Oh Suk Joon, Yang Jihoon, Kim Seon Gyu, Jung Sung Won, Koh Sung Hoon
From the *Institute of Burn, Reconstructive and Plastic Surgery, Bestian Seoul Hospital, Seoul; and †Department of Plastic and Reconstructive Surgery, Hallym University Sacred Heart Hospital, Anyangsi, Republic of Korea.
J Craniofac Surg. 2014 Mar;25(2):485-8. doi: 10.1097/SCS.0000000000000627.
Scar revision is one of the fundamental techniques in the field of plastic and reconstructive surgery. Local flaps, such as a Z-plasty, W-plasty, or geometric broken-line closure, have been used for scar revision. Camouflaging a scar during scar revision for marginal scars from skin grafts and flaps, trapdoor scars, and linear scars is difficult. We describe our experience with the use of modified dovetail-plasty for scar revision in these difficult areas. Our study group consisted of 28 cases among 22 patients (9 males and 13 females) with a mean age of 33.6 years (range, 6-61 years). The conspicuous scars were located on the face (50%) and extremities (50%). The authors designed Y-shaped incision lines to relax the skin tension lines on one side of the excision line and trapezoid incision lines on the other side. There were 16 follow-up operations performed over 6 months after the initial operation among a total of 22 patients. There were scar depressions (2 patients) and a hypertrophic scar (1 patient) at the interval area between the dovetail flaps. A diffuse hypertrophic scar occurred in 1 patient with a dorsal foot scar. The overall success rates of the procedure as assessed by the surgeons were as follows: excellent (75%), good (12.4%), fair (6.3%), and poor (6.3%). This new local flap can achieve an inconspicuous scar using a blurred scar line and reducing tension. The authors recommend a modified dovetail-plasty for the revision of trapdoor scars and scars under excessive tension.
瘢痕修复是整形与重建外科领域的基本技术之一。局部皮瓣，如Z成形术、W成形术或几何折线闭合术，已被用于瘢痕修复。在对皮肤移植和皮瓣边缘瘢痕、活板门瘢痕及线性瘢痕进行瘢痕修复时，隐匿瘢痕具有一定难度。我们描述了在这些困难区域使用改良燕尾成形术进行瘢痕修复的经验。我们的研究组包括22例患者中的28个病例（9例男性和13例女性），平均年龄33.6岁（范围6 - 61岁）。明显瘢痕位于面部（50%）和四肢（50%）。作者设计了Y形切口线以松解切除线一侧的皮肤张力线，另一侧为梯形切口线。在总共22例患者中，初次手术后6个月内进行了16次随访手术。在燕尾皮瓣之间的间隔区域出现了瘢痕凹陷（2例患者）和1例肥厚性瘢痕。1例足背瘢痕患者出现了弥漫性肥厚性瘢痕。外科医生评估该手术的总体成功率如下：优秀（75%）、良好（12.4%）、中等（6.3%）和差（6.3%）。这种新的局部皮瓣可通过模糊瘢痕线和减轻张力实现不明显的瘢痕。作者推荐改良燕尾成形术用于修复活板门瘢痕和张力过大的瘢痕。
