considering recurrence etc. Conservative treatments include application of adrenal cortical hormone-containing tape, adrenal cortical hormone local infusion therapy, silicone cushion therapy and oral tranilast. As surgical treatment, there is surgical resection and subsequent electron beam radiation therapy. Utilizing the features of each treatment, various methods were combined and the treatment effects were reflected depending on the individual sites, age and clinical pathology.
Results: In conservative treatments, silicone materials were used effectively notably application of a silicone cushion and local injection of triamcinolone acetonide (Kenacort). In surgical treatment, surgical resection and subsequent combination of electron beam radiation therapy was useful.
Conclusions: Because the properties change even in the same individual depending on the site and stage, it is necessary to consider site specific treatment policy classification, together with consideration of changes in the evaluation of effects due to the disease stage.
Yasuyoshi Tosa has completed his MD from Showa University, School of Medicine in 1986 and PhD from Showa University, Graduate School of Medicine (Department of Plastic Surgery). He was a Clinical Fellow in Plastic Surgery, Showa University, Tokyo, Japan (1986-1993). He was a Postdoctoral Research Fellow in Massachusetts General Hospital, Harvard Medical School, Boston, USA (1993-1995) and Postdoctoral Research Fellow in Shriners Burn Institute Boston, USA (1995). He has received Sumner L. Koch Award 1995 (Best Scientific Paper, Principal Investigator) at the 50th Annual Meeting of American Society for Surgery of the Hand (San Francisco, USA) in 2006 and Showa Medical Association Academic Award in 2006.He has served as Associate Professor, Department of Plastic Surgery, Showa University School of Medicine, Tokyo, Japan (2009) and Visiting Professor, Department of Plastic Surgery, Ohio State University School of Medicine, Columbus, USA(2015). He was the President of the 13th Annual Meeting of the Japan Scar Workshop 2018 in Tokyo, Japan, The 43rd Pan-Pacific Surgical Association Japan Chapter 2019 in Hawaii, USA.
E-mail: ytosa@med.showa-u.ac.jp
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