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Chapter-05 Principles and Techniques of Scar Management

BOOK TITLE: Sataloff's Comprehensive Textbook of Otolaryngology: Head & Neck Surgery (Facial Plastic and Reconstructive Surgery) - Volume 3

Author
1. Mashkevich Grigoriy
ISBN
9789351524595
DOI
10.5005/jp/books/12699_6
Edition
1/e
Publishing Year
2016
Pages
10
Author Affiliations
1. The New York Eye and Ear Infirmary, New York, New York, USA, New York Eye and Ear Infirmary at Mount Sinai, New York, New York, USA
Chapter keywords
Scar Management, neck scars, head scars, soft tissues, burns, acne, Facial scars, Relaxed skin tension lines, RSTLs, scar formation, Comprehensive scar assessment, intrinsic scar features, Meticulous planning, Tissue expansion, burn trauma

Abstract

This chapter discusses principles and techniques of scar management, where head and neck scars most commonly arise as a result of regional trauma and surgical manipulation of soft tissues. Additional causes include burns and acne, which can generate a wide regional scar requiring special considerations. Facial scars can vary widely with respect to their location and associated aesthetic and functional deficits. Relaxed skin tension lines (RSTLs) denote facial lines present in the facial skin when it is in a relaxed state. Incisions placed along RSTLs minimize tension across the wound and result in improved healing and optimal scar formation. Comprehensive scar assessment should include evaluation of intrinsic scar features, scar positioning with respect to aesthetic borders and RSTLs, and any associated functional impairments. Meticulous planning and technique cannot be overemphasized when performing scar revision. Tissue expansion can effectively recruit adjacent skin for resurfacing of wide scars and has been well described in a setting of burn trauma.

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