What to do with hand scars

Therapy can influence the remodeling phase of wound healing. Hypertrophic scar and keloid both result from abnormalities in the wound healing process, resulting in fibroproliferation and disorganized collagen deposition. Keloids differ from hypertrophic scars in that they extend beyond the zone of the initial insult, do not regress with time, have a high rate of recurrence, and are less amenable to therapeutic interventions.

Pressure therapy alters the structure of the extracellular matrix in hypertrophic scars.15 This is theorized to be secondary to the downregulation of cytokines and the induction of apoptosis of the hypertrophic scar derma, resulting in decreased scar proliferation. A pressure glove can be used to manage a hand wound. Custom and off-the-shelf gloves in various sizes are available. Daytime gloves are designed to extend only to the middle phalanges to allow sensory input and integration of the hand into activities of daily living. The hand also can be wrapped with an elastic bandage or placed in a padded splint with an elastic overwrap to provide compression into concave areas of the hand (ie, palm). Other methods of pressure application include self-adherent wraps that can be used for individual fingers. Alternatively, elastomer or other putty-type materials can be fitted into concave surfaces and secured with a splint or elastic wrap to provide pressure. To be effective, pressure therapy should be applied at a level of 24 to 30 mm Hg for 6 to 12 months. Pressure therapy is particularly effective for patients with burns and skin grafts