A new method for repair of superficial widened scars by applying the Chinese wood joinery mortise-and-tenon principle
10.3760/cma.j.cn114453-20230222-00039
- VernacularTitle:应用榫卯结构原理修复体表增宽瘢痕的临床效果
- Author:
Yingnan ZHAO
1
;
Jing SHI
;
Wen CHEN
Author Information
1. 中国医学科学院北京协和医学院整形外科医院面颈整形三科，北京 100144
- Keywords:
Cicatrix;
Skin tension;
Suture technique;
Mortise-and-tenon structure
- From:
Chinese Journal of Plastic Surgery
2023;39(8):838-843
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of intradermal suturing using the principle of mortise-and-tenon suture in repair of superficial widened scars.Methods:A retrospective analysis was performed on the clinical data of patients with superficial widened scars repaired in the Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2017 to January 2022. All patients were treated with this mortise-and-tenon method. During the operation, a pike incision was made along the outer margin of the scar to remove the top half of the dermal scar tissue, along with the epidermis. Serial tenon structures were created on the retained dermal scar tissue. Corresponding serial mortise structures were created by the removal of identically shaped blocks of dermal tissue opposite to the corresponding tenon structures. By suturing each tenon into its corresponding mortise, tensionless incision closure was readily achieved. Then, the skin was intermittently sutured. The incision was observed at postoperative follow-up, the Vancouver scar scale(VSS) was used to assess scar appearance, while higher scores indicated more severe scars; the scar width was measured, and patient satisfaction was recorded at 6 months postoperatively.Results:A total of 32 patients, 8 males and 24 females, aged from 8 to 44 years old (mean, 34 years old), were enrolled. All scars were elongated in shape and the VSS score was 3-7 (mean, 4.6). The scar width ranged from 2 to 11 mm (mean, 4 mm). The postoperative follow-up was 6 to 24 months. All incisions were healed by primary intention. 4 cases (12.5%) showed some degree of scar hyperplasia, which was improved by local compression and medication, and the remaining 28 cases (87.5%) showed small incision scars with a flat appearance, which were significantly improved compared with the preoperative period. Among these 28 cases, the VSS score was 0-2 (mean, 0.9). The scar width was 0.1-1.0 mm, (mean, 0.3 mm), including 11 cases with scar width <0.3 mm, 8 cases with scar width of 0.3-0.5 mm, and 9 cases with scar width of >0.5-1.0 mm. 28 patients were satisfied (satisfaction rate of 87.5%) and 4 cases were good.Conclusion:The proposed mortise-and-tenon scar repair technique can effectively reduce incision tension and thus the final incision scar is minimal.
