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BACKGROUND: The treatment of skin scars is a long-term focus and difficulty for plastic surgery and burn. Ultrasound has become a hot spot and trend in its scientific research due to its advantages of small trauma, fast recovery and low risk of scar treatment. OBJECTIVE: To explore the therapeutic effect of different intensities of ultrasound on abdominal skin scar in rabbits and its mechanism of action. METHODS: Sixteen 3-month-old New Zealand rabbits were selected and divided into four groups with four rabbits in each group, male and female, according to stratified random sampling method. After 21 days, sham ultrasound intervention was performed on abdominal scars in the sham ultrasound group, and 0.3, 0.5, and 0.8 W/cm2 ultrasound interventions were given to abdominal scars in the low-, medium- and high-intensity ultrasound groups, respectively, for 7 day each, for a total of two sessions with an interval of 2 days. The length and thickness of scars were measured before and after treatment. The area density of type I and III collagen in scar tissue after intervention was observed by Sirius red staining. The expression of serum N-terminal peptide of type III procollagen (PIIINP) was detected by ELISA before and after the intervention. RESULTS AND CONCLUSION: A total of 70 skin scars formed in 96 wound incisions, and the success rate of modeling was about 72.9%. After the intervention, the scar length in the low- and medium-intensity groups was significantly lower than that in the sham ultrasound group and the high-intensity group (P < 0.05). After the intervention, the scar thickness in the low-, medium- and high-intensity groups was significantly lower than that in the sham ultrasound group (P < 0.05). The scar thickness in the low-intensity group was significantly lower than that in the medium- and high-intensity groups (P < 0.05). After the intervention, the percentage of type I and III collagen in the low-intensity group was significantly higher than that in the high-intensity group (P < 0.05); the percentage of type I and III collagen in the high-intensity group was significantly lower than that in the sham ultrasound group (P < 0.05). After the intervention, the density ratio of type I/III collagen in the low-intensity group was significantly lower than that in the high-intensity group (P < 0.05). The difference of serum PIIINP expression before the intervention and after the first session was significantly lower in the low-, medium-, and high-intensity groups than the sham ultrasound group (P < 0.05), while the difference in the low-intensity group was lower than that in the medium- and high-intensity groups but with no statistical significance (P > 0.05). There was no significant difference between the two groups in the expression of serum PIIINP at the end of the first session and the end of the second session (P > 0.05). To conclude, low-intensity ultrasonic intervention has a better comprehensive effect on the treatment of hypertrophic scar. The mechanism of ultrasonic treatment may be to optimize the compliance of hypertrophic scar tissue through the mechanical, and physicochemica action on the arrangement of type I and III collagen fiber bundles in hypertrophic scar tissue, which still needs further research and confirmation. [ABSTRACT FROM AUTHOR]

Objective To observe and investigate the therapeutic effect of scorpion ointment on early hypertrophic scar in rabbit ear model. Methods From October 2019 to October 2020, 8 New Zealand white rabbits were randomly divided into control group and treatment group, 4 rabbits in each group. The rabbit ear hypertrophic scar model was established. The scorpion ointment was used in the treatment group and the PBS was used in the control group. At 7 and 28 days after treatment, the tissues of each group were taken for HE staining, Masson's trichrome staining and immunohistochemistry. Results At 28 days after rabbit ear model established, the wounds of rabbit ears in each group were completely healed and hypertrophic scar was formed. Significant hyperplasia of scars was found in the control group. In the treatment group, the scar volume was gradually decreased, and the texture and color were improved. The results of HE staining and Masson's trichrome staining showed that the degree of tissue fibrosis was significantly reduced after treatment with scorpion ointment (P<0.05). Compared with the control group, the immunohistochemistry results showed that the expression of CD31 and vascular endothelial growth factor (VEGF) in the treatment group at 7 and 28 days were significantly decreased (P<0.05). Conclusion Scorpion ointment can treat hypertrophic scar by reducing the degree of fibrosis and down regulating the expression of CD31 and VEGF. [ABSTRACT FROM AUTHOR]

Breast cosmesis is an important outcome for women after breast conservation. It has been shown to be correlated with better patient satisfaction, sexuality and self-esteem. This study reports the subjective and objective breast cosmesis outcomes for women treated at Auckland Hospital Radiation Oncology Department using hypofractionated radiation therapy. Breast cosmesis was evaluated using a subjective questionnaire and standardised photographs before radiation, at 6 weeks, 1 year, 3 years and 5 years after radiation. Objective evaluation of the photographs and completion of questionnaires were undertaken by clinicians at the same time points. The questionnaire evaluated global cosmesis on a four-point scale – excellent (E), good (G), fair (F) and poor (P). Patient, tumour and treatment factors were evaluated to assess the impact on cosmesis. Three hundred and fifty-eight patients completed the baseline assessments and two hundred and two patients completed the 5-year assessments. Sixty-eight per cent of patients at baseline and 70% at 5 years scored their cosmesis as E/G compared with 52% and 51%, respectively, by clinician assessment. Age >50 years, separation ≤25 cm, non-diabetic, T1 tumours, node negative, quadrant of the scar, no boost and no adjuvant endocrine therapy were correlated with E/G cosmesis. On multivariate analysis at baseline, the individual breast factors that were significantly associated with a score of E/G cosmesis were breast shape (P = 0.028) and scar appearance (P = 0.001). At 5 years, breast shape (P = 0.003), nipple shape (P = 0.019) and scar appearance (P = 0.001) were found to be significant. This study shows that most women reported no significant change in their breast cosmesis after hypofractionated radiation treatment over 5 years and that a number of patient, tumour and treatment factors may impact on breast cosmesis. • 70% of patients report excellent/good cosmesis after hypofractionated radiation. • Factors affecting cosmesis include: • Patient age >50 years, separation ≤25 cm, non-diabetic. • Tumour size and node negative. • Surgical scar position, radiation dosimetry, no boost. [ABSTRACT FROM AUTHOR]

Objective: To observe the early effect of scorpion ointment combined with asiaticoside ointment on hypertrophic scar and the effect of TGF-β signaling pathway in tissues was further explored. Methods: The New Zealand white rabbits were randomly divided into control group, model group, scorpion ointment group, asiaticoside ointment group and combined drug group. Scorpion ointment and/or asiaticoside ointment were applied immediately after operation in the treatment group for 35 consecutive days, and the treatment of scars in each group was recorded by photography. Pathological examination, real-time PCR and Western blot were performed on rabbit ear tissue samples of each group 35 days after operation. Results: Typical hypertrophic scars were observed in model group 35 days after operation and the inhibitory effect of combined drug treatment group was more significant than that of single drug treatment group. The results of H. E staining showed that compared with the model group, the degree of tissue fibrosis and the amount of collagen in each treatment group were reduced to some extent after treatment, but the combined use of drugs could significantly improve the degree of tissue fibrosis. The results of real-time PCR and western blot showed that the MMP level in the treated group was higher than that in the model group, and the levels of type Ⅰ collagen (Col I), type Ⅲ collagen (Col Ⅲ) and Samd 4 protein. The differences were all different, and the difference in the combination group was the most significant, and the treatment effect was better than that in the single drug group. Conclusion: The combination of scorpion ointment and asiaticoside ointment can effectively improve the level of cell fibrosis and reduce the deposition of collagen. The expression of Smad 4 protein can regulate the TGF-β signaling pathway and inhibit the formation of hypertrophic scar. [ABSTRACT FROM AUTHOR]