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The expanded pedicled deltopectoral flap (EPDF) has been widely used to repair large facial scars. Although doctors and patients are usually satisfied with the outcomes, the actual functional recovery and cosmetic effects of EPDF are still unknown. It is, therefore, necessary to objectively investigate the effect of transferred EPDF by using a variety of methods. From January 2008 to December 2018, 52 patients who underwent EPDF surgery at Xijing Hospital were enrolled. Sense of touch, static 2-point discrimination, elasticity, and color were measured. Thermesthesia and algesthesia were also tested. Postoperative scars were evaluated using the patient and observer scar assessment scale. Satisfaction of patients, doctors, and laypersons was investigated. The algaesthesis, thalposis, and rhigosis scores were 4.7 ± 0.7, 3.7 ± 0.9, and 4.5 ± 0.8, respectively. The tactile score was 0.3 ± 0.2 mN, and 2-point discrimination was 10.1 ± 4.8 mm. L*, a*, hemoglobin, and melanin content of the flaps were significantly different when compared with normal skin (P

This study explores the clinical application of the circular wide and deep (looped, broad, and deep buried, LBD) suture technique for scar resection and examines its clinical effectiveness for scar treatment. From June 2017 to March 2019, a total of 68 patients with scars were sutured using LBD technique, and recovery was achieved 24 months postoperatively. In all 68 patients, postoperative scars were slightly evident in two cases of cervical scar, one case of leg scar, and one case of chest scar. In addition, the remaining 62 patients were completely satisfied with the outcome. The LBD suturing technique could provide sustained and stable tension-reducing effects postoperatively and significantly improve scar formation in patients. This method is most applicable to incisions with tension. Therefore, it should be more widely used for clinical scar treatment.

To define the individual features of the organization of circadian rhythms, the term "chronotype" was proposed, which is becoming increasingly popular in research in the field of medicine. According to the analysis of literature data, biological rhythm affects not only the mental state, obesity but the human condition as a whole. Biological rhythms are a manifestation of the fundamental properties of the organic world, provide the ability of man to adapt and survive in the environment. In this aspect, of particular interest is the functioning of the organism, taking into account its individual characteristics in terms of the organization of biorhythmic processes. The research was conducted on the basis of the Department of Maxillofacial Surgery on the basis of CE «Poltava M. V. Sklifosovskyi Regional Clinical Hospital of the Poltava regional council». A total of 24 patients participated in the study. To study the materials, we analyzed patients who were hospitalized for routine surgery for congenital neck cysts and tumors of the head and neck. Patients were interviewed during hospitalization, as well as a questionnaire to determine the chronotype. Patients were divided into the following 2 groups, namely: group 1, which in turn comprised 2 subgroups: 1.1 - Patients with morning chronotype; 1.2 - Patients with evening chronotype. The first subgroup (1.1 - with the morning chronotype) consisted of 7 subjects who underwent surgery in the morning. The second subgroup (1.2 - with evening chronotype) consisted of 9 patients who underwent surgery at about 15:00. In each of these subgroups during surgery, intradermal administration of the drug "Cryocel" was performed. - group 2 (control). The second control group consisted of 8 patients, all patients in this group were operated on according to the classical method without the use of additional preventive measures. On the 90th day of the clinical study, we could observe a significant difference in the comparison of postoperative scars, namely in patients with morning chronotype and in patients with evening chronotype it was 42%, the difference with control was 71% and the difference between the subgroup 2 and the control group was 50%. On the 180th day of the study, we observed a significant difference between the groups, in patients of subgroups 1 and 2, as compared to the control group, clinical data in the description of postoperative scars were better by 25%. When comparing subgroups 1 and 2, no difference was observed. Thus, on the 180th day when examining patients, the clinical picture was more favorable in subgroups 1 and 2. According to the data obtained, we can say that in patients who underwent surgery in the morning and injected with placental cryoextract, wound healing and scar formation on the 90th day was faster and better than in patients who underwent surgery at lunchtime, and patients who underwent surgery according to the classical method without the use of additional preventive measures.

Objective: Development of postoperative scars is often a problem. This study aimed to evaluate the efficacy of gel containing Allium cepa extract, allantoin and heparin (Contractubex, Merz Pharmaceuticals GmbH, Frankfurt, Germany) in reducing scarring after a caesarean section by comparing it with a control group, and also intra-individually, using the Vancouver Scar Scale (VSS). Method: A total of 120 patients who underwent a second elective caesarean delivery and who presented with hypertrophic scar development after their first caesarean section were included in the study. A scar revision was performed for all patients during the second caesarean operation. Patients in the study group (n=60) were advised to apply the topical scar gel postoperatively for a period of 6 months. The control group (n=60) received no treatment. Results: Significant reductions were observed in the vascularity, pigmentation and height subgroups of the VSS for those in the group who continued the treatment to 24 weeks. An intra-individual analysis showed that the gel effectively reduced scarring after the second caesarean section. Conclusion: The prophylactic use of the gel to reduce scar development offers better results for vascularity, pigmentation and height subscales of the VSS after surgical removal of the primary caesarean scar during the second caesarean section. The results were better both intra-individually, and also in comparison with the control group and support the use of a gel containing Allium cepa extract, allantoin and heparin to reduce scarring after a caesarean section.

Objective To compare the effectiveness of silicone sheets and paper tape in the prevention of postoperative cesarean section scars. Methods Patients undergoing horizontal cesarean section were included in this randomized controlled trial. Surgical wounds were divided into two halves. Patients randomly applied silicone sheets or paper tape to each side of their wound as assigned for 3 months. Wounds were assessed at 1, 3, 6, and 12 months after surgery. Researchers used the objective Vancouver Scar Scale (VSS) to evaluate the scars and the subjective visual analog scale (VAS) to evaluate itch, pain, and scar appearance. Results No significant differences between the silicone sheet and paper tape groups were noted at postoperative follow-ups with respect to VSS scores. The silicone sheet group had significantly better VAS scores for scar appearance than the paper tape group at 6 (6.81 ± 1.47 vs 6.19 ± 1.62, P = .03) and 12 (6.88 ± 2.01 vs 6.2 ± 2.08, P = .04) months' follow-up, respectively. Conclusions The silicone sheet group showed statistically significant differences in comparison with the paper tape group in terms of scar appearance as determined by the VAS. However, the differences were too small to be clinically meaningful.

The coronal incision is the mainstay for access in craniosynostosis surgery. Scarring is a common concern of parents whose children are offered an open procedure. To the author's knowledge, there are no previous studies looking at the psychosocial impact of scarring from coronal access incisions for craniosynostosis procedures. The author's study focused on patients undergoing procedures for nonsyndromic single-suture craniosynostosis.This study comprised 3 parts: worldwide survey regarding coronal access incisions for craniosynostosis surgery, questionnaire to determine the psychosocial impact of the scars on patients and their parents, and measurement of postoperative scars in craniosynostosis patients.Survey responses from 46 craniofacial centers worldwide revealed a zig-zag was the most commonly utilized incision. Seventy-two percent of survey responses reported problems with postoperative stretching of the scar; only 20% of centers reported formal data collection of whether families were affected by this.Psychology questionnaires revealed that the majority of patients and their parents were not bothered by the zig-zag coronal scars. Patient felt the scars were less noticeable than the parents. Parent perceptions improved with age and time postsurgery.Coronal access scars following craniosynostosis surgery appear to stretch more in the supra-auricular region compared with the midline.These findings are useful for the craniofacial multidisciplinary team to inform parents contemplating surgery and who may be concerned about the impact of the scar in the future.

A scar is a product of skin regeneration by connective tissue structures after damage or inflammation to maintain the integrity of the body's integuments. To date, there is no single algorithmic approach to the tactics of treatment and cicatricial defects after cesarean section. This article presents the modern principles and advantages of the Nascar silicone gel on vascularization, pigmentation, thickness, surface area, elasticity of postoperative scars in women after cesarean section. This silicone gel is an effective and safe remedy for the prevention of cicatricial deformities after surgery, starting from the first days after surgery, it has a positive effect on a woman's quality of life, including her intimate life.Research objective: to evaluate the advantages of the effect of silicone gel on vascularization, pigmentation, thickness, surface area, elasticity of postoperative scars in women after cesarean section compared with no systematic local treatment.Materials and methods. The study involved 70 women aged 25–40 years after a cesarean section. Women were randomized into 2 groups of 35 each. Patients of group 1 (main) were applied silicone gel Nascar on the scar area with 2 times a day (morning and evening), starting from the 5–7th day of the postoperative period. Patients of group 2 (control group) did not receive local therapy of postoperative scars. Evaluation of the gel effectiveness was carried out according to the POSAS scale (the scar status was determined by the doctor and the patient).Results. This study showed the high efficacy and safety of the Nascar silicone gel when on the postoperative scar in women after cesarean section. An important advantage of silicone gel therapy compared to its absence was revealed.Conclusions. The results obtained make it possible to recommend Nascar silicone gel as an effective and safe drug for the prevention of cicatricial deformities after surgical interventions, starting from the first days after suture removal., Рубец – это продукт регенерации кожи соединительнотканными структурами после ее повреждения или воспалительного процесса для поддержания сохранности покровов организма. На сегодняшний день не существует единого алгоритмического подхода к тактике лечения и профилактике рубцовых дефектов после кесарева сечения. В данной работе приведены современные принципы и преимущества влияния силиконового геля Наскар на васкуляризацию, пигментацию, толщину, площадь поверхности, эластичность послеоперационных рубцов у женщин после кесарева сечения. Этот силиконовый гель является эффективным и безопасным средством для профилактики рубцовых деформаций после перенесенных хирургических вмешательств начиная с первых дней после операции, положительно влияет на качество жизни женщины, в том числе ее интимную жизнь. Цель исследования: оценить преимущества влияния силиконового геля Наскар британской компании Amaxa LTD на васкуляризацию, пигментацию, толщину, площадь поверхности, эластичность послеоперационных рубцов у женщин после кесарева сечения по сравнению с отсутствием систематизированного местного лечения.Материалы и методы. В исследовании приняли участие 70 женщин в возрасте 25–40 лет, которым было выполнено кесарево сечение. Женщины были рандомизированы на 2 группы по 35 в каждой. Пациенткам 1 группы (основной) на участок рубца наносили силиконовый гель Наскар 2 раза в день (утром и вечером) начиная с 5–7-го дня послеоперационного периода. Пациенткам 2 группы (контрольной) местная терапия послеоперационных рубцов на постоянной основе не проводилась. Оценка эффективности геля осуществлялась по шкале POSAS – определялось состояние рубца как врачом, так и пациенткой.Результаты. Исследование показало высокую эффективность и безопасность силиконового геля Наскар при применении на послеоперационном рубце у женщин после кесарева сечения. Выявлено важное преимущество терапии силиконовым гелем по сравнению с ее отсутствием.Выводы. Полученные результаты позволяют рекомендовать силиконовый гель Наскар британской компании Amaxa LTD как эффективный и безопасный препарат для профилактики рубцовых деформаций после перенесенных хирургических вмешательств начиная с первых дней после снятия швов., Рубець – це продукт регенерації шкіри сполучнотканинними структурами після її ушкодження або запального процесу для підтримки цілісності покривів організму. На сьогодні не існує єдиного алгоритмічного підходу до тактики лікування та профілактики рубцевих дефектів після кесаревого розтину. У роботі наведено сучасні принципи та переваги впливу силіконового гелю Наскар на васкуляризацію, пігментацію, товщину, площу поверхні, еластичність післяопераційних рубців у жінок після кесаревого розтину. Цей силіконовий гель є ефективним і безпечним засобом для профілактики рубцевих деформацій після перенесених хірургічних втручань починаючи з перших днів після операції, позитивно впливає на якість життя жінки, зокрема її інтимне життя.Мета дослідження: оцінити переваги впливу силіконового гелю Наскар британської компанії Amaxa LTD на васкуляризацію, пігментацію, товщину, площу поверхні, еластичність післяопераційних рубців у жінок після кесаревого розтину порівняно з відсутністю систематизованого місцевого лікування.Матеріали і методи. У дослідженні взяли участь 70 жінок віком 25–40 років, яким було виконано кесарів розтин. Жінки були рандомізовані на 2 групи по 35 у кожній. Пацієнткам 1 групи (основної) на ділянку рубця наносили силіконовий гель Наскар 2 рази на день (зранку та ввечері) починаючи з 5–7-го дня післяопераційного періоду. Пацієнткам 2 групи (контрольної) місцеву терапію післяопераційних рубців на постійній основі не проводили. Оцінювання ефективності гелю здійснювали за шкалою POSAS – визначення стану рубця як лікарем, так і пацієнткою.Результати. Дослідження показало високу ефективність і безпечність силіконового гелю Наскар при застосуванні на післяопераційному рубці в жінок після кесаревого розтину. Виявлено важливу перевагу терапії силіконовим гелем порівняно з її відсутністю.Висновки. Отримані результати дозволяють рекомендувати силіконовий гель Наскар британської компанії Amaxa LTD як ефективний і безпечний препарат для профілактики рубцевих деформацій після перенесених хірургічних втручань починаючи з перших днів після зняття швів.

Background: Management of Cicatricial alopecia has been a challenge to plastic surgeons nowadays ,the variability of surgical methods makes it difficult to choose the right treatment for each patient, also proper diagnosis of the type of cicatricial alopecia, whether it is primary or secondary, reversible or irreversible, scaring or non-scaring and stable or unstable, needs certain experience and skills. Objective: To assess results of Follicular Unit Extraction in management of secondary cicatricial alopecia. Patients and methods: This prospective cohort study, on 20 patients with secondary cicatricial alopecia. These Patients were operated upon in the Plastic and burn Department, Al-Azhar University Hospitals and were referred to our outpatient clinic for follow up visits. Results: There was sixteen (80%) males and four (20%) females, the mean age of the studied cases was 18.85 (±2.94 SD) with range (15-25) years. General outcome there were two (10%) bad, six (30%) good and twelve (60%) very good, according to hair density there were one (5%) poor, thirteen (65%) good and six (30%) very good, according to postoperative scars there were eighteen (90%) low and two (10%) high and according to hair direction there were four (20%) bad, eleven (55%) good and five (25%) very good. Among the studied cases there were nine (45%) who needed another surgery. Conclusion: We concluded that hair transplantation is very useful in the field of cicatricial alopecia treatment, hair transplantation has less hazards during anesthesia, less post-operative scars and less recovery time than the usual method of hair restoration.

Nipple reconstruction methods include various techniques, such as the local flap technique, free nipple grafting, and filler injection. The local flap technique can provide less donor site morbidity than a free nipple graft, but leaves an additional scar near the nipple. We present a novel method for reconstruction of the nipple using a flap located on one side of the nipple. The flap has a teardrop shape consisting of a circle and two wings folded to one side. The two wings form a pillar and cap, and the de-epithelialized tip of one wing fills the internal dead space of the new nipple. We applied this nipple reconstruction technique in the case of a 61-year-old patient who had a vertical scar due to inverted-T reduction mammoplasty. The patient had lost her nipple in previous breast-conserving surgery. The immediate postoperative nipple projection was 10 mm. At the 7-month follow-up visit, the nipple projection was 7.5 mm. The teardrop flap is an innovative technique that leaves no additional scar by using the scar already present on one side of the nipple.

Patients with complex abdominal wall defects usually have deformations of the abdomen, which may remain after the operation, and require the solution of a whole ramge of problems. Quite often, abdominal wall defects are combined with a variety of aesthetic deformities that are associated with abnormal postoperative scars, trophic ulcers, and fistulas. Though the restoration or improvement of abdominal wall functionality is the main goal of alloplasty for complex abdominal wall defects, the cosmetic aspects of the operation, sometimes far more important for patients, deserve special attention. The choice of optimal operative access largely depends on lateral surgery, but most surgeons do not pay special attention to it and mainly use framing incisions above the defect or protrusion. By this time, such values ​​as the type, size of the incision, depth, and borders of flaps flaking are reported empirically and often lead to additional deformation of the operative area and the development of complications. Abdominoplasty is one of the most controversial operations in aesthetic and plastic surgery, where complications reach 27.5-30.8%. The concept of "abdominoplasty" provides techniques for the operational correction of abdominal wall deformities presented by excess skin and subcutaneous fat, pathological postoperative scars, as well as defects of the muscular aponeurotic layer in abdominal area. There are several abdominoplasty techniques. The purpose of this work is to determine the efficacy of the modified abdominoplasty in the surgical treatment of complex abdominal wall defects. Materials and methods. The study involved 360 patients with complex abdominal wall defects operated on at the surgical department of the Poltava Municipal Hospital №1 in for the last 10 years. Various deformities of the abdominal wall were detected in 289 patients (80,3%). Localization of the defects can be described as following: M – 306 (85%), L – 31 (8,6%), ML – 23 (6,4%). The size of the defects: W1 – 103 (28,6%), W2 – 188 (52,2%), W3 – 69 (19,2%). Additional diastase rectus muscles were detected in 179 patients (49,7%). The combined surgical diseases were found in 332 patients (92,2%); 18,1% of them were diagnosed to have intra-abdominal pathology. Results and discussion. The following types of dermatolipectomy were used: longitudinal - 77 cases (28,1%), by Babcock - 114 cases (41,6%), by Kelly - 6 cases (2,2%), by Fernandes - 63 cases (22,9%), modified Fernandez - 7 cases (2,5%), by Berson - 3 cases (1,1%), by Torek - 2 cases (0,8%), by Hrazer – 2 cases (0,8%). Simultaneous operations were performed on in 65 patients (18,1%). Types of alloplasty used: «onlay» - 3 cases (0,8%), «sublay» - 289 cases (80,3%), «sublay-inlay» - 38 cases (10,6%), «inlay» - 3 cases (0,8%), Ramirez – 4 cases (1,1%), intra-abdominal - 2 cases (0,6%), combine – 21 (5,8%). Conclusions. The term abdominoplasty has a broader definition than it was considered previously. Differentiated surgical tactics for patients with complex abdominal wall defects improves the abdominoplasty outcomes.

Aim. To improve the results of treatment of patients with breast cancer after radical mastectomy through the development and application of a device for wound closure after radical mastectomy, providing favorable conditions for wound healing. Methods. The proposed device for wound closure after radical mastectomy was used in 42 patients after the mandatory informed consent. A patent for the invention was obtained for the developed device. The study group included patients with indications for performing Madden mastectomy (Halsted, Patey) for breast cancer in the range of stages T1-4N0-1M0. The age of the patients was 57.5±10.4 (m±δ) years. In group 1 (n=21), wound closure after radical mastectomy was performed using the developed device, in group 2 (n=21) - without it. Results. In the process of working with the developed device, the following positive features were observed. The magnitude of the buckling in the plane of the jaws follows the contour of the thorax in the region of operation of the patient preventing the appearance of the plots of overpressure by the device to the adjacent tissue and ensuring uniformity of traction paravulnar tissues. The complete absence of tissue tension in the area of the suture is the result of the suturing of surgical wounds only after the complete wound edges attachment by means of the device. The above-mentioned factors lead to the formation of point scars in the joints, the absence of extended forms of postoperative scars. Conclusion. The developed device for wound closure after radical mastectomy performed for breast cancer allows shortening the hospital stay after surgery by 36% (p=0.01) and the deadline for removal of drainage by 31% (p=0.01), reducing the incidence of local necrosis of the flap (p=0.44) compared to traditional suturing of the wounds.

Objective. To evaluate the efficiency of ASL-perfusion as a method of estimating of hemodynamics and detection of residual tumor tissue after surgical treatment of glioblastoma.Material and methods. 56 patients after brain tumor’s surgical resection of glioblastoma (GRADE IV). CBF values were determined in 3 different areas - in the presumed tumor tissue with maximum perfusion, in the postoperative scar tissue and in the deep white matter of the opposite hemisphere. All patients were divided into 2 groups according to CBF value.Results. 1st group: 38 (67.9%) patients - the average CBF in suspected tumor was 137.6±35.2 (79.6-227.6) ml/100 g/min. It was 6-8 times higher than CBF in the deep white matter of the opposite hemisphere, and 5-6 times higher than in the postoperative scars.2nd group: 18 (32.1%) patients with no pathological elevation of CBF in postoperative scar tissue. CBF there was 22.3±5.9 (13.9-37.1) ml/100 g/min. CBF in white matter in the contralateral hemisphere was similar.There was no significant differences in CBF of scar tissue (p=0,52) and in white matter of contralateral hemisphere (p=0,96) in both groups.Conclusion. The possibilities of ASL-perfusion are enough to estimating of hemodynamics and detection of residual tumor tissue after surgical removed glioblastoma.

OBJECTIVE: This study was performed to evaluate the clinical effect of skin redraping on lower eyelid epiblepharon accompanied by a medial epicanthal fold. METHODS: This retrospective case series involved 572 eyes of 286 patients who underwent skin redraping surgery to treat lower eyelid epiblepharon accompanied by a medial epicanthal fold from January 2015 to May 2019. The postoperative surgical results were classified as “good”, “fair” and “poor”. The incision scars were assessed using the Vancouver scar scale. The patients’ subjective satisfaction and incidence of complications were also documented. RESULTS: The mean patient age at the time of surgery was 6.9 ± 3.6 years (3–12 years), and the mean follow-up time was 32.6 ± 13.5 months (6–58 months). The clinical symptoms and severity of keratopathy were improved postoperatively. “Good” surgical outcomes were obtained in all patients, the mean Vancouver scar scale score was 1.1 ± 0.3, and hypertrophic scar formation did not occur. A total of 272 patients and their guardians were “very satisfied” with the cosmetic outcomes. CONCLUSION: Skin redraping was effective and endurable in the treatment of lower eyelid epiblepharon accompanied by a medial epicanthal fold. The postoperative scars were slight and nearly invisible, and no cases of recurrence were observed in this study.

The technique of maxillectomy has been revised since it was first described in the 1820s. During the past decade, the endoscopic approach has been widely practiced for resecting maxilla. Compared with the traditional approaches, the combined endoscopic and transoral approach has many advantages such as avoiding facial incisions and postoperative scars and better visualization of the surgical margin. However, this technique is complicated to master and possess several challenges. Here, we demonstrate this approach step-by-step to show how to perform a total maxillectomy. We also reported nine cases with malignant tumors originating from the maxilla, and for all of them total maxillectomy was performed with combined endoscopic and transoral approach. Our data showed that the combination of the endoscopic and transoral approach could be used to resect the total maxilla successfully, though the tumor extended to the infratemporal and pterygopalatine fossa should be treated very carefully to avoid its spread in the local area. Furthermore, besides denture, other reconstruction methods should be attempted to improve the postoperative quality of life after the total maxillectomy.

Reconstruction of breast defects of patients who underwent mastectomy can be challenging. This study was designed to review a series of 43 breast cancer patients who underwent immediate breast reconstruction (IBR) using the latissimus dorsi myocutaneous flap with/without implants. The demographic characteristics, clinical application feasibility, and the satisfaction rates of the patients were retrospectively collected and evaluated. A total of 43 breast cancer patients who underwent mastectomy between August 2015 and February 2020 were included in the retrospective study. The included patients were subjected to IBR using latissimus dorsi muscular flap (LDMF) with/without implants. The clinical application feasibility and the satisfaction rates of the patients were evaluated. Among these patients, 35 patients underwent nipple-sparing mastectomy and 8 patients underwent skin-sparing mastectomy. Twenty-nine patients underwent IBR using LDMF with implants, and 14 patients underwent IBR using LDMF without implants. Among these patients, 2 patients had partial LDMF necrosis and atrophy, and showed significant shrink of the reconstructed breast. One patient developed seromas, and seromas were improved by active dressing change and sucking out the fluid via the skin using a syringe. Two patients had local skin flap necrosis on the chest, 1 patient had preserved areola and local necrosis of the nipple, and this was healed after dressing change. Based on the Harris method, 27, 9, 5, and 2 cases were evaluated as “excellent,” “good,” “fair,” and “poor,” respectively. In the present study, the reconstructed breast has natural shape, good symmetry, and hidden postoperative scars. The aesthetic effect is relatively good, and the use of LDMF may represent an acceptable and valid option for IBR. The success of this procedure depends on the design of the incision, the skill and proficiency of the operation, as well as the correct treatment after surgery.

lt;bgt;Objective:lt;/bgt; The feasibility, surgical outcomes and possible risks and complications encountered during a facelift procedure for patients with parapharyngeal space (PPS) tumor were analyzed.lt;brgt;lt;bgt;Method:lt;/bgt; This retrospective analysis examined 10 patients who underwent surgery for PPS tumor using a facelift incision at our institutes between April 2015 and August 2019.lt;brgt;lt;bgt;Results:lt;/bgt; This study included four retro-styloid (benign nerve sheath tumor) and six pre-styloid tumors (pleomorphic adenoma). Mean tumor dimensions were 4.1 x 4.2 x 3.8 cm respectively. None of the patients needed conversion to conventional open resection. Transient sensory changes in the auricle occurred in 30% of the patients; however, all recovered within four months. In all the patients, postoperative scars were fully concealed by the auricle and hair. No recurrences were detected during a mean follow-up period of 16.6 months.lt;brgt;lt;bgt;Conclusion:lt;/bgt;The facelift procedure provides adequate visualization, workspace and excellent cosmetic results in properly selected cases.

Introduction: There are several surgical techniques for unilateral cleft lip repair. In most of these techniques, the points where the postoperative scars cross the vermilion border are on the peak of the Cupid’s bow. These scars make the shape of Cupid’s bow indistinct. To maintain the natural shape of the Cupid’s bow, we modified the surgical technique. Methods: We modified the modified Millard’s surgical technique (Onizuka’s surgical technique). The main point of this modification was as follows: we combined a small triangular flap and a vermilion triangular flap (described by Noordhoff). We maintained the projection point on the lateral side of cleft lip which was coordinated to the peak of the Cupid’s bow. Results: We could preserve the shape and symmetry of the peak of the Cupid’s bow. Conclusion: To keep the projection point on the affected side of cleft lip and the surrounding vermilion border as one curve structure is important in maintaining the natural shape of the Cupid’s bow.

BackgroundScars with poor cosmesis that develop after wound healing may affect normal life.ObjectiveTo assess the efficacy and safety of botulinum toxin type A (BTXA) in preventing postoperative hypertrophic scars or keloids.MethodsA systematic review was performed by searching the PubMed, Cochrane Library, and EMBASE databases from their inception date up to February 2020 for randomized controlled trials (RCTs) evaluating the efficacy of BTXA in preventing hypertrophic scars or keloids. The primary outcome measures included the Vancouver Scar Scale (VSS) score, Visual Analog Scale (VAS) score, scar width, patient satisfaction, and adverse events.ResultsTwelve RCTs involving 497 cases (372 patients) were included. The meta-analysis showed significant differences in the VAS score (weighted mean difference [WMD] = 1.31, 95% CI = 1.06 to 1.55, P < .00001), VSS score (WMD = −1.02, 95% CI = −1.72 to −0.32, P = .004), scar width (WMD = −0.18, 95% CI = −0.29 to −0.08, P = .0008), and patient satisfaction (relative risk = 1.25, 95% CI = 1.06-1.49, P = .01). Four studies reported trivial adverse events.ConclusionsThis meta-analysis showed that BTXA was more effective than the control treatment in preventing postoperative scars and improving the cosmetic appearance of facial scars for East Asians, and no serious adverse events were found during the follow-up period. However, there was insufficient evidence to support the use of BTXA for the prevention of scars in patients from other ethnic groups and regions or scars in non-facial areas.

This clinical study is a first attempt to use autofluorescence for recurrence diagnosis of skin cancer in postoperative scars. The proposed diagnostic parameter is based on a reduction in scar autofluorescence, evaluated in the green spectral channel. The validity of the method has been tested on 110 postoperative scars from 56 patients suspected of non-melanoma skin cancer, with eight patients (13 scars) available for the repeated examination. The recurrence diagnosis within a scar has been made after two subsequent autofluorescence check-ups, representing the temporal difference between the scar autofluorescence amplitudes as a vector. The recognition of recurrence has been discussed to represent the significant deviations from the value of vector angle θ. This new autofluorescence-based method can be easily integrated into the postoperative monitoring of surgical scars and can help diagnose the recurrence of skin cancer from the early stage of scar development.

Summary Introduction The effect of radiation on uncomplicated postoperative scars is unclear. This study aimed to analyze irradiated and non-irradiated scars in patients with unilateral breast cancer, who underwent oncoplastic breast reduction surgery and radiation therapy (RT), to identify how postoperative scar changes with radiation. Methods Twenty breast scars in 10 patients were analyzed after unilateral breast-conserving surgery, oncoplastic breast reduction, and RT. Scars were assessed using the Vancouver scar scale (VSS) by two independent blinded observers and three-dimensional scar analysis camera. Paired t-test between irradiated and non-irradiated scars in each patient and correlation of scar score differences with potential contributing factors were analyzed. Results The VSS was significantly lower for the irradiated scar than that for the non-irradiated contralateral scar (1.40 vs. 4.05, p = 0.001), although time interval from the last radiation to scar assessment had a negative correlation with paired differences of VSS (Spearman's correlation coefficient: –0.637, p = 0.048). Compared with the non-irradiated scar, the irradiated scar showed a significantly high level of hemoglobin (1.04 vs. 1.26, p = 0.017) and melanin (0.55 vs. 0.63, p = 0.03). Conclusions Postoperative scars with radiation showed better results in objective and subjective assessments than scars without radiation. These findings suggest that radiation has a positive effect on general scar maturation.

In this chapter, Vincent Hunsinger, MD, former chief of clinic in the department of Professor Lantieri at Georges Pompidou European Hospital in Paris and in post-bariatric silhouette surgery after massive weight loss under the direction of Professor Ibrahim Dagher (Hospital Antoine Beclère, Clamart, France) presents a technique of improvement of postoperative scars by the use of an automated 1210 nm diode laser system (UrgoTouch®). The interest of this technique is to limit/prevent postoperative hypertrophy and scar enlargement.

Introduction We present our experiences using a modified surgical approach from the edge of the tragus for mandibular condyle fractures, to reduce the risk of postoperative complications and visible scars. Materials and methods Thirty-two patients presenting with mandibular condyle fractures were treated through a modified approach on the edge of the tragus. The age of the patients ranged from 6 to 62 years. All mandibular condyle fractures were fixed. The patients were asked to start open-mouth training one week postoperatively, undergoing a cone-beam computed tomography examination and clinical follow-up. Postoperative complications were evaluated after surgery. Results Mouth opening was normal (average 39.5 mm) in all the patients during the operation and the occlusion improved significantly compared with preoperatively. No cases of damaged facial nerves were observed during the final follow-up at six months and postoperative scars were less noticeable. Conclusions The modified surgical approach from the edge of the tragus for mandibular condyle fractures provides a good view of the operative field, reduces the risk of facial nerve damage and produces a less noticeable postoperative scar.

For the treatment of double primary cancer of the breast and thyroid, endoscopic thyroidectomy might be an excellent option in terms of cosmesis; however, it may not offer curability, and it makes the accuracy of follow-up examinations difficult. The postoperative scars after endoscopic thyroidectomy may modify the estimation of recurrence. To achieve improve cosmesis and the accuracy of follow-up examination, we developed a novel method for thyroid surgery: hybrid-type endoscopic thyroidectomy (HET). Here we report two cases of double primary cancer, one synchronous and the other metachronous. HET lobectomy and HET total thyroidectomy were performed in combination with some modifications of breast surgery. In each case, the postoperative course was uneventful, and cosmetic satisfaction was very high. Furthermore, there were no problems during the follow-up period. Based on our results, HET could become a standardized treatment of double primary cancers.

In modern dermatology and cosmetology, the task of developing a complex method of therapy for the symptomatic complex remains acute, despite a large number of studies on this problem. The effectiveness of the treatment of postoperative scars was evaluated by the combined use of laser ablation (ablative photothermolysis) on the SmartXide Dot (Deka) device and autologous platelet enriched plasma (auto-OTP). The result of treatment of a patient with clinical manifestations of atrophic and hypertrophic postacne scarring 4th grade (according to the scorecard scale of post acne D. Goodmantal, 2006) on the skin of the face and back is presented. The tactics of managing the patient during rehabilitation after combined use of laser ablation and auto-OTP with application of topical retinoids are described. As a result of the therapy, there were fewer clinical manifestations of atrophic scars on the face skin on 70-80% and mainly hypertrophic scars on the skin of the back on 50-60%.

Not available.

Backround Secondary ventral hernias are incisional hernias developed in former postoperative scars. Up to 30% of all patients undergoing laparotomy develop an incisional hernia. Open ventral hernia repair is often performed under general anaesthesia but can also be performed under regional anaesthesia. Case report We report the case of an elderly man, who underwent open surgery of a large incisional hernia in spinal block. Regional anaesthesia was chosen due to the patient's additional diseases and disorders. Conclusion Open surgery of large ventral hernia in spinal anaesthesia can be performed because the spinal anaesthesia provides adequate conditions for ventral hernia repair. The patient has to be in good physical condition in order for the surgery to be successful. During the surgery the patient has to be watched over vigilantly by the anaesthesiologist., Highlights • Original case report. • A rare case, not published previously in the literature. • In literature there are rare descriptions of ventral hernia operations under spinal anaesthesia. • Quality intraoperative images.

The review presents the possibilities and experience of using diode lasers for treatment of oral inflammatory diseases. Earlier, low-intensity laser was used in dentistry only as a physiotherapeutic device. The laser applications range has expanded significantly with the advent of new technologies. Diode laser has a high level of safety, so it can be used in periodontics and endodontics without fear of tooth tissue structure damaging. In surgical dentistry, high-intensity laser radiation is used as an alternative to cutting and rotational instruments. Features of diode laser for surgical interventions are sterile conditions during the intervention and avoidance of bleeding during and after surgery, predicted depth of injury, high incision accuracy. Accumulated experience of using a diode laser shows good hemostatic effect, which leads to minimal recession of gingival margin. Many authors emphasize that postoperative scars are absent or are more tender and elastic, not constricting tissues. In comparison with traditional methods, use of laser scalpel can reduce epithelialization time of a wound by half. Also, a number of authors claim that the diode laser stimulates immune system, reduces pathogenicity of microflora, increases its sensitivity to antibiotics, positively regulates the function of dental cement in vitro. Use of laser technology improves the quality and effectiveness of ongoing treatment, reduces repeated paient visits, shortens treatment time, avoids relapses and complications. Due to this, the question of expanding the indications for diode lasers use in dentistry and improving the methods remains of current interest.

“Balanced” bone decompression of the orbit was performed in a patient with endocrine ophthalmopathy, CAS3, OD=30 mm, OS=31 mm with the use of minimally invasive transconjunctival approaches and frameless neuronavigation. At the first stage the preoperative computed tomography of the orbits was imported into the navigation software, and then marked the area of the proposed resection of the orbit walls. Further, in the operating room, the patient was registered in the navigation system. To perform bone decompression of the orbit and lipectomy, we used preseptal, transcaruncular and lateral retrocanthal approaches. These approaches are transconjunctival and do not leave postoperative scars. Upon completion of the orbitotomy, its accuracy and dimensions were determined by the intraoperative pointer of the neuronavigation system. Results. The postoperative period was uneventful. In the early postoperative period there was a regression of exophthalmus OD=26 mm, OS=27 mm, closure of the eye gap, but retraction of the eyelids remained. When examined 3 months after the operation, the exophthalmic regression was OD=23 mm, OS=24 mm, retraction of the eyelids — 1 mm, with lead — finishing to the lateral adhesion. When examined after 6 months — the position of the eyeballs in orbit: ОD=21 mm, ОS=22 mm, retraction of the eyelids is not present, there is no violation of oculomotorics, complications were not recorded. A satisfactory result was obtained. Conclusion. Minimally invasive transorbital approaches allow the transconjunctival acces to all orbital walls to perform decompression of the orbit and lipectomy without cutaneous incisions, to achieve good cosmetic and functional results. And the intraoperative use of the neuronavigation system ensures the bone decompression of the orbit in full. The technique is promising and requires further randomized studies.

The purpose: to develop differential diagnostic criteria of recurrence and scarring by using various MRI techniques.Materials and methods. MRI of the pelvis was performed in 139 patients at different times after removal of colorectal cancer. Recurrence was diagnosed in 48 (34.5%) patients. The shape, size, structure, signal characteristics and the intensity of the accumulation of contrast agent in zones of recurrence and scarring were analyzed. The patients were divided into three groups with different types of postoperative MRI pattern of pelvic: patients without scarring in the pelvis, patients with a homogeneous scarring, patients with inhomogeneous scarring. The present study was compared with MRI data performed in the early stages after surgery.Results. The recurrences with typical MR characteristics were so easy to identify and did not require differential diagnosis. The patients with recurrence occurred in severe scar process in the pelvis needed for differential diagnosis. The detection of recurrence and monitoring of patients without scarring in the pelvis was not difficult. The greatest difficulties arose during the initial examination of patients with inhomogeneous scarring. The difficulties in the differential diagnosis occurred at small sizes of recurrence up to 15 mm, making it impossible to assess their structure and signal characteristics; in the event of relapse in presacral areas of scarring, the presence of areas of hemorrhage in the tumor structure.Conclusions. The presence of severe scar process in the pelvis was the main reason for difficulties in detection and differential diagnosis of recurrence of rectal cancer.

The purpose of the study was to compare the effectiveness of various compression techniques with a prolonged-action patch on postoperative scars.The study included 21 patients aged 3.6±1.7 years who had scars after surgery. The patients were divided into two groups: group No 1 (n=11), in which they applied longitudinal patch of prolonged-action Contractubex according to the standard technique; group No 2 (n=10) - transverse imposition of the patch on the postoperative scar (according to the author's method).In 20 (95.5%) patients, good compliance was noted. By the 90Thus, the effectiveness of the proposed technique of transverse imposition of the patch Contractubex on the postoperative scar after surgical intervention was confirmed by a good cosmetic and functional result of scar formation.Цель исследования - сравнение эффективности различных методик компрессии пластырем пролонгированного действия на послеоперационные рубцы. Материал и методы. В исследование был включен 21 пациент в возрасте 3,6±1,7 года, имевших рубцы после оперативных вмешательств по поводу удаления образований кожных покровов. Больные были разделены на две группы: 1-я группа (n=11) с продольным наложением пластыря пролонгированного действия Контрактубекс по общепринятой методике; 2-я группа (n=10) - поперечное наложение пластыря на послеоперационный рубец (по авторской методике). Результаты. У 20 (95,5%) пациентов отмечали хорошую комплаентность. К 90-м суткам после оперативного вмешательства ширина рубца в 1-й группе была достоверно больше, чем во 2-й группе, составляя 2,5±0,15 и 2,0±0,1 (p0,05). Выводы. Таким образом, эффективность предложенной методики поперечного наложения пролонгированного пластыря Контрактубекс после оперативных вмешательств подтверждалась хорошим косметическим и функциональным результатом формирования рубца.

Shady M Ibrahim,1 Wael M Saudi,2 Mohamed F Abozeid,3 Mohamed L Elsaie4 1Department of Dermatology, Al Azhar University, Cairo, Egypt; 2Department of Dermatology, Misr University for Science & Technology, 6th of October City, Egypt; 3Department of Plastic surgery, Cairo University, Giza, Egypt; 4Department of Dermatology, National Research Centre, Cairo, Egypt Background: Fractional CO2 laser is one of the most effective treatment options used to resurface scars. Objective: To evaluate the efficacy and safety of early treatment of postsurgical scar by fractional ablative CO2 laser. Methods: A total of 27 Egyptian patients with recent postoperative scars were enrolled in this study. Three sessions of fractional CO2 laser with a 1-month interval were started 4 weeks after surgery. Vancouver Scar Scale (VSS) was used as an assessment tool at 1 and 3 months after the final treatment. Patients reported their satisfaction using a subjective 4-point scale. Results: Results demonstrated a statistically significant overall average improvement of the VSS (5.33±1.33) before compared with (2.55±1.06) 3 months after the last laser treatment (P≤0.001). Among the individual parameters in the VSS, the most significant improvements were found in pigmentation, height, and pliability. Patient’s subjective satisfaction scores showed a significant greater degree of satisfaction after laser treatment. Conclusion: Fractional ablative CO2 laser is an effective and safe treatment modality for surgical scars in the early postsurgical period. Keywords: scar, fractional, CO2 laser

BACKGROUND: The main goal of excision of a pigmented nevus is to achieve an esthetically pleasing result. A single nevus can be removed by simple excision, whereas S-shaped suture can be used for the excision of 2 adjacent nevi. However, the choice of suturing method is based on the experience of the dermatologic surgeon, as there is no uniform standard for suture following the excision of 2 adjacent nevi. The aim of the present study was to determine whether S-shaped wound closure is appropriate for the excision of 2 adjacent nevi. METHODS: The outcomes of 21 patients who underwent simultaneous resection of 2 adjacent nevi were retrospectively reviewed. Of these patients, 17 chose S-shaped suture and 4 chose direct suture. Patients were followed-up for more than 6 months to review their postoperative scars. Differences between the 2 methods were compared based on the patient and observer scar assessment scale. Diameters and the proportional relationship between the 2 nevi were analyzed. RESULTS: Patients who underwent S-shaped wound closure surgery were more satisfied compared to those who had direct suturing (P

Circumferential bodylift is a powerful procedure for achieving dramatic and natural body contouring changes in the massive weight loss patient. The care of these patients has raised our awareness of several important issues including safety, nutritional status, skin quality, recurrent laxity, surgical steps, and postoperative scars. Integration of this knowledge with various technical modifications over the last 15 years has improved our care for this cohort. We have not only seen a rise in the number of surgeries performed, but also the development of principles, techniques, and details that the authors feel necessary to share to achieve improved contour and more predictable outcomes. Level of Evidence 4![Graphic][1] Therapeutic [1]: /embed/inline-graphic-1.gif

We treated nine patients with skin defect produced by digital mucous cyst (DMC) excision on the finger and toe using lateral finger flap (LFF). The postoperative scars were esthetically acceptable and no recurrence of mucous cysts was observed. Our LFF is a simple method to repair minor distal dorsal finger defects.

It was organized a non-formal course with the objectives to increase the capacity to develop research projects, understanding and critical interpretation of scientific articles, changing their ideas into research projects, in order to fulfill the need of students to be involved in research. Together with students from Faculty of Medicine and Faculty of Biology, we have developed projects regarding treatment of spinal trauma, innovative treatment of diabetes, decrease the postoperative scars, motherese. The diversity of subjects covered reflects the diverse interests of students and prove a great curiosity and an increased willingness to solve a major social problem.

Background Silicone sheet is commonly used for scar management but hard to apply to irregular surfaces or mobile areas, and difficult to conceal. On the contrary, silicone gel is easy to apply and nearly unnoticeable. Therefore, we conducted this study to compare their effectiveness. Methods Patients undergoing horizontal cesarean section were included. Surgical wounds were divided into 2 halves. Patients randomly applied silicone sheets and silicone gel on either side of their wounds for 3 months. The wounds were assessed at 1, 3, 6, and 12 months after surgery. We used the Vancouver Scar Scale (VSS) for an objective evaluation and the visual analog scale (VAS) for a subjective evaluation. Results There was no statistical significance between the silicone sheet and silicone gel groups with respect to VSS score. The silicone sheet group showed a statistically significant higher VAS score for itch at 1 month follow-up (1.18 ± 2.04 vs 0.35 ± 0.85, P = .01). However, the difference was less than 1 on a scale of 10, so it might not be clinically meaningful. Conclusion Silicone sheet group showed statistically significant worse VAS score in terms of itch. However, the difference was too small to be clinically meaningful.

The aim of the study was to evaluate the effectiveness of compression therapy with a prolonged plaster of Contractubex in the formation of skin scarring in children after surgery.In a prospective open-label randomized trial, 109 patients aged 5.3±2.1 years after surgery: boys - 73, girls - 36. Patients were divided into 2 groups: in the main group (54 children) the application of the prolonged plaster Contractubex was performed; in the control group (55 patients) - dynamic observation. The scar deformation was assessed according to the Vancouver scale for 10, 30 and 90 postoperative days.94.4% patients had good compliance; in 2 (3.7%) - satisfactory; in 1 (1.9%) - unsatisfactory compliance. In our study, the formation of hypertrophic scars in the main group was significantly less frequent than in the control group (1 and 8 patients, respectively, χThus, the use of the prolonged plaster Contractubex in the near and distant period a good cosmetic and functional result in the formation of a postoperative scar was provided.Цель исследования - оценка эффективности компрессионной терапии пластырем пролонгированного действия Контрактубекс в формировании рубцов кожи в детском возрасте после оперативных вмешательств. Материал и методы. В проспективном открытом рандомизированном исследовании участвовали 109 пациентов в возрасте 5,3±2,1 года после оперативного вмешательства (73 мальчика и 36 девочек). Пациенты были разделены на 2 группы: в основной группе (54 ребенка) выполнялось наложение пролонгированного пластыря Контрактубекс, в контрольной группе (55 пациентов) - динамическое наблюдение. Рубцовую деформацию оценивали по Ванкуверской шкале на 10, 30 и 90-е послеоперационные сутки. Результаты. У 94,4% пациентов отмечали хорошую комплаентность, у 2 (3,7%) - удовлетворительную, у 1 (1,9%) - неудовлетворительную комплаентность. В проведенном исследовании образование гипертрофических рубцов в основной группе отмечалось достоверно реже, чем в контрольной группе (1 и 8 пациентов соответственно, χ

Introduction Single-incision pediatric endosurgery (SIPES) for the treatment of acute appendicitis in children has recently gained popularity due to its advantages including minimization of postoperative scars or less incisional pain. The principal disadvantages of SIPES include the limited degrees of freedom of movement and high health care costs. To overcome these issues, some surgeons have reported to use noncommercial ports for SIPES appendectomy. Case Report In this report, we present a case of a 10-year-old female patient with acute appendicitis undergoing SIPES appendectomy using own homemade glove port and straight rigid instruments. Conclusion SIPES appendectomy using the glove port is a low-cost alternative to commercially available port systems. It is easy to set up and use.

Background Surgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire. Methods A total of 40 patients (17 men and 23 women) with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS) and the Wake Forest University rating scale. Results The total patient score was 8.59 (range, 6-15) in the two-step incision group and 9.62 (range, 7-18) in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034) but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03). Conclusions Compared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.

Transoral approach is nowadays gaining the enormous attention among the thyroid surgeons, as it showed definite merits over the previously developed remote-access approaches for thyroidectomy, such as the ideal cosmetic outcome without remaining the postoperative scars, and the lesser dissection of the flap resulting in the decreased operation time and lesser postoperative pain. Instead of using the conventional endoscopic operation apparatus and instruments, we could successfully introduce the robotic surgical system to this novel surgical approach, and, in turn, could have the optimal surgical outcomes enhanced by the unique three-dimensional operative vision and multiple articulating instruments, after overcoming some trials and errors encountered during the initial developmental era. I herein describe the procedures of transoral robotic thyroidectomy (TORT) which we uniquely developed, and show my personal opinion on the advantages and disadvantages of the TORT.

Objective: To evaluate the efficacy of alginate oligosaccharides and sodium alginate (seaweed biological glue) after incision drainage for breast abscess. Methods: randomly selected 80 patients with breast abscess, observation group and control group 40 cases, observation group using alginate oligosaccharides, sodium alginate (seaweed biological glue) for postoperative patients with breast abscess incision drainage treatment disposal, the control group with saline treatment disposal, using t test to compare two groups of patients with postoperative incision healing time, switching frequency, the satisfaction degree of the patients of postoperative scar, using chi-square test to compare the postoperative recurrence rate. Results: the incisions of the two groups were completely healed, and the observation group had shorter healing time, fewer drug changes, lower recurrence rate and higher satisfaction to postoperative scars than the control group. Conclusion: the treatment of patients with breast abscess after open and drainage with algal oligosaccharide and sodium alginate (alginate biogel) after operation can significantly shorten the wound healing time of patients, reduce The Times of dressing changes, and improve patients’ satisfaction with scars and reduce recurrence.

WOS: 000348823600014 Background and Design: Postoperative scar development is an important problem for patients treated in plastic surgery clinics. Most patients think that continuous intradermal suturing is superior to interrupted suturing because they assume that it creates less scarring. We evaluated scars that form following intradermal and interrupted suturing. This article presents our controlled study that objectively compared the scars on patients faces using a wound evaluation scale. Materials and Methods: Thirty-five patients, who had undergone operations on the bilateral cheeks, were included in this study. Thirty patients were female; five patients were male. Their mean age was 40.05 years. The average scar evaluation time after surgery was 9.05 months. Elliptical excisions were made on the lesions under local anesthesia. The incisions on the right cheeks were sutured with 6/0 monofilament nonabsorbable sutures using the continuous intradermal suturing technique. The left cheek incisions were sutured with same sutures using the interrupted suturing method. Results: The patients were evaluated 7-11 months after operation (mean: 9.05 months) using the Stony Brook Scar Evaluation Scale. A Related Samples T-test was used for statistical evaluation of the differences between the suturing techniques. No significant differences were noted in scar formation between the two suturing methods (p>0.05). Conclusion: We found no differences in scar formation between the two frequently used suturing techniques studied here. We believe that the suturing technique is a less important determinant of scar formation than are other factors.

Background The application of less invasive techniques for liver surgery in patients undergoing living donor hepatectomy (LDH) has been reported. The objective of this study was to evaluate physical status according to type of incision in donors. Methods One hundred and forty-seven living liver donors underwent hepatectomy using three types of incisions: (i) Mercedes-Benz incision (M.B.), (ii) right subcostal incision with midline up to xiphoid incision (S.C.), and (iii) short upper midline incision (U.M.). A total of 100 donors answered the questionnaires, and 87 had sufficient data for the analyses. An original questionnaire designed to evaluate the physical status concerning postoperative scars. The questionnaire consisted of three major categories: appearance, sensation, and daily activities. The univariate analysis was performed using the chi-square test. Results Numbness of the abdominal wall was reported more frequently by the donor with M.B.s and right subcostal incisions up to xiphoid incisions. In terms of appearance, sensation, and daily activities, LDH with a U.M. was found to have a good self-assessment compared with that performed using other types of incisions. Conclusions LDH with a U.M. is a preferable procedure in terms of physical status and safety.