Which of the following are accepted adjuncts in the management of hypertrophic scar?

a. Local steroid injection

b. Compression garments

c. Topical silicone

d. Release or excision with autografting

Hypertrophic scar formation is a major source of long-term morbidity after burns. All healed and grafted burns become hypervascular shortly after successful epithelialization. Wounds destined to become hypertrophic develop a second surge of neovascularization between 9 and 13 weeks. Wounds that are most commonly associated with hypertrophy are deep dermal burns that heal in three or more weeks and full thickness wounds that heal by contraction and epithelial spread from wound edges. Current tools used in the prevention of hypertrophic scars include compression garments, topical silicone sheets, steroid injections, and release or excision and autografting.