Optimal Elective Scalp Incision Design

Abstract

Scalp incisions of an elective nature are commonly used as an approach in upper cranial maxillofacial surgery. Similarly, isolated linear parietal incisions are occasionally used to harvest outer table calvarial bone grafts. Although morbidity from these incisions is generally minimal, there is a tendency, particularly when a scar is widened, for it to be more visible if it is of a linear nature. In this review we will present our results with 16 consecutive patients in which a geometric pattern incision was used instead of a straight incision in hopes of improving the ultimate appearance of this scar. We have found that, in general, incisions made in a geometric fashion are less noticeable than traditional linear elective scalp incisions. This is particularly true when there was widening of the scar.

Minimizing complications associated with coronal approach by application of various modifications in surgical technique for treating facial trauma: A prospective study

“…[20] and Marschall et al . [3] have all reported excellent access to the upper midfacial skeleton,[710] Lefort III fracture,[7] supraorbital margin,[7] frontonasal suture,[21] nasoethmoidal suture, lateral orbital region,[8] zygomatic complex fracture,[18] zygomatic arch, and TMJ[9] by the coronal surgical incision. The finding of our study correlates with the above findings, with excellent access.…”

“…[4] reported that it is the widely accepted approach for the reduction of upper and middle facial fractures along with reconstruction of this area because of its direct accessibility to the fractured site. [37101526]…”

“…It is esthetically also excellent because most of the surgical scar is hidden within the hairline; even if the incision is extended into the preauricular region, it was not clearly visible. [34722123242526] The duration of postoperative hospitalization, which was to be considered as disadvantage was evaluated. Instead of giving multiple incisions for exposing the fracture site in the upper and middle third region of the face which will cause an esthetically unpleasant appearance with minimal hospitalization, a single incision with hidden scar with mild extended postoperative hospitalization is better.…”

“…Hemostatic clips (Raney's) were avoided in our study to minimize hair loss. [7] The flap is raised to gain exposure of the fractured site. If supraorbital margins had to be exposed neurovascular bundles were released from the supraorbital notch/foramen and reflected along with the flap.…”

The Coronal Incision

“…The straight-line incision used in the traditional coronal approach may leave a noticeable straightline scar; this may be especially obvious with the hair parted away from the inci-sion or when the hair becomes wet. 6,7 To help alleviate this problem, Munro and Fearon 6 introduced a modification they called the stealth incision. The stealth incision is a zigzag incision line that helps camouflage the coronal scar.…”