Hypertrophic scar tissue : its microstructure and mechanical properties and the effects of pressure therapy

The formation of hypertrophic scar tissue during the process of wound healing results in severe disfiguring and disabling consequences for the patient. This thesis presents the detailed micro-structure of hypertrophic scar tissue, as viewed with the S.E.M. and discusses the inter-relationship between the microstructure and mechanical properties of the tissue. The effect of sustained pressure (in the form of pressure therapy) upon the micro-structure and the mechanical properties is also discussed. A review of the literature concerning normal wound healing and the formation of hypertrophic scar tissue, together with a review of the different forms of therapy currently in use is presented. A detailed micro-architectural picture of hypertrophic scar tissue has been established. Abnormalities in collagen fibre size and packing arrangement, together with abnormally large diameter - blood vessels and excessive numbers of fibroblasts have been observed. A motor driven, rotary biopsy punch, for obtaining undistorted, full thickness cores of scar tissue for microscopical analysis was designed and developed. Pressure therapy has been found to result in an acceleration of the natural remodelling process of the hypertrophic scar tissue. This corresponded with observed changes in fibre micro-architecture and fibroblast concentration, together with a remodelling of mechanical characteristics towards those of normal skin. The inter-relationship between micro-structure and mechanical properties of the scar tissue is discussed. Anisotropy in the mechanical characteristics has been observed to be reflected in the fibre orientation within the scar tissue dermis. The aggravating effect of static and dynamic tensions in the formation of these scars is discussed. The discussion centres on establishing a better understanding of the aetiology of hypertrophic scar tissue and the way in which pressure therapy works, in order that the treatment of already established scars can be optimised; and in the future, that their formation can be prevented.

Name dc:type.qualificationname

phd

Level dc:type.qualificationlevel

doctoral-pg

Grantor dc:publisher.institution

University of Strathclyde

Year dc:date.issued

1980

Author dc:creator

• Tully, A. E.

DOI

10.48730/6r89-2c97

Identifier

uk.bl.ethos.290858
T3867

OAI identifier oai:identifier

oai:strathclyde:2j62s484w