Scar Revision

7.16.1 Discuss when to revise a scar.

7.16.2 Describe the difference between relaxed skin tension lines and Langer lines.

7.16.3 Describe the technique of Z-plasty. Draw and calculate the effect of 30deg, 45deg, and 60deg Z-plasties.

7.16.4 Demonstrate how to use a Z-plasty to lengthen a contracted scar, change the direction of a scar, and break a straight line.

7.16.5 Describe the concept of geometric broken line closure and draw its use in scar revision.

7.16.6 Describe the technique of dermabrasion. Discuss its use in scar revision and the limitations and complications of this technique.

Jones N. Scar Tissue. Curr Opin Otolaryngol Head Neck Surg. 2010 Aug;18(4):261-5. PMID:20631534.

7.16.7 Discuss the non-surgical management of keloids. Silicone gel sheeting? Mederma? Lasers?

Robles DT, Moore E, Draznin M, Berg D. Keloids: Pathophysiology and management. Dermatol Online J. 2007 Jul 13;13(3):9. PMID:18328203.

7.16.8 When would you excise a keloid? How would you prevent a recurrent keloid?

7.16.9 Discuss the role of local flaps for scar camouflage.

Clark JM, Wang TD. Local Flaps in Scar Revision. Facial Plast Surg. 2001 Nov;17(4):295-308. PMID:11735064

7.16.10 Your high maintenance cosmetic patient wants you to pick the suture for the best wound outcome.

Guyuron B, Vaughan C. Comparison of polydioxanone and polyglactin 910 in intradermal repair. Plast Reconstr Surg. 1996 Oct;98(5):817-20. PMID:8823020

Gabrielli F, Potenza C, Puddu P, Sera F, Masini C, Abeni D. Suture materials and other factors associated with tissue reactivity, infection, and wound dehiscence among plastic surgery outpatients. Plast Reconstr Surg. 2001 Jan;107(1):38-45. PMID:11176599