Alternative techniques for reduction of scar length during staged excision

Area of Science:

• Dermatology
• Surgical Oncology
• Plastic Surgery

Background:

• Staged excision is a standard technique for removing cutaneous lesions, minimizing functional loss and patient debilitation.
• Conventional staged excision yields shorter scars compared to traditional elliptical excision (3:1 ratio).

Purpose of the Study:

• To introduce and describe alternative staged excision techniques for further scar length reduction.
• To identify modifications that shorten the final scar without increasing the number of surgical stages.

Main Methods:

• Geometric simulations were employed to analyze variants of conventional staged excision.
• The study focused on methods to shorten the scar's long axis while maintaining the same number of excision stages.

Main Results:

• Three distinct techniques demonstrated the potential to shorten final scar length.
• These include the 'doughnut' method, central excision with purse-string closure, and the compressed design method.
• Each technique involves specific geometric modifications and suturing strategies to abbreviate the scar.

Conclusions:

• The described modified staged excision techniques offer further reduction in final scar length.
• These novel approaches require additional clinical validation based on initial testing in a small cohort.