Clinical Applications of Basic Research that Shows Reducing Skin Tension Could Prevent and Treat Abnormal Scarring: The Importance of Fascial/Subcutaneous Tensile Reduction Sutures and Flap Surgery for Keloid and Hypertrophic Scar Reconstruction

Double Layer Continuous Intradermal Sutures in Keloid Operation

“…They used skin adhesive and buried running sutures in epidermal layer closure to prevent suture marks after subdermal and dermal suture which keep the wound edge elevated. In Ogawa,s report, they emphasized the importance of subcutaneous/fascia tensile reduction suture [4]. They usually put some sutures in deep fascia layer.…”

“…Surgical methods especially wound closure methods are very important in recurrence prevention. Many suture methods were reported in literature Cosmetic result is another issue to be considered in keloid treatment [4]. Cosmetic outcome is as important as recurrence prevention.…”

Keloids and Hypertrophic Scars Can Now Be Cured Completely: Recent Progress in Our Understanding of the Pathogenesis of Keloids and Hypertrophic Scars and the Most Promising Current Therapeutic Strategy

“…The usefulness of subcutaneous/fascial tensile reduction sutures reflects the fact that keloids and hypertrophic scars arise from the dermis 12 . Dermal sutures do not effectively reduce tension on the dermis: to achieve this, we must access much deeper structures, namely, the superficial and deep fascia, and suture them.…”

Optimization of treatment and prevention of scars

“…Применялись подкожные фасциальные швы [51,91,100], при которых натяжение имелось на слоях глубокой и поверхностной фасции вместо дермы. Это сводило к минимуму исполь-зование кожных швов.…”

“…В связи с этим, по утверждению автора, оптимальным является метод Conway (иссечение келоида с частичным сохранением его узкого края по пе-риферии) или свободная кожная пластика. Некоторые ав-торы придерживались такого же мнения [65,91], считая, что при обширных келоидах можно иссекать только цен-тральную их часть.…”