8. Surgical Methods for Hypertrophic Scars and Keloids
Ogawa R, Nomoto S, Akaishi S, Ono S, Ishii N, Kobe K, Hyakusoku H
Department of Plastic and Reconstructive Surgery, Nippon Medical School,
In this paper, we would like to present our new methods on 1.
keloidectomy and 2. skin closure. These methods are “small wave
incision”, skin closure using three-layered suture and tissue adhesive (Dermabond®)
or surgical tape (Proxistrip®). The small wave incision consists of many
of small waves of about 1cm long. The methods were mainly used for long
keloids. In surgical treatment of long keloids over 10cm in length,
“small wave incision” was performed to reduce tension in order to avoide
recurrence. Here, the shape leaves an “accordion effect” but makes an
inconspicuous linear scar. Because the wound that was incised with small
waves becomes a fluent wave shape almost like a straight line after
suturing. This incision was designed with a minimal normal skin margin.
For the skin closure, in addition to a three-layered suture we have
attempted skin closure using Dermabond® or Proxistrip® to protect the
skin as much as possible. We sometimes use these items for epidermal
closure after a subcutaneous (3/0 Vicryl®) or dermal suture (5/0 PDSⅡ®).