Feinendegen Dominik L, Waldkircher Natascha J, Bannwart Fridolin, Kalbermatten Daniel F, Tremp Mathias
Institute of Plastic, Reconstructive and Aesthetic Surgery, Zuerich-Zollikon, Switzerland.
Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland.
Plast Reconstr Surg Glob Open. 2019 May 23;7(5):e2286. doi: 10.1097/GOX.0000000000002286. eCollection 2019 May.
We suggest that the degree of scar improvement with a beveled incision technique with an angle of about 20 degrees to the skin can be translated for various reconstructions on the face and can be verified by a validated clinical assessment scale and histology.
A total of 5 patients (2 men and 3 women) with a mean age of 68 years (range 54-84 years) undergoing elective surgeries on the face for tumor excision or cosmetic procedures were included. The beveled incision technique was compared with the conventional vertical incision (control group). Outcome measures were major and minor complications, pain and scar quality using the Patient and Observer Scar Assessment Scale, and histomorphologic scar assessment.
After a mean follow-up of 7.6 months (range 6-13 months), all patients healed uneventfully without pain, hypertrophic scars, or infection. We found a better overall Patient and Observer Scar Assessment Scale score in the beveled incision technique group (15 ± 3.4) compared with the conventional vertical incision group (18.4 ± 7.8, = 0.7). Histomorphologic analyses showed after 6 months less scar zone, less inflammatory reaction, fewer macrophages, less foreign body reaction, and more hair follicles in the beveled incision technique group compared with the vertical incision group.
We showed that the beveled incision technique using a 20-degree angle in elective surgeries on the face yields a cosmetic pleasant result for both the patient and the surgeon, which also goes in line with our histomorphologic analyses.
我们认为，与皮肤呈约20度角的斜切技术所带来的瘢痕改善程度可应用于面部的各种重建手术，并且可以通过经过验证的临床评估量表和组织学检查来验证。
纳入了5例患者（2例男性和3例女性），平均年龄68岁（范围54 - 84岁），他们因肿瘤切除或美容手术而接受面部择期手术。将斜切技术与传统垂直切口（对照组）进行比较。观察指标包括主要和次要并发症、使用患者和观察者瘢痕评估量表评估的疼痛和瘢痕质量，以及组织形态学瘢痕评估。
平均随访7.6个月（范围6 - 13个月）后，所有患者均顺利愈合，无疼痛、增生性瘢痕或感染。我们发现，与传统垂直切口组（18.4 ± 7.8，P = 0.7）相比，斜切技术组的患者和观察者瘢痕评估量表总体评分更好（15 ± 3.4）。组织形态学分析显示，6个月后，与垂直切口组相比，斜切技术组的瘢痕区域更小、炎症反应更轻、巨噬细胞更少、异物反应更少且毛囊更多。
我们表明，在面部择期手术中使用20度角的斜切技术对患者和外科医生而言都能产生美观的效果，这也与我们的组织形态学分析结果相符。
