Optimizing Postsurgical Scars: A Systematic Review on Best Practices in Preventative Scar Management.

Area of Science:

• Plastic Surgery
• Dermatology
• Evidence-Based Medicine

Background:

• Scar management is vital for plastic surgery outcomes and patient satisfaction.
• A comprehensive analysis of recent literature on scar care algorithms is lacking.
• This study systematically reviews preventative scar management best practices.

Purpose of the Study:

• To conduct a systematic review of the literature on scar management.
• To identify the highest level of evidence for scar care practices.
• To develop a clinical algorithm for scar prophylaxis.

Main Methods:

• A computerized MEDLINE search was performed for scar management studies.
• Publications were screened for randomized clinical trials.
• Inclusion/exclusion criteria were applied to select relevant articles.

Main Results:

• The systematic review was conducted in May 2016.
• An initial search yielded 13,101 articles; 12 relevant articles were selected.
• All included studies were randomized, controlled clinical trials.

Conclusions:

• Optimal scar care depends on incisional tension, anatomical location, and Fitzpatrick skin type.
• A streamlined algorithm for scar prophylaxis is presented.
• The algorithm is based on contemporary level I and II evidence to guide clinical practice.