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The fate of sternotomy scars in children
1Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Sternal split incision scars in children were evaluated. Factors like suture type, sex, and age influenced scar quality, with most hypertrophic scars improving over time.
Area of Science:
- Pediatric Surgery
- Cardiology
- Dermatology
Background:
- Sternal split incisions are common in pediatric cardiac surgery.
- Scar quality can significantly impact patient satisfaction and body image.
- Understanding factors influencing scar outcomes is crucial for surgical practice.
Purpose of the Study:
- To assess the quality of sternal split incision scars in children one year post-surgery.
- To identify factors correlating with scar quality.
- To evaluate the long-term evolution of hypertrophic scars.
Main Methods:
- Retrospective analysis of 101 children's sternal scars at least one year after cardiac surgery.
- Scar rating scale: excellent, good, acceptable, or poor.
- Analysis of potential correlating factors: suture material, patient sex, age at operation, and initial scar appearance.
Main Results:
- Poor scar quality was associated with intracuticular polyglycolic acid suture closure.
- Male patients tended to have better scar outcomes than females.
- Younger age at operation correlated with improved scar results.
- Of 69 initially hypertrophic scars, only 18 remained so after a 5.5-year follow-up.
Conclusions:
- Suture type, patient sex, and age at operation are significant factors in pediatric sternal scar quality.
- Most hypertrophic scars show significant improvement over time, suggesting favorable long-term healing.
- Optimizing surgical closure techniques may enhance aesthetic outcomes for pediatric cardiac surgery scars.
Abstract:
The scars from sternal split incisions were examined and rated in 101 consecutive children attending a cardiology clinic at least 1 year after surgery. Each scar was rated as excellent, good, acceptable, or poor. Factors that may correlate with scar quality were analyzed. This analysis showed that poor scars were most likely to have been closed with intracuticular polyglycolic acid suture; males were more likely to have better scars than females; the younger the child at operation, the better was the scar result; and only 18 of the 69 scars that were hypertrophic 1 year postoperatively remained so after a mean of 5.5 years.