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Optimizing Postsurgical Scars: A Systematic Review on Best Practices in Preventative Scar Management

Perez, Justin L., M.D.; Rohrich, Rod J., M.D.

Plastic and Reconstructive Surgery: December 2017 - Volume 140 - Issue 6 - p 782e-793e
doi: 10.1097/PRS.0000000000003894
Cosmetic: Special Topic
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Background: Scar management is critical for every plastic surgeon’s practice and, ultimately, the patient’s satisfaction with his or her aesthetic result. Despite the critical nature of this component of routine postoperative care, there has yet to be a comprehensive analysis of the available literature over the past decade to assess the best algorithmic approach to scar care. To this end, a systematic review of best practices in preventative scar management was conducted to elucidate the highest level of evidence available on this subject to date.

Methods: A computerized MEDLINE search was performed for clinical studies addressing scar management. The resulting publications were screened randomized clinical trials that met the authors’ specified inclusion/exclusion criteria.

Results: This systematic review was performed in May of 2016. The initial search for the Medical Subject Headings term “cicatrix” and modifiers “therapy, radiotherapy, surgery, drug therapy, prevention, and control” yielded 13,101 initial articles. Applying the authors’ inclusion/exclusion criteria resulted in 12 relevant articles. All included articles are randomized, controlled, clinical trials.

Conclusions: Optimal scar care requires taking into account factors such as incisional tension, anatomical location, and Fitzpatrick skin type. The authors present a streamlined algorithm for scar prophylaxis based on contemporary level I and II evidence to guide clinical practice.

Dallas, Texas

From the Department of Plastic Surgery, University of Texas Southwestern Medical Center; and the Dallas Plastic Surgery Institute.

Received for publication September 19, 2016; accepted April 3, 2017.

Presented at the Cosmetic Bootcamp Meeting, in Aspen, Colorado, July 7 through 10, 2016.

Disclosure:Dr. Rohrich receives instrument royalties from Eriem Surgical, Inc., and book royalties from Thieme Medical Publishing. Neither author has any financial interest in any of the products or devices mentioned herein. Dr. Perez has no financial information to disclose. No funding was received for this article.

Rod J. Rohrich, M.D., 9101 N Central Expressway, Suite 600, Dallas, Texas 75231, rod.rohrich@dpsi.org, @DrRodRohrich

Copyright © 2017 by the American Society of Plastic Surgeons