Small-Wave Incision Method for Linear Hypertrophic Scar Reconstruction: A Parallel-Group Randomized Controlled Study

Huang, Chenyu; Ono, Shimpei; Hyakusoku, Hiko; Ogawa, Rei

doi:10.1007/s00266-011-9821-x

Cited by 17 publications

(18 citation statements)

References 15 publications

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“…These include methods that are directly based on the mechanics theory. These tension-reduction or shielding methods aim to prevent the development of scars and include the use of z-plasties, w-plasties, and small-wave incision design, 56 local flaps to cover the wound, subcutaneous/fascial sutures, 57 and silicon sheeting. 58 Similarly, another approach, the application of snake oil in traditional African medicine, is a nutrition-based therapy that seems to have some efficacy.…”

Section: Current Clinical Therapies For Pathological Scarringmentioning

confidence: 99%

Keloids and Hypertrophic Scars

Huang

Murphy

Akaishi

et al. 2013

Plastic and Reconstructive Surgery Global Open

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122

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Summary:The development of cutaneous pathological scars, namely, hypertrophic scars (HSs) and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated. The generally held concepts that keloids and HSs represent “aberrant wound healing” or that they are “characterized by hyalinized collagen bundles” have done little to promote their accurate clinicopathological classification or to stimulate research into the specific causes of these scars and effective preventative therapies. To overcome this barrier, we review here the most recent findings regarding the pathology and pathogenesis of keloids and HSs. The aberrations of HSs and keloids in terms of the inflammation, proliferation, and remodeling phases of the wound healing process are described. In particular, the significant roles that the extracellular matrix and the epidermal and dermal layers of skin play in scar pathogenesis are examined. Finally, the current hypotheses of pathological scar etiology that should be tested by basic and clinical investigators are detailed. Therapies that have been found to be effective are described, including several that evolved directly from the aforementioned etiology hypotheses. A better understanding of pathological scar etiology and manifestations will improve the clinical and histopathological classification and treatment of these important lesions.

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Section: Current Clinical Therapies For Pathological Scarringmentioning

confidence: 99%

Keloids and Hypertrophic Scars

Huang

Murphy

Akaishi

et al. 2013

Plastic and Reconstructive Surgery Global Open

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122

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“…First, no additional incision or excision of normal skin is required, thereby avoiding additional scarring and keloid recurrence. 6 Second, aesthetic results are good, and noticeable long and zigzag-shaped scars can be avoided. 6 In future studies, we plan to evaluate patient satisfaction using the visual analog scale and so on.…”

Section: Discussionmentioning

confidence: 99%

“…Z-plasty and W-plasty also result in noticeably long zigzag-shaped scars, and there is also a risk of additional scarring and keloid recurrence. 1,6 This dilemma motivated us to invent a new surgical procedure by including the best of everything.…”

Section: Introductionmentioning

confidence: 99%

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S-shaped Wound Closure Technique for Dumbbell-shaped Keloids

Komatsu

Azumi

Hayashi

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Summary:Dog-ear collection, Z-plasty, and W-plasty are often performed for excision of dumbbell-shaped keloids; however, these procedures require additional incisions or excision of normal skin. Thus, an S-shaped wound closure technique was performed. The keloid lesions were extralesionally excised above the deep fascia, and the wound edges were shifted in opposite directions along the major axis to form an S-shape. The incision was closed by applying deep fascial sutures, subcutaneous sutures, and superficial sutures. Postoperative external beam radiation therapy was started within 6 hours after surgery at a dose of 20 Gy applied in 4 fractions. All wounds were covered with silicone-gel sheeting and fixed with tape after suture removal. No intralesional corticosteroid injection or oral tranilast was administered. Corticosteroid tape was applied in cases with suspected postoperative recurrence. Scoring was performed using the Manchester Scar Scale. A total of 8 lesions were treated. Temporary erythema and scar elevation were observed in 2 chest lesions; however, both were flattened and turned white using corticosteroid tape. Other than these 2 lesions, there was no recurrence or complication. The mean score improved from 15.8 to 7.2. The S-shaped wound closure technique has 3 advantages. First, no additional incision or excision is required, and additional scarring and keloid recurrence can be avoided. Second, aesthetic results are good, and noticeably long and zigzag-shaped scars can be avoided. Third, dispersion of tension on the scar can be expected. Although the S-shaped wound closure technique has limited application, it is a useful option for keloid treatment.

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“…If a scar is subjected to a considerable amount of tension, a tension releasing technique should be used. Surgery by means of Z-plasties, W-plasties and small wave incisions has been proven effective in reducing scar hypertrophy as one of its main effects is to convert the direction of the tension lines [18,22,23].…”

Section: Primary Closure and Tension Releasing Techniquesmentioning

confidence: 99%

On the surgical treatment of hypertrophic scars: a comprehensive guideline for the surgical treatment of hypertrophic scars

et al. 2012

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Background: Treating the hypertrophic scar remains a challenging problem. It often leaves the clinician with the questions whether, when and how to treat a hypertrophic scar.Methods: This review will focus on the surgical treatment of hypertrophic scars considering the latest research in this field.Results: We present a rough treatment guideline that offers guidance for choosing the most appropriate surgical technique possible for the treatment of scar hypertrophy.Conclusions: The presented guideline may help the clinician to get a better understanding of scar hypertrophy: whether and when to treat it surgically, and what treatment to use.

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Small-Wave Incision Method for Linear Hypertrophic Scar Reconstruction: A Parallel-Group Randomized Controlled Study

Abstract: The small-wave method can meet both the functional and the cosmetic requirements of long linear hypertrophic scar reconstruction while reducing complication risks.

Cited by 17 publications

References 15 publications

Keloids and Hypertrophic Scars

Keloids and Hypertrophic Scars

S-shaped Wound Closure Technique for Dumbbell-shaped Keloids

On the surgical treatment of hypertrophic scars: a comprehensive guideline for the surgical treatment of hypertrophic scars

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