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Objective assessment of maturation of post-burn hypertrophic scar: a longitudinal study.

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

Identiferoai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_322021
Date January 1997
ContributorsFong, Siu Lai., Chinese University of Hong Kong Graduate School. Division of Surgical Sciences.
Source SetsThe Chinese University of Hong Kong
LanguageEnglish
Detected LanguageEnglish
TypeText, bibliography
Formatprint, ix, 240 leaves : ill. (some col., some mounted) ; 30 cm.
RightsUse of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/)

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