When is skin grafting needed?
If the scar area is large and after excision the edges of the wound cannot be brought together without strong tension, the defect is covered with a free skin flap. Donor skin is taken from an area hidden by clothing, usually from the thigh or buttock. The method is used for the consequences of burns, extensive injuries and scar contractures that limit movement in the joint. Engraftment of the flap requires special care in the first days, and the donor area heals on its own in 2–3 weeks.
Why can't a scar be completely removed?
Any cut in the skin heals through the formation of a scar - this is the only way of recovery available to the body. Therefore, the task of the operation is not to “remove the scar,” but to replace a wide, retracted or deforming scar with a thin and inconspicuous one, located along the lines of skin tension.
The result depends not only on the technique, but also on the individual tendency to scarring, localization and subsequent care. Scars always form worse on the sternum, shoulders and back than on the face.
Types of scars
- normotrophic - at the skin level, the most favorable
- atrophic - retracted, below skin level
- hypertrophic - protruding, but within the boundaries of the wound
- keloid - grows beyond the wound, prone to relapse
When to operate
A fresh scar takes 6–12 months to mature: it gradually turns pale, flattens and softens. It is not advisable to operate earlier - the result may be worse than the natural result of maturation. The exception is scars that limit movement or deform facial features.