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

Abstract

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.

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

“…Various techniques have been described, in which the scar is used for augmentation without being excised. 2,3,11 The basic principle in these techniques is to shape the subcutaneous tissue within itself without excision. Preserving the tissue reduces the risk of depression.…”

“…1 Tethered scars result from adhesion of the dermis to subcutaneous tissues such as fascia, muscle, and periosteum. 2,3 Tethered scars are difficult to evaluate and manage due to epidermal thinning accompanied by subcutaneous contractures. This problem usually occurs for the following reasons: technical failures that occur during suturing; fat atrophy; inflammatory diseases such as acne; post-traumatic wounds; tension at the wound edges, and post-surgery.…”

Hybrid double‐dermal flap technique for vest‐over‐pants‐closure correction of depressed abdominal scars

“…Correcting these deformed scars is challenging. To reduce and prevent the recurrence of the depressing force, a de‐epithelised dermal layer of skin is created between the scar and the abdominal fascia to prevent adhesion and augment the depressed scar 13,14 . This article describes a novel technique for repairing depressed abdominal scars using hybrid double‐dermal flaps.…”