The behaviour of presternal scars in a fair-skinned population.

The incidence of keloid and hypertrophic change and of scar stretching in the presternal region were studied in a fair-skinned population following open heart surgery through a median sternotomy incision. No patient in this study developed keloid change although scar hypertrophy and stretching were frequent. These changes were unrelated to the material used in subcuticular suture of the skin in a comparison of catgut, prolene and polyglycolic acid. Hitherto, unrecognised differences of scar maturation between different areas of the presternal skin were noted to be statistically significant. Scar hypertrophy is most likely in that part of the scar overlying the body of the sternum and particularly in the female. Scar stretching occurs most frequently in the lower third of the scar overlying the xiphisternum and extending onto the abdomen.