Fong Siu Lai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 187-196). / Acknowledgement --- p.v / Abstract --- p.vii / Chapter Chapter One --- INTRODUCTION --- p.1 / Chapter Chapter Two --- LITERATURE REVIEW --- p.4 / Chapter 1 --- STRUCTURE OF SKIN --- p.4 / Chapter 1.1 --- epidermis / Chapter 1.1.1 --- stratum corneum / Chapter 1.1.2 --- stratum lucidum / Chapter 1.1.3 --- stratum granulosum / Chapter 1.1.4 --- stratum spinosum / Chapter 1.1.5 --- stratum germinativum / Chapter 1.2 --- dermis / Chapter 1.2.1 --- collagen / Chapter 1.2.2 --- elastin / Chapter 1.2.3 --- reticulin / Chapter 1.2.4 --- fibroblasts / Chapter 1.2.5 --- ground subsatnce / Chapter 1.3 --- dermo-epidermal junction / Chapter 1.4 --- skin appendages / Chapter 1.4.1 --- hair / Chapter 1.4.2 --- nails / Chapter 1.4.3 --- glands / Chapter 1.5 --- cutaneous vascular system / Chapter 1.5.1 --- cutaneous blood flow and its significance / Chapter 1.5.2 --- cutaneous lymphatic flow / Chapter 2 --- FUNCTIONS OF SKIN --- p.24 / Chapter 2.1 --- protection / Chapter 2.2 --- sensation / Chapter 2.3 --- thermal regulation / Chapter 2.4 --- absorption / Chapter 2.5 --- protection against ultraviolet radiation / Chapter 2.6 --- storage / Chapter 3 --- BIOMECHANICS OF SKIN --- p.28 / Chapter 3.1 --- skin elasticity and the physical variation / Chapter 3.2 --- mechanical properties / Chapter 3.2.1 --- tensile strength / Chapter 3.2.2 --- distensibility / Chapter 3.2.3 --- Young's modulus / Chapter 3.2.4 --- visco-elastic character / Chapter 3.2.5 --- hysteresis / Chapter 3.3 --- fibre orientation / Chapter 3.4 --- mechanical considerations / Chapter 3.5 --- physiological factors / Chapter 3.6 --- clinical application / Chapter 4 --- PHYSIOLOGICAL RESPONSE OF HUMAN SKIN --- p.47 / Chapter 4.1 --- response to mechanical loading / Chapter 4.1.1 --- triple response / Chapter 4.1.2 --- reactive hyperaemia / Chapter 4.2 --- thermal response / Chapter 4.2.1 --- skin temperature / Chapter 4.2.2 --- response to heat / Chapter 4.2.3 --- response to cold / Chapter 4.3 --- local tissue response to burn / Chapter Chapter Three --- BACKGROUND OF THE PRESENT STUDY --- p.55 / Chapter 1 --- BURN INJURIES --- p.55 / Chapter 1.1 --- nature / Chapter 1.2 --- depth / Chapter 1.3 --- extent / Chapter 1.4 --- location of burn / Chapter 1.5 --- age / Chapter 1.6 --- "associated major trauma, inhalation injury" / Chapter 1.7 --- general health status / Chapter 2 --- WOUND HEALING PROCESS --- p.65 / Chapter 2.1 --- role of collagen in wound healing / Chapter 2.2 --- role of oxygen in wound healing / Chapter 2.3 --- role of fibroblasts and myofibroblasts in wound healing / Chapter 2.4 --- role of mast cells in wound healing / Chapter 3 --- HYPERTROPHIC SCAR --- p.71 / Chapter 3.1 --- aetiological factors / Chapter 3.1.1 --- age / Chapter 3.1.2 --- time for wound healing / Chapter 3.1.3 --- racial factor / Chapter 3.1.4 --- depth of injury / Chapter 3.1.5 --- location / Chapter 3.1.6 --- tension / Chapter 3.2 --- characteristics / Chapter 3.3 --- pathogenesis of hypertrophic scar / Chapter 3.3.1 --- blood flow / Chapter 3.3.2 --- tissue gas / Chapter 3.3.3 --- filamentous material / Chapter 3.3.4 --- mast cells / Chapter 3.3.5 --- chondroitin sulfate / Chapter 3.3.6 --- enzyme proline hydroxylase / Chapter 3.4 --- histopathology / Chapter 3.5 --- response towards pressure / Chapter 4 --- TREATMENT OF POST-BURN HYPERTROPHIC SCAR AND THEIR RESPONSE --- p.92 / Chapter 4.1 --- surgery / Chapter 4.2 --- radiotherapy / Chapter 4.3 --- ultrasonics / Chapter 4.4 --- chemotherapy/ intralesional injection of steroid / Chapter 4.5 --- pressure therapy / Chapter 4.6 --- topical silicone gel / Chapter 4.6.1 --- mechanics / Chapter 4.6.2 --- bacteriology / Chapter 4.6.3 --- water-vapour transmission rate / Chapter 4.6.4 --- appearance in the Scanning Electronic Microscope / Chapter 4.7 --- prevention of hypertrophic scar and scar contracture / Chapter 5 --- ASSESSMENT TOOLS FOR HYPERTROPHIC SCAR AND THE CLINICAL APPLICATION --- p.105 / Chapter 5.1 --- clinical observation of the appearance / Chapter 5.2 --- ultrasonography and thickness / Chapter 5.2.1 --- ultrasound / Chapter 5.2.2 --- pulse-echo distance measurement / Chapter 5.2.3 --- echo generation / Chapter 5.2.4 --- transducer beam pattern / Chapter 5.2.5 --- ultrasound instrumentation / Chapter 5.2.6 --- application of ultrasound in the study of hypertrophic scar thickness / Chapter 5.3 --- elastometry (Cutometer) and elasticity / Chapter 5.4 --- application of elastometry / Chapter Chapter Four --- OBJECTIVES & METHODOLOGY OF THE STUDY --- p.123 / Chapter 1 --- Objectives of the study --- p.123 / Chapter 2 --- Study subjects --- p.123 / Chapter 3 --- Methodology --- p.125 / Chapter 4 --- Assessment of thickness of hypertrophic scar --- p.128 / Chapter 5 --- Assessment of visco-elasticity of hypertrophic scar --- p.130 / Chapter 6 --- Clinical rating scale --- p.133 / Chapter 7 --- Study of normal skin as control --- p.133 / Chapter 8 --- Reliability of the ultrasound and cutometer measurement --- p.134 / Chapter Chapter Five --- RESULTS --- p.136 / Chapter 1 --- Inter- and intra- examiner variations of the ultrasound and cutometer measurement --- p.136 / Chapter 2 --- Comparison with normal skin control --- p.138 / Chapter 3 --- Results of ultrasonographic measurements of thickness of hypertrophic scar and its correlation with the clinical grading --- p.139 / Chapter 4 --- Results of Cutometer reading (visco-elastic properties) and the correlation with clinical grading --- p.142 / Chapter 5 --- Observation from raw data --- p.152 / Chapter Chapter Six --- DISCUSSION --- p.154 / Chapter 1 --- Measuring thickness with ultrasonography and clinical grading --- p.157 / Chapter 2 --- Elastic properties of hypertrophic scar and clinical grading --- p.158 / Chapter 3 --- The predictive value of the ultrasonography and elastometry through monthly longitudinal measurement --- p.161 / Chapter 4 --- Inter- and intra- examinar reliability of the ultrasonography and elastometry in the assessmetn of post-burn hypertrophic scar --- p.164 / Chapter 5 --- "The use of a composite ""Visco-elasticity-Thickness Chart"" and case studies" --- p.165 / Chapter 6 --- Limitations of the study --- p.182 / Chapter Chapter Seven --- CONCLUSION AND RECOMMENDATION FOR FURTHER STUDY --- p.184 / REFERENCES --- p.187 / APPENDICES --- p.197 / Appendix 1 Patients' record --- p.197 / Appendix 2 Record of the scars --- p.200 / Appendix 3 Clinical Grading of the hypertrophic scar --- p.202 / Appendix 4 Measurement of the visco-elastic properties --- p.204 / Appendix 5 Ultrasonic measurements of the hypertrophic scars --- p.235 / Appendix 6 List of graphs --- p.237 / Appendix 7 List of figures --- p.238 / Appendix 8 List of tables --- p.240