Extramarginal excision is preferable for hypertrophic scars

Area of Science:

• Dermatology
• Plastic Surgery
• Wound Healing

Background:

• Peripheral keloids show increased fibroblast proliferation and collagen production.
• Hypothesis: Incomplete removal of active fibroblasts at scar margins leads to high recurrence rates.
• Investigating surgical margins' impact on hypertrophic scar and keloid recurrence.

Purpose of the Study:

• Evaluate the influence of surgical margins on hypertrophic scar recurrence.
• Compare recurrence rates between intramarginal and extramarginal excision.

Main Methods:

• Retrospective review of 15 patients with car tire injury-induced hypertrophic scars (2004-2010).
• Patients divided into intramarginal excision and extramarginal excision groups.
• Comparison of recurrence rates between the two surgical margin groups.

Main Results:

• Intramarginal excision group had a significantly higher recurrence rate.
• All intramarginal excision patients recurred within six months.
• Extramarginal excision (3-5 mm margin) showed a lower recurrence rate (2 out of 9 patients).

Conclusions:

• Extramarginal excision effectively removes abnormal collagen bundles.
• This technique is a viable alternative for foot reconstruction post-scar excision.
• Extramarginal excision significantly decreases hypertrophic scar and keloid recurrence.