Risk of skin tears associated with nursing interventions: A systematic review

BackgroundSkin tears are a significant problem for patients and healthcare professionals. They can cause pain, impact quality of life, and become chronic and infected. The risk of skin tears is associated with dependence in daily life activities and with nursing interventions.ObjectivesTo examine which nursing interventions increase the risk of skin tears.DesignSystematic review. Data sources: The MEDLINE, CINAHL, Scopus, and Cochrane Library databases were searched in March 2022.Publication yearsPublications included were from 2012 to 2022.ResultsSeventeen articles were included in the final analysis reporting nursing interventions associated with the risk of skin tears. Hygiene with cold water and soap, not applying leave-on products to moisten/protect dehydrated skin, and wearing short sleeves were found to be associated with skin tears. Transferring patients into and out of bed in a rough manner and wearing jewelry or long nails can increase the risk of skin tears. Removal of adhesive dressings or bandages can also cause skin tears.ConclusionNursing staff need to know which interventions put their patients at risk of skin tears and which interventions are recommended to prevent skin tears. Nursing care can affect the health of the patient's skin.     

The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal

BackgroundWarts can be extremely painful conditions that may be associated with localised bleeding and discharge. They are commonly treated by cryotherapy or immunotherapy. However, each of these therapies have discomforting side effects and are no official dermatological guideline that exist that may be used to determine which of these methods would work on an individual patient.ObjectiveThis study aimed at developing a machine learning algorithm that improved the prediction of the outcome of wart removing using cryotherapy and immunotherapy.MethodsSupport vector machines, core vector machines, random forest, k-nearest neighbours, multilayer perceptron and binary logistic regression was applied on datasets in to create a model that predicted the outcome of an immunotherapy and cryotherapy treatments based on sex, age, time that has passed since last treatment, number of warts, type, area, diameter and result of treatment.ResultsThe average accuracy of the immunotherapy prediction was 88.6%±8.0% while the same measure for cryotherapy prediction was 94.6%±4.0%. The most efficient immunotherapy and cryotherapy model had an accuracy of 100%, predicating the correct treatment outcome when applied to all test cases.ConclusionThis study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal. This model created a more in-depth guideline for understanding is immunotherapy would work and took a new approach to cryotherapy.     

The Chinese version of the skin tear knowledge assessment instrument (OASES): Cultural adaptation and validation

BackgroundSkin tear knowledge is an important predictor of the decreased incidence and management of skin tears, and the knowledge level among Chinese nurses is unknown so far. A validated instrument for measuring skin tear knowledge is urgent.ObjectiveTo culturally adapt the skin tear knowledge assessment instrument (OASES) into Chinese and verify its validity and reliability in the Chinese context.MethodsThe cultural adaptation process for OASES into Chinese was established on Beaton's translation model. Content validity was determined by the 8-expert group in wound care. A nationwide psychometric validation study was performed on a convenience sample of 3333 nurses from 113 tertiary hospitals, of whom 98 nurses finished the test-retest procedure for reliability analysis. Item validity (item difficulty and discriminating index) and construct validity (known-groups technique) were tested.ResultsThe content validity index was 0.88–1.00. The item validity was as follows: Item difficulty ranged from 0.16 to 0.86, with an average value of 0.52; the discriminating index varied between 0.05 and 0.61. The known-group technique demonstrated excellent construct validity with a significant difference between predefined groups with theoretically expected higher knowledge scores and theoretically expected lower knowledge scores (P < 0.001). For the test-retest reliability, the Intraclass correction coefficient (ICC) during a 14-day interval for the overall tool was 0.79 (95% CI = 0.71–0.86), and Cohen's kappa value for each item varied from 0.17 to 0.62.ConclusionsThe Chinese version of OASES was validated to be suitable for skin tear knowledge assessment with acceptable psychometric properties, through which the knowledge and training priorities of skin tear among Chinese nurses can be quantified.     

Finite element models of wound closure

AimThe achievement of a well-healed wound depends on many factors including its size and location on the body and the properties of the skin. The aim of this study is to develop computational wound closure models and compare the results of using different excision shapes.MethodsFinite element models were developed that simulated the incision, excision and closure of skin. Skin was represented by an orthotropic constitutive law. The size of extrusions, maximum stresses and the force to close wounds with differently shaped excisions were analysed.ResultsCircular excisions resulted in closed wounds with extrusion heights 76% larger than fusiform or lazy S-plasty excisions. The extrusion length for circular excisions was 50% longer than the lazy S-plasty extrusion length. The maximum stresses around closed wounds with elliptical excisions were between 30 and 40% lower than the maximum stresses around fusiform and lazy S-plasty closed wounds. The force required to close an elliptical wound was between 27 and 66% lower than the closure force of fusiform and lazy S-plasty excisions. The orthotropic nature of skin and the orientation of the excision significantly influence the behaviour of the skin around the closed wound. The in vivo pre-stress, often ignored in wound closure models, influences the size of extrusions. Increasing the pre-stress by a factor of twenty decreased extrusion heights by 40%. A similar change in pre-stress decreased extrusion lengths by 50%.ConclusionThese models have potential as valuable clinical tools to determine the optimum excision shape that will minimise adverse stress fields and reduce scarring. Models that are patient-specific would be useful to design strategies to ensure favourable healing and improve the quality of life of the person.     

Uso del aprendizaje automático en el diagnóstico del melanoma. Limitaciones por superar

BackgroundAutomated image classification is a promising branch of machine learning (ML) useful for skin cancer diagnosis, but little has been determined about its limitations for general usability in current clinical practice.ObjectiveTo determine limitations in the selection of skin cancer images for ML analysis, particularly in melanoma.MethodsRetrospective cohort study design, including 2,849 consecutive high-quality dermoscopy images of skin tumors from 2010 to 2014, for evaluation by a ML system. Each dermoscopy image was assorted according to its eligibility for ML analysis.ResultsOf the 2,849 images chosen from our database, 968 (34%) met the inclusion criteria for analysis by the ML system. Only 64.7% of nevi and 36.6% of melanoma met the inclusion criteria. Of the 528 melanomas, 335 (63.4%) were excluded. An absence of normal surrounding skin (40.5% of all melanomas from our database) and absence of pigmentation (14.2%) were the most common reasons for exclusion from ML analysis.DiscussionOnly 36.6% of our melanomas were admissible for analysis by state-of-the-art ML systems. We conclude that future ML systems should be trained on larger datasets which include relevant non-ideal images from lesions evaluated in real clinical practice. Fortunately, many of these limitations are being overcome by the scientific community as recent works show.     

Wound healing after laser skin resurfacing: The effect of a silver sulfadiazine-hyaluronic acid-containing cream under an occlusive dressing

Abstract

Introduction: Occlusive dressings promote wound healing after laser skin resurfacing. Our goal was to evaluate whether a cream containing hyaluronic acid–silver sulfadiazine could improve this process. Methods: Ten guinea pigs received laser resurfacing on the skin of their backs. Polyurethane foam film adhesive dressing was applied. A cream containing hyaluronic acid–silver sulfadiazine was applied under the dressing over half of the wound. Skin biopsies were taken at days 2, 4, 7 and 9 and examined by a pathologist blinded to the study. Results: Re-epithelialization appeared to occur faster in the cream-treated areas, together with a lower level of acute inflammation in the early phase of the healing process. Conclusions: The cream containing silver sulfadiazine/hyaluronic acid seems to improve wound healing after laser skin resurfacing in guinea pigs. The clinical application of this finding on humans should be assessed.     

Surrounding skin management in venous leg ulcers: A systematic review

ObjectivesChronic venous insufficiency may lead to the development of venous leg ulcers, the most common form of chronic wounds in the lower extremity. Key to venous leg ulcer care is the maintenance of healthy skin surrounding the ulcer, as failure to maintain skin integrity may influence the healing outcome. We thus reviewed the scientific literature looking for assessment and management instruments regarding this common but often neglected issue.MethodThe search included all studies published between 2000 and May 2019. Keywords used were: “peri-wound skin care”, “surrounding skin venous ulcers”, “surrounding skin management leg ulcers”, and “peri-lesional skin management”.ResultsManagement of moisture-balance with the selection of appropriate dressings is the most important target in surrounding-wound skin care. Moreover, contact dermatitis related to products and the dressings themselves is a neglected problem in patients with chronic leg ulcers which clinicians increasingly have to manage. The literature search revealed that there is an increasing interest in the use of noninvasive assessment tools in the field of wound care, and focusing on the surrounding-wound skin plays a role in assessing the potential of wound healing. Transepidermal water loss measurement (TEWL) and ultrasonography are two of the measurement techniques available.ConclusionThe integrity of the surrounding skin is necessary for wound healing, and appropriate management is needed to address this aspect which is part of an overall approach to treating wounds.     

Chitosan and gelatin biopolymer supplemented with mesenchymal stem cells (Velgraft®) enhanced wound healing in goats (Capra hircus): Involvement of VEGF,TGF and CD31

AimCell-based therapy has emerged as promising strategy for chronic and impaired wounds treatment. Current research is focused on developing biomaterial systems that act as a niche for mesenchymal stem cells (MSCs) to promote wound healing through paracrine molecular cascading. This study was aimed to evaluate the wound healing potential of Velgraft, a ready-to-use biodegradable artificial skin substitute, on excision wound in goats.Materials and methodsTwelve male goats were randomized divided in to three groups of four animals each. After infliction of surgical wound, Velgraft and Soframycin were applied on wounds of the animals of Groups II and III while Group I (sham operated) served as control. Wound diameters were measured at pre-defined time-points for determination of progressive wound healing up to 28 days. Skin sections were stained using Hematoxylin and eosin (H&E) for examining the histoarchitectural changes, Masson trichome staining for ascertaining collagen synthesis and immunohistochemistry for expression of CD31, VEGF and TGF-β1 proteins to determine post-treatment angiogenesis in the inflicted wounds.ResultsVelgraft application appreciably enhanced wound closure by day 21 which was confirmed through restoration of the normal skin architecture as evident based on histopathological examination and characterized by complete regeneration of epidermal layers, collagen fibers, blood capillaries and hair follicular formation. Stimulation of angiogenesis markers was also observed at different time-points post-Velgraft application; which is suggestive of the improved angiogenesis and vasculogenesis.ConclusionVelgraft facilitates wound healing by augmenting early wound closure, enhancing collagen synthesis and deposition, trichosis development and promoting revascularization and epidermal layers restoration.     

The prevalence and associated factors of skin tears in Belgian nursing homes: A cross-sectional observational study

Background

Although skin tears are among the most prevalent acute wounds in nursing homes, their recognition as a unique condition remains in its infancy. Elderly patients are at risk of developing skin tears due to increased skin fragility and other contributing risk factors. In order to provide (cost-) effective prevention, patients at risk should be identified in a timely manner.

Improving skin picking diagnosis among Brazilians: validation of the Skin Picking Impact Scale and development of a photographic instrument

BackgroundSkin picking disorder is a prevalent disorder frequently comorbid with depression and anxiety, which is underdiagnosed mainly by dermatologists. Assessment of skin picking disorder is based on instruments influenced by the awareness about skin picking disorder and comorbid symptoms. To date, there is no validated instrument for Brazilian individuals nor an instrument to evaluate the severity of skin lesions in an objective way.ObjectivesValidate the Skin Picking Impact Scale for Brazilian Portuguese and create a photographic measurement to assess skin lesions.MethodsThe sample was assessed through the Skin Picking Impact Scale translated into Brazilian Portuguese, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Clinical Global Impression Scale. The patients’ skin lesions were photographed. Photos were evaluated regarding active excoriation, crust/bleeding, exulceration, and linear lesions.ResultsThere were 63 patients included. The Skin Picking Impact Scale translated into Brazilian Portuguese had good internal consistency (Cronbach's alpha = 0.88), which tests of goodness-of-fit, showing a suitable model. The reliability of photographic measurement was 0.66, with a high internal consistency (Cronbach's alpha = 0.87). Photographic measurement was not correlated with the Skin Picking Impact Scale, the Clinical Global Impression Scale, or comorbid symptoms.Study limitationsLack of a previously validated instrument to evaluate dermatillomania in the Brazilian population for comparison.ConclusionThe Skin Picking Impact Scale validated in Brazilian Portuguese is a good instrument to evaluate skin picking disorder. Photographic measurement is a consistent way of assessing skin lesions, but it does not reflect the impact of skin picking disorder on the individual's life.     

Skin self-management of community-dwelling patients with spinal cord injury: A cross-sectional study

Backgroundcommunity-acquired pressure injury is one of the most common and troublesome complications of discharged patients with spinal cord injury. Previous studies have shown that pressure injury can not only increase the financial burden and care burden of patients, but also seriously affect their quality of life.AimTo evaluate the skin self-management of community-dwelling patients with spinal cord injury and to explore the related independent influencing factors.MethodsThis was a cross-sectional survey study. A convenience sample of 110 community-dwelling patients with spinal cord injury recruited from three rehabilitation centers in Guangzhou and Chengdu in China completed the survey from September 2020 to June 2021. They were asked about their demographic data, skin self-management, knowledge about skin self-management, attitude to skin self-management, self-efficacy, and functional independence. Univariate analysis and multiple linear regression were performed to isolate the most important relationships.ResultsThe skin self-management of community-dwelling patients with spinal cord injury was relatively low, and they also performed poorly in the three categories of: skin check, preventing pressure ulcer, and preventing wounds. Skin self-management was found to be most often associated with level of knowledge about skin self-management, higher reimbursement and self-efficacy.ConclusionCommunity-dwelling patients with spinal cord injury with lower level of knowledge about skin self-management, with lower self-efficacy, and those with higher reimbursement have worse skin self-management.     

The effect of pH-compatible cleansing cloths on skin pH and the development of pressure ulcers

AimSkin care plays an important role in the prevention of the development of pressure ulcers. The aim of this study was to determine the effect of skincare with a body pH-compatible cleansing cloth on the development time of pressure ulcers and on skin pH.MethodsThis experimental research was conducted with 156 patients hospitalized in intensive care clinics of a state hospital between September 2019 and 2020. The sample was calculated with a power of 80% and a significance level of 0.05 (α error) and as a result, 78 elderly patients formed the intervention group and another 78 elderly patients made up the control group. Data were collected using the Elderly Information Form, Braden Risk Assessment Scale, Pressure Ulcer Staging Tool and Skin pH Measurement Form. The pre- and post-care skin pH of both groups was measured with a skin pH meter. P < 0.05 was considered statistically significant.ResultsThe average development time for pressure ulcers was 14.9 days in the control group, 18.9 days in the intervention group and the difference was not statistically significant (p > 0.05). Skin pH decreased in the intervention group after the skin care routine was applied, whereas it increased in the control group.ConclusionIt can be said that care of one's skin with a body pH-compatible cleansing cloth has a positive effect on the development time of pressure ulcers and also positively changes the skin pH to acidic.     

Determination of the effect of prophylactic dressing on the prevention of skin injuries associated with personal protective equipments in health care workers during COVID-19 pandemic

AimThe present study was carried out as a comparative observational study in order to determine the effect of prophylactic dressing on the prevention of skin injuries due to the use of personal protective equipment (PPE) in health care workers (HCWs) working with COVID-19 patients. In addition, the effect of nasal strip on the prevention of discomfort in breathing with mask was also investigated.Materials and methodsThe present study was carried out with 48 HCWs (Control Group-CG, n = 20; Experimental Group 1-EG1, n = 20; Experimental Group 2-EG2, n = 8) who use PPE on the face region and work with COVID-19 patients. Data was collected with Data Collection Form developed by researchers. In participants in CG, normal procedures of the institution in using PPE were followed. In EG1, prophylactic dressing was used on risky areas on the face. In EG2, nasal strip sticky on one side was used in addition to prophylactic dressing. The evaluation of the facial skin was made once a day by a researcher with expertise in wound management.ResultsGroups were similar in terms of demographic characteristics of participants. Overall rate of skin injuries associated with PPE use was 47.9%. Skin injuries developed in all participants in CG (n = 20), and in two and one participants in EG1 and EG2 respectively, with significant difference between groups. The most common skin injuries were Stage 1 pressure injury (29.2%), blanchable erythema of intact skin (27.1%) and itching (18.8%). No participant in EG2 reported discomfort in breathing (n = 8). Significant difference was found between groups in favor of EG2 in terms of experiencing discomfort in breathing (p < 0.001).ConclusionsIn the present study, it was established that using prophylactic dressing under PPE prevents skin injuries on the facial skin and using nasal strip prevents discomfort in breathing with mask. In view of these results, it was recommended that prophylactic dressing should be used under PPE.     

In vivo reflectance confocal microscopy: automated diagnostic image analysis of melanocytic skin tumours

Background In vivo reflectance confocal microscopy (RCM) has been shown to be a valuable imaging tool in the diagnosis of melanocytic skin tumours. However, diagnostic image analysis performed by automated systems is to date quite rare. Objectives In this study, we investigated the applicability of an automated image analysis system using a machine learning algorithm on diagnostic discrimination of benign and malignant melanocytic skin tumours in RCM. Methods Overall, 16 269 RCM tumour images were evaluated. Image analysis was based on features of the wavelet transform. A learning set of 6147 images was used to establish a classification tree algorithm and an independent test set of 10 122 images was applied to validate the tree model (grouping method 1). Additionally, randomly generated ‘new’ learning and test sets, tumour images only and different skin layers were evaluated (grouping method 2, 3 and 4). Results The classification tree analysis correctly classified 93.60% of the melanoma and 90.40% of the nevi images of the learning set. When the classification tree was applied to the independent test set 46.71 ± 19.97% (range 7.81–83.87%) of the tumour images in benign melanocytic skin lesions were classified as ‘malignant’, in contrast to 55.68 ± 14.58% (range 30.65–83.59%; t‐test: P < 0.036) in malignant melanocytic skin lesions (grouping method 1). Further investigations could not improve the results significantly (grouping method 2, 3 and 4). Conclusions The automated RCM image analysis procedure holds promise for further investigations. However, to date our system cannot be applied to routine skin tumour screening.     

Treatment of hypertrophic scars and keloids with a fractional CO2 laser: A personal experience

Abstract

Keloids and hypertrophic scars are both abnormal wound responses in predisposed individuals but they differ in that keloids extend beyond the original wound and almost never regress, while hypertrophic scars remain within the original wound and tend to regress. How keloids grow is not totally clear because there is no animal model; in fact, keloids affect only humans. Different injuries can result in keloids, including burns, surgery, ear piercing, lacerations, abrasions, tattooing, vaccinations, injections, insect bites and any process causing skin inflammation (chicken pox, acne, folliculitis, zoster). Skin or wound tension is considered a critical factor in the formation of keloids and hypertrophic scars. This study is based on eight consecutive patients (four females and four males, F:M = 1:1) with a total of 12 keloids. All of whom were treated monthly with a MiXto SX CO₂ laser, using 13 W of power, 8 SX of index and 40% coverage (density) in combination with Same Plast Gel^® twice a day. Each scar required 12 treatments, and all the patients, followed up for 1 year after the last treatment, had optimum results and no recurrence.     

Activation of STING signaling accelerates skin wound healing

BackgroundThe process of repair after skin injury is precisely regulated by a variety of mediators such as cytokines and chemokines. Recent reports demonstrated that cytoplasmic DNA-sensor cyclic GMP-AMP synthase (cGAS) activates the stimulator of interferon genes (STING) via production of cyclic GMP-AMP (cGAMP) and subsequently induces inflammatory cytokines, including type I interferon (IFN).ObjectiveWe examined whether activation of the STING pathway by cGAMP affects the process of skin wound repair.MethodsThe skin wound repair model was established using wild-type (WT) mice. Two full-thickness skin biopsies were taken from the right and left subscapular regions. One site was treated with ointment containing cGAMP, and the other was treated with a control ointment. Changes in wound size over time were calculated using photography.ResultsTreatment with cGAMP significantly accelerated skin wound healing up to day 6. Biochemical analyses showed that topical treatment with cGAMP on wound sites promoted STING signaling pathway and enhanced the expression of IFN-β, CXCL10 and CCL2 in the wound sites treated with cGAMP markedly compared with the control. The scratch assay also revealed that cGAMP treatment accelerated wound closure in mouse embryonic fibroblasts. The acceleration of skin wound repair by cGAMP in WT mouse was impaired by administration of anti-IFNR antibody and anti-CXCR3 antibody respectively.ConclusionThese results revealed that topical treatment with cGAMP accelerates skin wound healing by inducing type I IFN and CXCL10/CXCR3. Topical administration of cGAMP might contribute to new effective treatments for accelerating skin wound healing.     

Thy-1 knockdown retards wound repair in mouse skin

BackgroundThy-1 (CD90) is a glycophosphatidyl-inositol (GPI) linked, cell surface glycoprotein located in non-caveolar lipid raft microdomains.ObjectiveThe biological functions of Thy-1 in many tissues are well known, however, its role in skin wound healing remains unclear.Methods and resultsIn fibroblasts cells, Thy-1 affects cell migration into the wound, cell proliferation and the cytoskeleton structure. Additionally, Thy-1 is mainly expressed in the wound dermis. Here, we compared the in vivo aspects of the repair process with and without Thy-1 siRNA treatment. Temporally blocking Thy-1 in skin wound regions worsens the quality of healing and retards the rate of wound healing. Specifically, the level of TGF-β1 at the wound continuously increased.ConclusionThese data suggest that blocking Thy-1 at wound areas using siRNA reduces repair and affects the re-epithelialization and over-expression of TGF-β1 of the wound during the skin healing process.     

Aplicación de membrana amniótica en el tratamiento de las úlceras crónicas de extremidades inferiores

IntroductionApproximately 1% of the general population have venous or arterial lower limb ulcers. These lesions can be treated with biological skin substitutes such as cadaver skin or tissue-engineered skin equivalents, but treatment fails in 25% of cases, resulting in pain and loss of patient autonomy, as well as increased morbidity and health care costs. In the treatment of corneal ulcers, amniotic membrane has been shown to have antimicrobial and bacteriostatic properties, and to protect the wound without eliciting an immune response. The same properties have been reported in the treatment of burns and postthrombotic ulcers.ObjectivesTo assess the effectiveness of amniotic membrane transplantation in the treatment of refractory chronic leg ulcers.Patients and methodsAmniotic membrane was grafted onto 4 refractory ulcers in 3 patients. The mean time required for partial and complete re-epithelialization was calculated by measuring the wound area at weeks 0, 4, 8, 12, and 16. Pain intensity was assessed at the same intervals using a visual analog scale.ResultsComplete wound re-epithelialization was achieved for 1 ulcer by week 8; in the other 3 cases, there was a 50% reduction in size compared to baseline. At week 16, the mean reduction in wound size for the 4 ulcers was 81.93%. The corresponding reduction in pain intensity was 86.6%. No adverse effects were observed.ConclusionsAmniotic membrane transplantation might be an effective alternative for the treatment of refractory chronic vascular ulcers on the lower limbs.     

“Doctor,how long will it take?” Results from an historical cohort on surgical pressure ulcer healing delay and related factors in persons with spinal cord injury

BackgroundFlap surgery for deep pelvic pressure ulcers has already shown its effectiveness. Most studies relating to the postoperative period assessed complications rates and associated risk factors, but none focused on delayed wound healing. The objective of this study was to describe wound healing delay after primary flap surgery in patients with spinal cord injury (SCI) and to assess associated risk factors.MethodsThis observational retrospective study based on medical charts included all persons with SCI operated for primary flap surgery for pelvic PU in the Hérault department of France between 2006 and 2014. Overall, 100 biomedical, psychological, socioeconomics and care management factors were studied. The primary outcome was wound healing delay, defined as time from surgery to complete cutaneous closure.Results85 patients were included. Median healing time was 48 days (R: 20–406). Healing rate was 70% at 3 months and 90% at 4 months. After a multivariate analysis three factors were significantly associated with delayed wound healing: duration of hospitalization in the acute care unit (HR = 2.68; p = 0.004), local post-operative complication (HR = 10.75; p = 0.02), and post-operative sepsis (HR = 2.18; p = 0.02).ConclusionAfter primary skin flap surgery for PU in persons with SCI, delayed wound healing is related to local or general complications as well as care management organization. The risk of delayed wound healing justifies the implementation of a coordinated pre-operative management to prevent complications and a structured care network for an earlier transfer to a SCI rehabilitation center.     

Laser-Assisted Skin Healing (LASH) in hypertrophic scar revision

Abstract

Laser-Assisted Skin Healing (LASH) is based on the therapeutic effects of controlled thermal post-conditioning. The authors have previously demonstrated on humans that an 810-nm diode-laser system could assist wound closure leading to an improvement of wound healing with a resulting indiscernible scar. A 47-year-old woman (skin type II), who developed systematically hypertrophic scars after surgery, was enrolled for a hypertrophic scar revision. Excess scar tissue was removed. Immediately after the conventional closure of the incision, laser irradiation (120 J/cm²) using a 0.8 cm² spot size (rectangular spot, length = 20 mm, width = 4 mm) was applied. Topical silicone gel sheeting (Cerederm®) was applied for 2 months afterwards to prevent a thick scar from reforming. No complications occurred during the course of this study. No recurrence of hypertrophic scarring was noticed 6 months after scar revision. This study reports, for the first time, the possibility of improving the appearance of hypertrophic scarring in scar revision by altering through thermal stress the wound-healing process. Since the appropriate initial management of wounds is of importance, the LASH technique could be offered as a new approach to prevent hypertrophic scarring.