The results of therapeutic and prophylactic measures in three groups of patients were studied: in subgroup A (n = 40, main group), surgical excision was performed followed by the introduction of diprospanone into the subcutaneous zone and the use of the silicone patch and compression therapy application; in subgroup B (n = 53), the infiltration of the scar was performed with a solution of corticosteroid and lidocaine along with "Mepiform" (Sweden) silicone patch and compression therapy application. In a control group (n = 45), the only excision was performed without the prevention of the defective scar recurrence. By usage of ultrasonic dermascanning in dynamics, the size, volume and acoustic scan density were measured. Acoustic density measurements of the dermis was carried out in the area of the scar location; as a control, there was measured acoustic density of the dermis on a healthy contralateral area of the skin. For the scars less than 3 mm in width (ultrasonographic evaluation), a conservative therapy was used (patients of subgroup B). Control ultrasound examinations were carried out 3-5 days before and in 1, 3 and 6 months after the stitches were removed or diprospan was injected. There was carried out the morphological and immunohistochemical study of the removed scars. Due to the combined use of glucocorticoids, compression bandages and silicone patches, in the first study group, there was achieved a decrease in collagenogenesis, capillary degeneration and, consequently, prevention of the defective scar recurrence. In 6 months, the normotrophic scars were observed in 62.5 %, hypotrophic - in 32.5 % patients of the main group subgroup A and in subgroup B - in 67.9 % and 22.6 % patients, respectively. However, in the control group, keloid scars were detected in 40 % of cases, hypertrophic - in 44.5 % after 1 month and in 51.1 % and 44.5 %, respectively, in 6 months. The obtained data confirms that surgical excision, as an additional mechanical trauma, does not provide an ideal solution for the elimination of defective scar, only a combined curative and preventive measures should be applied.
