A comparison of intramarginal and extramarginal excision of hypertrophic burn scars.

Hypertrophic scarring is common in burn patients. The treatment of such scarring is difficult, and recurrence of the hypertrophic changes after scar revision is not uncommon. It has been suggested that intramarginal excision diminishes the chances of recurrent hypertrophic scarring, but we could not find any papers in the literature actually comparing intramarginal and extramarginal excisions. We therefore reviewed our experience with intramarginal and extramarginal excision of hypertrophic scars. Between October 30, 1979, and March 26, 1986, we excised 50 hypertrophic scars in 23 burn patients. Thirty-one (62 percent) of the excisions were intramarginal and 19 (38 percent) were extramarginal. We compared the results and observed that the intramarginal excisions yielded better results than the extramarginal excisions.