Whenever a Living Human body suffers some kind of injury like a burn, sore or any kind of wound, it heals after some time by a process of fibrosis ; which creates the so called long term sign of injury, better known as Scar. Scars may produce some kind of functional impediment and also may cause cosmetic disfigurement. If the scar is present in a visible area like face, it may be a cause of considerable anxiety or embarrasment for the person.
A thorough examination of the patient with the relevant history is one of the most fundamental things to do, before agrreing on a treatment plan. This is more so on the case of scars. The first thing to be ascertained is what is the reason of scar or How the scar was produced. This can significantly alter the course of treatement. The duration of scar is also very important ; as a scar can take anywhere from 9-12 months to mature and the final appearance of the scar can only be judged after this period, so no revisional surgery should be done before this period. The location of the scar in the human body and it’s relation to Relaxed Skin Tension Lines (RSTL) is also ascertained. Presence of scar neighbouring to vital structures should be noted. For example - in face scars near Lateral canthus, Eyebrow, oral commissure and Nasal Ala deserve special consideration at time of treatment, as the surrounding structure may be affected.
1) SIMPLE EXCISION - This one of the simplest forms of surgery, in which a ellipse is drawn across the scar, with the length approximately 3 times the width. This whole area is injected with a haemostatic - anaesthetic solution for pain free and decreased bloody surgical field. The injection is done with a syring having number 26 needle, so that the patient doesnot feel much pain at time of injecting. The ellipse is then excised with a sharp blade. After securing haemostasis the wound is closed in layers. Because the objective of simple fusiform excision is to hide the resulting incision closure in the RSTL, the long axis of the fusiform ellipse needs to lie parallel to the RSTL but not necessarily parallel to the long axis of the scar.
2) SERIAL EXCISION Simple excision of scar is restricted to scars, which are rather relatively smaller in size. For the scars which are relatively bigger in size to be excised in one stage, serial excisions are used. So in simple terms serial excision, is basically multiple simple excision, done in stages, with sufficient interval in between them, so that the skin gets an oppurtunity to get back it’s elastic properties. The initial incision is made entirely within the original scar, and normal and abnormal tissue is advanced. Usually a gap of at least 3-4 months are kept between each sitting. This is done till the whole of scar is excised. But one of the disadvantage of this procedure, is that it is possible only upto a certain percentage of the body area.
It is important after surgery to follow up the patient to ensure that there are no or minimal complications like Keloid or Hypertrophic scarring or scar widening. Hypertrophic or keloid scars respond well to intralesional steroid injection. Routine use of Pressure garments and Silicon Sheets have almost made those complications obsolete. **Scar Removal – Looking for Scar Removal Surgery Gurgaon? Contact to Dr. Raja the best Scar Removal Surgeons offers best Scar Removal in Gurgaon Delhi NCR Mob. 7042355075**