Hypertrophic scars: modern concepts of prevention and treatment

Despite a large number of studies, the problem of impaired wound healing, in particular hypertrophic scars, remains relevant. Currently, there is no “gold” standard for the management of patients with hypertrophic scars. The purpose of this work was to analyze modern methods of prevention and treatment of hypertrophic scars, in terms of pathogenetic aspects, advantages and disadvantages. The review article includes systematic reviews, original research, and clinical cases describing the prevention and treatment of hypertrophic scars. The search was conducted for the key terms “hypertrophic scar”, “scar-free healing”, “therapeutic strategic”, and “wound healing” in the bibliographic databases PubMed, Scopus, and eLibrary. Articles with the highest citation index were selected from the data obtained. A total of 3,861 titles, 1,484 full articles were reviewed, and 139 articles are included in this review. An analysis of numerous scientific papers has provided a deep understanding of modern strategies for the prevention and treatment of hypertrophic scars. In this article, all the presented methods can be divided into 2 groups: methods that directly affect the blocking of extracellular matrix overproduction and methods that improve regeneration, including tissues around the wound. The latter, according to a few authors, are a promising area of wound healing, as they reduce the overall healing time, thereby contributing to a noticeable aesthetic improvement in the appearance of scars.