[Scar treatment after surgery - evidence and recommendations. A systematic review]

Postoperative scars may lead to both functional and aesthetic impairments and represent a significant challenge, particularly in predisposed patients. The demand for evidence-based scar management is therefore of clinical and patient centered importance. The aim of this study is to provide a comprehensive overview of the literature on scar treatment after surgical procedures, as well as to present the corresponding recommendations and their evidence.

A systematic literature search on the topic of postoperative scar treatment was conducted in the PubMed and Cochrane Library databases, including all publications up to September 2024. Studies that focused exclusively on conservative treatment methods for postoperative scars and that were written in English or German, were included.

From 252 results, ultimately, 20 studies were included in the synthesis of results. Most of the included studies focused on the use of silicone-based treatments und laser therapy, indicating a particularly high level of evidence for these treatment modalities. All methods used for postoperative scar treatment led to a significant improvement in scar appearance. However, costs varied, and all methods required multiple sessions, extending over a period of weeks to months.

While more complex procedures such as laser therapy or local injection are primarily reserved for specialized centers, topical treatments with silicone preparations or onion extract are particularly suitable for general practitioner or surgical practice due to their good tolerability and ease of use. Studies indicate that longer-term treatment is necessary to significantly improve the scar appearance. Appropriate information for patients is required.