Papers of The 1st Japan Scar Workshop

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, Tokyo, Japan

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®).
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