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Scar modification. Techniques for revision and camouflage.

B B Horswell1

  • 1Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, Maryland, USA.

Atlas of the Oral and Maxillofacial Surgery Clinics of North America
|March 22, 2002
PubMed
Summary

Scar revision is a complex, year-long process involving skin preparation, surgical skill, and diligent wound care. Patient factors and compliance are crucial for optimal scar management outcomes.

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Area of Science:

  • Dermatology
  • Plastic Surgery
  • Wound Healing

Background:

  • Scar management is a lengthy, multi-stage process requiring up to a year to complete.
  • Patient preparation, skin health, and adherence to post-operative care significantly influence scar revision results.
  • Keloid and burn contracture scars present unique challenges due to their distinct morphophysiologic characteristics.

Purpose of the Study:

  • To outline the comprehensive, staged approach to surgical scar revision.
  • To emphasize the critical role of patient preparation and compliance in achieving successful scar outcomes.
  • To discuss advanced techniques and management strategies for challenging scars like keloids and burn contractures.

Main Methods:

  • A staged management protocol including skin preparation, scar softening (steroids, massage, pressure), surgical execution, and postoperative wound care.

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  • Utilizing new grafting techniques, such as cultured autodermal grafts, for initial burn wound management.
  • Employing steroid injections, pressure treatment, meticulous surgery, and extended wound support for keloid and hypertrophic scars.

    • Main Results:

    • The scar revision process is protracted, typically spanning one year, with results often being a compromise.
    • Optimal patient preparation and adherence to prescribed wound care are paramount for effective scar revision.
    • Advanced techniques like cultured autodermal grafts can improve initial burn management, potentially optimizing subsequent scar revision.

    Conclusions:

    • Successful scar revision necessitates a comprehensive, year-long, staged approach.
    • Patient-centric factors, including preparation and compliance, are essential for optimizing scar management outcomes.
    • Specialized treatments are required for challenging scars, with new techniques offering improved management possibilities.