Scar Revision of Wide Facial Scar by Serial Excision Using the Sure-Closure(R)

ABSTRACT

Conventional methods of scar revision of wide facial scar are skin graft, local flap coverage, local flap using the tissue expander, and free flap method, but these methods have disadvantages such as color dismatching, deformity of facial structure, inevitable additional scar, great expense, and waste of time. From April 1996 to April 2001, we performed the scar revision of wide facial scar by serial excision using the Sure- Closure(R) in 8 patients. Of these, 4 had scars on the cheeks, 2 on the preauricle, and the remaining 2 on the mentum and temporal area. The mean follow-up period was 18 months, ranging from 6 to 24 months. By pinching the skin on the scar site, we got a rough idea as to whether the available skin on either side of excision margin was sufficient for closure. The tension on the skin margin was 3.0 kilograms and the device was employed over a duration of 50 minutes. A skin stretching device is designed to exploit the viscoelastic properties, that is mechanical creep and stress relaxation. In this study, we use the serial excision with the Sure- Closure(R), because excessive scar excision could result in the deformity of facial structure and wound dehiscence, hypertrophic scar, and skin necrosis. The skin stretching device is easy to use and achieves good aesthetic results in the scar revision of wide facial scar.