Download PDF
Facial Plast Surg 2012; 28(05): 492-496
DOI: 10.1055/s-0032-1325649
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Revising Large Scars

Dara R. Liotta
1   Department of Otolaryngology, Lenox Hill Hospital, New York Head and Neck Institute, Northshore-LIJ Health System, New York, New York
,
Peter D. Costantino
1   Department of Otolaryngology, Lenox Hill Hospital, New York Head and Neck Institute, Northshore-LIJ Health System, New York, New York
,
David H. Hiltzik
1   Department of Otolaryngology, Lenox Hill Hospital, New York Head and Neck Institute, Northshore-LIJ Health System, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
01 October 2012 (online)

Also available at
    Permissions and Reprints

Abstract

Large scars in the head and neck are often the cause of significant emotional distress to patients, and often present unique challenges to the plastic and reconstructive surgeon undertaking their revision. The primary goal of scar revision is to eliminate compromise of function that may have resulted from scar contracture; a secondary goal is to improve the appearance of the scar. Special techniques for the revision of large scars include serial partial excision, rapid intraoperative or prolonged tissue expansion, split- and full-thickness skin grafting, regional flaps, and free microvascular tissue transfer. Recent research has investigated the use of artificial skin and autologous fat grafting for large scar revision.

Keywords

scar revision - large scars - serial partial excision - tissue expansion - skin grafts
 

  • References

  • 1 Tower I, Lasko LA, Kathju S. Secondary surgery for cicatricial complications of facial injury. J Oral Maxillofac Surg 2010; 68: 751-755
    CrossrefPubMedGoogle Scholar
  • 2 Koska MS, Thoman JR. Scar revision. In: Papel ID, , ed. Facial Plastic and Reconstructive Surgery. New York, NY: Theime; 2002: 55-60
    Google Scholar
  • 3 Hoffman JF. Tissue expansion in reconstruction of the head and neck. In: Papel ID, , ed. Facial Plastic and Reconstructive Surgery. New York, NY: Theime; 2002: 549-590
    Google Scholar
  • 4 Verhaegen PD, van der Wal MB, Bloemen MC , et al. Sustainable effect of skin stretching for burn scar excision: long-term results of a multicenter randomized controlled trial. Burns 2011; 37: 1222-1228
    CrossrefPubMedGoogle Scholar
  • 5 Verhaegen PD, van Trier AJ, Jongen SJ , et al. Efficacy of skin stretching for burn scar excision: a multicenter randomized controlled trial. Plast Reconstr Surg 2011; 127: 1958-1966
    PubMedGoogle Scholar
  • 6 Baker SR, Swanson NA. Rapid intraoperative tissue expansion in reconstruction of the head and neck. Arch Otolaryngol Head Neck Surg 1990; 116: 1431-1434
    CrossrefPubMedGoogle Scholar
  • 7 Swenson RW. Controlled tissue expansion in facial reconstruction. In: Baker SR, , ed. Local Flaps in Facial Reconstruction. Philadelphia, PA: Elsevier-Mosby; 2007: 667-689
    Google Scholar
  • 8 McCarn K, Hilger PA. 3D analysis of tissue expanders. Facial Plast Surg Clin North Am 2011; 19: 759-765 , x
    CrossrefPubMedGoogle Scholar
  • 9 Shimizu R, Kishi K. Skin graft. Plast Surg Int 2012; 563493: 1-5
    PubMedGoogle Scholar
  • 10 Stallings JO, Ban JL, Pandeya NK, Abramsohn L, Bergman RS. Secondary burn reconstruction: recent advances with microvascular free flaps, regional flaps, and specialized grafts. Am Surg 1982; 48: 505-513
    PubMedGoogle Scholar
  • 11 Abramson DL, Pribaz JJ, Orgill DP. The use of free tissue transfer in burn reconstruction. J Burn Care Rehabil 1996; 17: 402-408
    CrossrefPubMedGoogle Scholar
  • 12 Mast BA, Newton ED. Aggressive use of free flaps in children for burn scar contractures and other soft-tissue deficits. Ann Plast Surg 1996; 36: 569-575
    CrossrefPubMedGoogle Scholar
  • 13 Stiefel D, Schiestl C, Meuli M. Integra Artificial Skin for burn scar revision in adolescents and children. Burns 2010; 36: 114-120
    CrossrefPubMedGoogle Scholar
  • 14 Klinger M, Marazzi M, Vigo D, Torre M. Fat injection for cases of severe burn outcomes: a new perspective of scar remodeling and reduction. Aesthetic Plast Surg 2008; 32: 465-469
    CrossrefPubMedGoogle Scholar
  • 15 Sultan SM, Barr JS, Butala P , et al. Fat grafting accelerates revascularisation and decreases fibrosis following thermal injury. J Plast Reconstr Aesthet Surg 2012; 65: 219-227
    CrossrefPubMedGoogle Scholar