Staged Excision Technique to Reduce Scar Length

Abstract

Patients and surgeons are often disappointed with the scar length after conven-tional staged excision of large disfiguring skin lesions. We have developed an alternative ap-proach to facilitate scar length reduction. We aimed to report the efficacy of our staged exci-sion method, which includes a hexagonal-pattern excision, wide undermining, and purse-string suture. Sixty-five patients, each with one lesion, were included in the current study. The lesion length and width were recorded, and the scar area was calculated at each stage. The final scar length after performing the altered staged excision method was compared with that obtained after the conventional staged excision method, which was calculated using a theoretical scar model. Patient satisfaction was also evaluated. The mean longest axis length was 9.41 +/- 3.83 cm preoperatively, 9.50 +/- 3.92 cm after the first stage postoperatively, and 10.19 +/- 3.98 cm after the final stage. The mean lesion width was 6.50 +/- 3.48 cm preoperatively, 3.60 +/- 1.77 cm after the first stage postoperatively, and 0.42 +/- 0.31 cm after the final stage. The final scar length obtained using the altered procedure was much shorter than what would be obtained using conventional staged excision. The patient satisfaction score was 8.8 +/- 1.1 out of a pos-sible 10.0 rating. Staged excision with a hexagonal-pattern excision, wide undermining, and purse-string closure may improve aesthetic results.(c) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by El-sevier Ltd. All rights reserved.