Revision of a Widened Scar Using Dermal Splinting Technique

Abstract

Background Scar revision is a fundamental technique in the field of plastic and reconstructive surgery. Methods using local flaps, such as a Z-plasty, W-plasty, or geometric broken-line closure, have been used for scar revision. Widening of scars is a frustrating event that most plastic surgeons have encountered. Several therapeutic modalities have been proposed, but frequently, the result is disappointing. We describe our experience with the use of a dermal splinting technique for scar revision. Methods We propose a technique by which tension on the wound is applied by tough scar tissue instead of the suture line, thereby reducing the incidence of postoperative widening. This technique was used to treat 21 nonburn scars that had widened:5 scars were facial (3 patients), 8 were on the extremities (6 patients), and 8 were on the torso (5 patients). All scars were at least 4 months old. The operations were perform ed between January 2003 and December 2012; follow-up was 9 to 24 months. Results Only one scar widened during the follow-up period. Overall, satisfaction with scar appearance and surgery was assessed with a visual analog scale (VAS). Mean patient satisfaction was 8.1 ± 0.5. Conclusions We recommend this technique in dealing with widened scars in highly tensile areas during revision surgery.

Comparison of the effect of silicone gel sheets by thickness on excisional scars in pediatric and adolescent patients

“…However, due to the lack of a reliable scar assessment tool, uneven patient compliance, and difficulty in obtaining consent from caregivers in pediatric and adolescent patients, the study of these groups has been limited, except for a few studies on scars following cleft lip surgery or burn injury [3].Various surgical techniques are used to reduce the widening of scars. These range from commonly used methods, such as Z-plasty or local flaps, to new techniques, such as the dermal splinting technique, in which the dermal structure of the scar is subjected to tension [4]. Laser treatments are also very prevalent after surgical excision.…”

“…Various surgical techniques are used to reduce the widening of scars. These range from commonly used methods, such as Z-plasty or local flaps, to new techniques, such as the dermal splinting technique, in which the dermal structure of the scar is subjected to tension [4]. Laser treatments are also very prevalent after surgical excision.…”