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Updated: Jan 11, 2026

Visualizing Scar Development Using SCAD Assay - An Ex-situ Skin Scarring Assay
Published on: April 28, 2022
Longitudinal Assessment of Facial Scars after Acellular Dermal Matrix Grafting following Skin Cancer Resection: Focus
Kyu-Il Lee1, Won-Seok Song2, Seung-Kyu Han2
1From the Department of Plastic Surgery, Taean Public Health Office.
Background:
Skin cancer commonly affects the face, presenting significant reconstructive challenges, particularly for older patients, who may benefit from minimally invasive techniques. The authors' team used acellular dermal matrix (ADM), as this technique provides a relatively simple alternative that reduces the complexity associated with autologous graft surgery. The objective of this study was to assess changes in color matching and the extent of scar contraction over time with this method.
Methods:
This retrospective study assessed 153 ADM grafts applied after skin cancer resection on the face. The authors quantified color disparity between the scar and adjacent skin using dE2000 scores and evaluated scar contraction by measuring scar areas. The severity of distortion of nearby anatomical landmarks was categorized into 3 grades (0 to 2). The authors tracked changes in these 3 measures immediately after wound healing and at 3, 6, and 12 months after healing.
Results:
The dE2000 scores immediately after healing and at 3, 6, and 12 months were 17.6 ± 0.5, 14.3 ± 0.5, 10.6 ± 0.4, and 6.2 ± 0.3, respectively ( P < 0.01). According to reference standards, the 12-month score was deemed "very good." Scar contraction increased from 50.5% ± 1.2% immediately after healing to 57.0% ± 1.3% at 3 months, then decreased to 19.8% ± 1.1% at 12 months ( P < 0.01). Average landmark distortion grades declined from an initial 0.76 ± 0.06 to 0.33 ± 0.05 at 12 months ( P < 0.01).
Conclusion:
Scars following ADM grafting initially exhibit suboptimal results; however, marked improvements are evident by 12 months after healing.
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