Scar therapy after injury: what aesthetic medicine can do

Since 2014, it has become commonplace for Ukrainian doctors to treat combat wounds and bring military personnel back to life. But quite often, treated injuries leave behind scars that cause discomfort and pain. And at this stage of rehabilitation, aesthetic medicine, which has effective methods of scar treatment, can help and improve the quality of life. Naturally, this area of ​​treatment, given the huge number of both military and civilians with penetrating wounds and burns, has developed.

One of the «engines» of development, which already has enormous experience in the treatment of scars and burns, is the volunteer project «Unburnt». Thanks to him, Ukrainians who received similar injuries as a result of the war can receive free medical care in more than three dozen Ukrainian clinics participating in the project.

«The idea of ​​the «Unburnt» arose as soon as a full-scale war began, and work on the project itself began in August-September 2022, — says Maxim Turkevych, manager, director of the «Unburnt» rehabilitation program. — We started with 8 clinics, and now 32 clinics treat post-traumatic scars free of charge. There are established protocols distributed among all clinics. There is also a medical commission that expertly accompanies each case. Members of the medical commission directly advise specialists participating in the Burning Ones. In the future, internal training is planned for clinics participating in the project; we are working on their format. There are currently about 150 patients undergoing treatment, 60% of whom are veterans. The most complex injuries are usually burns, but they depend on each individual case.»

All doctors participating in the project are highly qualified, experienced specialists with many years of experience working with scars and burns, who are based on the principles of evidence-based medicine in providing assistance. Based on their findings, they created «Recommendations for the treatment of post-combat burns and scars: Ukrainian national consensus.»

«Consensus is the result of the work of the «Unburnt» team of doctors and their experience, — says Alexander Turkevych, Ph.D., dermatovenerologist, oncologist, associate professor of the department of dermatology and venereology at Lviv National Medical University. D. Galitsky, professor of dermatovenerology at the University of Rome. J. Marconi. — This is applied practical assistance to all Ukrainian doctors who will be faced with the problems of burns and scars for a long time on how to treat correctly. This is the most practical document that can be, because it shows the logic of therapy, recommendations and approaches to treating patients with combined post-combat trauma.»

«The Сonsensus was formed from the cases of patients who were treated by the Burning Ones. Consensus is both a case study and the combined experience of a huge number of specialists, and as a result, patient treatment protocols», — sums up Maxim Turkevych.

Let's consider the use of the developments of «Unburnt» using the example of one of the cases.

Patient Alexander Chaika, 34 years old, is undergoing post-traumatic rehabilitation after being wounded at the So Beauty laser hair removal and cosmetology clinic in Kyiv.

In 2022, at the very beginning of a full-scale war, Alexander went to the Territorial fulfillment center. He was drafted into the ranks of the military and given the position of rigger — before that he had never held a weapon in his hands, except perhaps a sports bow. But I had to quickly master military affairs, because I almost immediately got to zero.

«The shell hit me right, — says Alexander. — There were terrible wounds on my right leg. The piece of debris severely cut his buttock, the wound was such that two fists could be shoved into it. The doctors couldn’t even stitch the edges of the wound right away. And when this was later successful, the intact skin was stretched so much that keloid scars formed.»

Alexander underwent treatment in Ukraine, and in September of the same 2022 he went to the USA for prosthetics. The scar at the site of the wound was pressed in by the prosthesis and a very strong pain was felt, from which the man almost fell. But, despite the pain, he took his first steps on the prosthesis in the first week, which greatly surprised the doctors. And his sports training contributed to this — from a young age the guy was involved in parkour, martial arts and athletics.

*Full version of the access article in Ukrainian and Russian