Matthias Aust1 and Desmond Fernandes2*
1Department of Plastic and Aesthetic Surgery, Hannover Medical School, Germany
2Department of Plastic and Reconstructive Surgery, Shirnel Clinic - Cape Town, South Africa
We aim to show that deeper needling of skin (1 mm to 3 mm depth) is a valuable tool for treating people with burn scars. Currently numerous ablative cutaneous treatments and surgical procedures are the mainstay of treating burn scars. Needling takes us to a new paradigm of instigating a regenerative phase to remove scar collagen and replace it with normal lattice patterned collagen and thereby reducing the appearance of nodular hypertrophic scars and contractions. This occurs because skin needling causes perforation of blood vessels and an automatic cascade of platelet derived growth factors etc. The dominant growth factor is TGF-β-3 which surges after needling in a way not seen in normal adult tissues but which the usual pattern is found in foetal regenerative wound repair. By repeating needling treatments one can flatten hypertrophic/ burn keloid scars and softens contractures and get closer to the ideal treatment of scars. The authors believe skin needling should be done reasonably soon after the initial injury.
Aust M, Fernandes D. The Value of Medical Needling in Burn Scars. Clin Surg. 2017; 2: 1612.