A New Technique for Correction of Tethered and Depressed Scars: Layered Dermal Support

Ceran, Candemir; Akşam, Ersin; Çiçek, Çağla; Tezcan, Soner; Demirseren, Mustafa Erol

doi:10.1007/s00266-016-0672-3

Cited by 5 publications

(11 citation statements)

References 10 publications

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“…8 Ceran et al described a layered dermal support in 21 depressed scars. 9 The deep parts of the dermal layers are stitched to each other in a vertical manner and not in a tubing technique to maintain a strong derma support. However, minor hypertrophic scarring was noticed in some patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, minor hypertrophic scarring was noticed in some patients. 9 The technique of using a bilateral de-epithelised hinge flap was described by Hwang et al 10 The technique involves de-epithelising the scar in an oval shape and then dissecting both ends from the underlying tissues, leaving the central third attached to the bed. Both dermal fat ends are folded as a hinge on each other and sutured in the middle.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Some surgeons approach the problem by de-epithelialising the depressed scarry area and building up of the missing tissue by local flaps. [8][9][10] We evaluate the aesthetic outcome of using double vest lipodermal flaps for treating depressed facial scars.…”

Section: Introductionmentioning

confidence: 99%

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Double vest lipodermal flaps for depressed facial scars

Qassim

Amini

Alfeehan

et al. 2020

annals

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Introduction Depressed tethered scar is a common problem that can cause emotional, social and behavioural problems, especially when it involves the exposed body parts. Several techniques have been described for treating these depressed scars, but none of these can fulfil the optimal results. Aim Evaluating the aesthetic outcome of using a double vest lipodermal flaps for treating depressed facial scars. Materials and methods The study included 25 patients with depressed facial scars who underwent scar revision. Their mean age was 31 years. Under local anaesthesia, the scarred area was de-epithelialised and double dart lipodermal flaps were used for revision. Visual analogue and Vancouver scar scales were used as subjective and objective parameters of evaluation, respectively. Results All the patients followed up for five to eight months. No complications were observed during the scar healing period. Patients satisfaction according to the visual analogue scale showed an average value of 8. The mean total scale according to the Vancouver scar scale was 2.6. Conclusion The new technique of using double vest lipodermal flaps is simple and offers a promising alternative for revising depressed scars.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Double vest lipodermal flaps for depressed facial scars

Qassim

Amini

Alfeehan

et al. 2020

annals

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“…When surgical revision is chosen, three-dimensional tissue rearrangement is needed [14][15][16][17]. In reports of many other surgical methods, it was stated that the scar tissue was not discarded, and that de-epithelialized scar tissue was utilized for volume replacement [11,18,19]. However, many patients present with combined scar problems.…”

Section: Discussionmentioning

confidence: 99%

Scar dermal transposition flap for depressed scars: A valuable technique for depressed scar management

Kim

Kwon

Moon

et al. 2019

Arch Aesthetic Plast Surg

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Scar formation is a natural, physiological response to the healing of damaged tissue. However, abnormal or disturbed collagen synthesis can cause skin texture irregularities, such as depression. Scar treatments should improve both functional and aesthetic aspects of the scarred area to optimize patient satisfaction. Plastic surgeons use surgical, nonsurgical, and multimodal strategies to treat scars, which begin with an accurate understanding of the characteristics of the scar, as well as the patient's needs. Depressed scars may occur when the injured tissue is replaced by scar tissue, which causes adhesion and tethering between the overlying skin and the underlying tissues, such as muscle or fascia. The main technique used to resolve depressed scars is to disrupt the connection between the skin and underlying tissue and to prevent re-adhesion [1,2]. However, many patients present with combined scar problems. In such cases, making an additional skin incision over a depression site is considered to be uneconomical. Therefore, we used de-epithelialized scar tissue of the widened scar portion as a transposition flap to fill under the depressed area for volume augmentation and to prevent re-adhesion.

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“…Several treatment techniques have been defined such as filler injection, augmentation with de-epithelialized dermal tissues, reconstruction with expander and local, and distant flaps. [3][4][5] The most important disadvantages of these techniques are the lengthening of the scar due to recurrence. Complicated procedures should be performed for the facial area because of the increased aesthetic importance.…”

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confidence: 99%

A Novel Method for Correction of the Tethered and Contracted Facial Scars: The Three-Dimensional Subcutaneous Z-Plasty

Demir

Yaşar²,

Alagöz³

2021

Journal of Craniofacial Surgery

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Objective: Scar revision is 1 of the basic surgery in the field of plastic and reconstructive surgery. The classic treatment of the scar is excision scarless tissue, wide undermining and suture by planes. This method has had unsatisfying results on contracted and tethered scars. The aim of this study is to present the threedimensional subcutaneous z-plasty technique for correction of tethered facial scars without scar lengthening. Materials and Methods: Twenty tethered scars were corrected using this technique. All scars were located on the face. Objectively, the final result was evaluated by using the Stony Brook Scar Evaluation Scale. Subjectively, patients' overall satisfaction was assessed 1 year after the surgical operation. In addition, the information on the age, gender, etiology, scar location, scar length, type of anesthesia, and follow-up period were examined. Results: This procedure was used in nineteen patients (8 males and eleven females). The mean follow-up period was 15.3 months. There was a mean increase of 2.85 points increase in the Stony Brook Scar Evaluation Scale value. The overall success rates for the procedure, as assessed by the patients, were: very satisfied in 12 patients, satisfied in 5 patients, and slightly satisfied in 2 patients. One patient had minimal wound dehiscence. No complications including hypertrophic scar, infection, hematoma, and suture reaction were observed in any patients. Conclusions: The three-dimensional subcutaneous z-plasty technique is a procedure that uses only basic plastic surgery principles. It offers a good solution for the correction of tethered and contracted scars without recurrence. This technique combines the advantages of elliptical excision and z-plasty by enabling the augmentation of the depressed area without extending the scar length.

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A New Technique for Correction of Tethered and Depressed Scars: Layered Dermal Support

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 5 publications

References 10 publications

Double vest lipodermal flaps for depressed facial scars

Double vest lipodermal flaps for depressed facial scars

Scar dermal transposition flap for depressed scars: A valuable technique for depressed scar management

A Novel Method for Correction of the Tethered and Contracted Facial Scars: The Three-Dimensional Subcutaneous Z-Plasty

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