SURGICAL SCAR CORRECTION – SUCCESSFULLY TREATING SCARS

Hypertrophic scars are characterised by thick, reddish raised scar tissue that does not grow beyond the wound boundaries. The scar shape remains conspicuous and disturbing. However, the hypertrophic scar can also regress spontaneously. These scars can be treated with conservative compression therapy, also in combination with corticosteroids. If this does not bring the hoped-for success, plastic surgery would be recommended.

Keloids are scars that proliferate beyond the wound wheel and are often itchy or painful. The scars continue to spread even after the wound has healed. Keloids often affect the ears, shoulders or chest area. Often darker than the normal skin tone, keloid scars do not disappear spontaneously. Instead, regular injections directly into the keloid tissue help. These minimise the scar and reduce the burning and itching. If injections do not have the desired effect, the scar tissue can be removed during a surgical procedure. Unfortunately, keloids often recur. The best results are achieved by combining surgical scar removal with pressure dressings, silicone films, injections and radiotherapy.

Sunken scars occur when too few new connective tissue fibres are formed during wound healing to completely fill the defect. A distinction is made between ice-pick scars, which are funnel-shaped, and varioliform scars, which are U-shaped and very similar to chickenpox scars. There are also wave-shaped scars, also known as m-shaped scars. Scars after severe inflammatory acne are usually atrophic. Promising treatment approaches that stimulate collagen production such as needling, laser procedures, lactic acid injections and chemical peeling can help here.

Tightly contracted scars are usually caused by accidents or burns. These firm scars can restrict mobility. In the case of a contracture, careful removal of the scar is often the only solution. There are numerous methods for this, which are applied individually. In most cases, an operation to remove the contractures is followed by physiotherapy.

Disfiguring scars are often the result of accidents and burns or self-inflicted injuries. Depending on the body part and depth, it is the skill of an experienced plastic-reconstructive surgeon to make these scars barely visible.

In a serial excision, the scar is surgically reduced in several stages. This may be necessary if the scar is too large to be removed in a single operation or if it needs to be re-stitched. The scar is gradually reduced in several operations at intervals of three to six months. Ideally, only a fine line will ultimately be visible.

For larger scar areas, it may be necessary to remove healthy skin to cover the visible injuries. The healthy skin is taken from less visible areas of the body. With the help of an expander, the healthy skin can be pre-stretched over a period of approx. three months. This allows a piece of healthy skin to be created that is large enough to cover the scar area. As a rule, the newly transplanted autologous skin grows very well. Nevertheless, a longer inpatient stay at the ETHIANUM is often necessary. This allows us to ensure your care and the application of compression garments and silicone pads or the changing and checking of dressings.

If a deeper defect is created when the scar is removed, pre-treatment with one of the most modern skin replacement procedures can be very helpful under certain circumstances. The primary transplantation of so-called artificial skin with subsequent autologous skin transplantation results in a greater elasticity of the skin grafts, which comes very close to the condition before the injury. An inpatient stay of approximately one week is unavoidable due to the hygienic and medical care required.

Skin flap surgery is a displacement of localised tissue. In this method, both the skin and the underlying tissue, possibly up to the muscle tissue, are removed. The skin and tissue are then surgically inserted into the required area of the body. A microsurgical procedure may also be necessary. This involves reconnecting the blood vessels to supply the skin flap with blood. The operation requires an inpatient stay of around two weeks.

With this surgical technique, the troublesome scar is relocated so that it can blend in better with the natural tension lines of the skin. The tissue relaxes as a result of the operation. This makes the scar less noticeable and any movement restrictions can be alleviated or prevented. The operation is performed under local or general anaesthetic and can usually be performed on an outpatient basis.