Scar dermal transposition flap for depressed scars: A valuable technique for depressed scar management

ABSTRACT

BACKGROUND: Various methods have been reported for the improvement of widened or depressed scars. However, scars can be complex at presentation. If a widened but flat portion is combined with a tethered or a depressed area, a scar revision method that can effectively resolve all issues is needed. The authors utilized a dermal portion of the widened scar as a re-adhesion barrier and filled tissue after the release of the tethering or depression. METHODS: From July 2014 to December 2017, a total of eight patients presented with combined scars with both widened and depressed areas and underwent scar revisions with scar dermal transposition flaps. The scar flap of the widened scar was de-epithelialized, leaving the dermo-cutaneous pedicle near the depressed area. Without any additional skin incision on the depressed site, the tethering was released by making a skin incision at the scar flap. The de-epithelialized scar dermal flap was transpositioned under the depressed area of the scar. RESULTS: The surgical wounds of all eight patients healed without any complications. The mean follow-up period was 5.25 months. The filling effect of the scar flap persisted without the conspicuous relapse of a depression or tethering. The patients were satisfied with the final results and the fact that no additional incision was needed for the tethered and depressed scar. CONCLUSIONS: If the depressed site is near a widened scar, a scar dermal transposition flap may be a versatile option for improving the depression without an additional skin incision.