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Principles to minimize scars include attention to a multitude of intrinsic and extrinsic patient factors preoperatively, operatively, and postoperatively. Preoperatively the goal is to maximize the treatment of patient specific comorbidities and limit the usage of medications that can have negative effects on healing. Operatively, the focus is on proper incisional planning, meticulous surgical technique and hemostasis, judicious use of prophylactic antibiotics, and focus on tensionless closures. Postoperatively, we must maximize the healing environment by keeping the wound well hydrated and closely monitoring and intervening early in high-risk wounds. We also have the responsibility to provide evidence-based recommendations, to the best of our ability, regarding the myriad of over-the-counter products. The field of scar prevention is ever changing and the new frontier focuses on controlling the microenvironment of wounds and altering signaling molecules to promote near scarless healing., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

It is important to understand the histology and physiology of skin for the prediction and optimization of wound healing. Optimal postoperative wound healing to minimize scarring entails minimizing local, systemic, and environmental factors that lead to poor wound healing. Keeping the wound clean and moist, minimizing trauma, and infection are the local wound tenets. Systemic tenets include minimizing medications that inhibit processes of wound healing, maintaining adequate nutrition, pain palliation, UV protection, and smoking cessation. This article presents the dynamic process of wound healing and the basic tenets to minimize scarring., (2011 Elsevier Inc. All rights reserved.)