Papers of The 9th Japan Scar Workshop

6. Measurement of the Tension-Reduction Effect on the Dermis after Deep Fascia Suturing of the Pectoralis Major Muscle in Surgery for Anterior Chest Wall Keloids

Rei Ogawa1, Lukas Capek2, Satoshi Akaishi1, and Hiko Hyakusoku1
1:Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan
2:Technical University of Liberec, Department of Applied Mechanics, Liberec, Czech Republic

Keloids are oriented from the reticular layer of the dermis. Moreover, a high level of tension at the wound surface is a risk factor for the development of keloids. Thus, it is important to release tension on the dermis intraoperatively. For this purpose, we performed deep fascia suturing of the pectoralis major muscle in surgery for anterior chest wall keloids. In this study, the tension-reduction effect of such sutures was measured using a digital force gauge. Ten cases with chest wall keloids were enrolled. After keloid removal, the tension on the edge of the wound was measured before deep fascia suturing, superficial suturing, and dermal suturing. Deep fascia, superficial, and dermal suturing reduced tension on the wound edge by 87.9%, 11.2%, and 0.9%, respectively. Thus, it was suggested that deep and superficial fascial sutures are important to release tension on the dermis during anterior chest wall keloid surgery.
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