Overview of Surgical Scar Prevention and Management

다국어 초록 (Multilingual Abstract)

Management of incisional scar is intimately connected to stages of wound healing. Themanagement of an elective surgery patient begins with a thorough informed consentprocess in which the patient is made aware of personal and clinical circumstances thatcannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. Inscar prevention, the single most important modifiable factor is wound tension during theproliferative and remodeling phases, and this is determined by the choice of incisiondesign. Traditional incisions most often follow relaxed skin tension lines, but no such linesexist in high surface tension areas. If such incisions are unavoidable, the patient must beinformed of this ahead of time. The management of a surgical incision does not end whenthe sutures are removed. Surgical scar care should be continued for one year. Patientparticipation is paramount in obtaining the optimal outcome. Postoperative visits shouldscreen for signs of scar hypertrophy and has a dual purpose of continued patient educationand reinforcement of proper care. Early intervention is a key to control hyperplasticresponse. Hypertrophic scars that do not improve by 6 months are keloids and should bemanaged aggressively with intralesional steroid injections and alternate modalities.

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