Delayed wound closure and scar revision

Delayed closure is an underutilized technique that can produce a good cosmetic result in lower leg wounds and can significantly shorten the healing time. To be successful, the surgeon should be able to utilize tension-relieving techniques and manage dead space. Scar revision should be limited to simple elliptical excision or modifications thereof until experience is developed. Sliding skin flaps, Z-plasties, and W-plasties are used infrequently and require adequate preoperative planning.