Surgical wound hyperplasia

Hyperplasia of surgical wounds is a common reaction after surgery. This type of scar is generally difficult to repair, and because of the large difference in color from the surrounding skin, it looks rather abrupt. Moreover, if the hyperplasia of surgical wounds is not handled correctly, it can cause great harm to the human body. It is not only unsightly, but also affects the normal function of parts of the skin. So, what exactly is surgical wound hyperplasia?

1. Features

In the early stage, the local area swells, hardens and becomes congested. The tissue structure is that the surface layer is covered by a layer of atrophic epithelial cells, the middle layer is vascular dilation and inflammatory cell infiltration, and the bottom layer is less collagen fibers and a large amount of connective tissue hyperplasia. This type of scar is higher than the surface of the skin. In the early stages, the local area becomes thickened and hardened, and the capillaries are congested and appear red or dark red. The base of the scar is generally not adhered to the deep tissue, can be pushed, and has little contractility, and most of the time will not cause serious functional disorders.

2. Hazards

Scars are the inevitable product of the human body's trauma repair process. Broadly speaking, there is no trauma healing without scars. The main component of scar tissue is fibrin. The production and deposition of scar tissue collagen increase the strength of the wound. However, if the scar tissue is not formed sufficiently, the damaged tissue cannot obtain normal tension, which can cause many complications. For example, if the scar of the healing abdominal wall incision is weak, the scar may reopen under the action of intra-abdominal pressure, or the abdominal contents may gradually bulge outward to form an abdominal wall hernia. On the contrary, if scarring is excessive, it may cause serious cosmetic or functional problems. The harm of scar depends on its nature and characteristics, as well as its secondary fixation effect on deep tissue.

Hypertrophic scars are always an imperfect replacement of damaged tissue. From a mechanical point of view, its resistance is weakened; from a nutritional point of view, it creates obstacles to the exchange of oxygen and nutrients; from a functional point of view, it causes deformity and dysfunction of damaged tissues; from an aesthetic point of view, it causes damage to the appearance.

Impact

Hypertrophic scars are less contractile than contracture scars. Hypertrophic scars occurring in non-functional areas generally do not cause serious functional impairment, but large hypertrophic scars in joint areas, due to their thick and hard splinting effect, hinder joint movement and cause functional impairment. Hypertrophic scars located on the flexion surface of the joint may shrink significantly in the late stage, resulting in obvious functional disorders such as jaw-neck adhesion. Surgical hypertrophic scars have been constantly changing since they occurred. At the beginning, the fibers in the scar proliferate rapidly and in large quantities. Excessive fibrosis often compresses and closes the blood vessels inside the scar, causing it to gradually become ischemic.