Whenever there is breach in continuity of skin or mucosa, a wound
is formed. Body heals the wound leaving end result known as
Scars are the unavoidable results of injury or surgery. Development of a scar can be unpredictable. Poor healing may contribute to scars that are visible, obvious, unsightly or disfiguring.
Even after good wound healing, Scar so formed can be very light or a scar that affects the appearance. Scars may be noticeable due to their size, shape or location; they can also be raised or depressed, and may differ in color or texture from the surrounding healthy tissue.
Scar revision surgery will attempt to minimize scar appearance, but, cannot achieve NO SCAR situation. Patient should be realistic. He/she should understand that Cosmetic scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly. A scar cannot be completely erased.
Technique largely depends upon type and site of scar. Appropriate technique is chosen from the list below:
1. Excision of scar with closure.
2. Z – plasty
3. W - plasty
4. V-Y plasty
5. Flap rotation
6. Split thickness skin grafting.
7. Full thickness skin grafting.
Hypertropic scars - They are often raised, red and/or uncomfortable. Scar tissue that develop directly at a wound site and may become wider over time.
Keloids are larger than hypertropic scars. They can be painful or itchy, and may also pucker. They extend beyond the edges of an original wound or incision. Keloids can occur anywhere on your body, but they develop more commonly where there is little underlying fatty tissue, such as on the face, neck, ears, chest or shoulders.
Contractures are scars that restrict movement due to skin and underlying tissue that pull together during healing. They can occur when there is a large amount of tissue loss, such as after a burn. Contractures also can form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck.