The "Sea" should not be operated on in scar revision for "Island-Like" scars

Tomohisa Nagasao, Yusuke Hamamoto, Motoki Tamai, Hiroo Kudo, Toshiya Ensako, Tetsukuni Kogure, Naoki Takano, Yoshio Tanaka

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Scars developing on body surfaces not only restrict body movement, but are also problematic from a cosmetic standpoint. Hence, revision is conducted by removing the scar and re-suturing the resultant defects. In performing scar revision, care should be taken to prevent the re-sutured wounds from developing hypertrophy again. Scars often present a pattern where hard, red parts are separated by soft parts in between. As the hard and soft parts may be analogized as islands and seas respectively, we call this the "Island-Like" scar. Two strategies can be taken to treat scars of this type. The first is to remove the entire scar-including both hard and soft parts; the second is to remove only the hard parts and leave the soft parts untouched. The authors conducted a biomechanical study using finite element analyses and found that as a body moves, greater stresses occur in the peri-wound regions with the first strategy than with the second strategy. A wound's likelihood to develop hypertrophy increases as the stresses working on it increase. Hence, it is hypothesized that the second strategy carries less risk of the operated wounds developing re-hypertrophy than the first strategy. Based on this logic, in performing scar revision for scars consisting of hard and soft parts, it is recommended only to remove only hard parts and not to operate on soft parts in between.

Original languageEnglish
Pages (from-to)215-218
Number of pages4
JournalMedical Hypotheses
Volume85
Issue number2
DOIs
Publication statusPublished - 2015

Fingerprint

Islands
Oceans and Seas
Cicatrix
Hypertrophy
Wounds and Injuries
Finite Element Analysis
Cosmetics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Nagasao, T., Hamamoto, Y., Tamai, M., Kudo, H., Ensako, T., Kogure, T., ... Tanaka, Y. (2015). The "Sea" should not be operated on in scar revision for "Island-Like" scars. Medical Hypotheses, 85(2), 215-218. https://doi.org/10.1016/j.mehy.2015.04.026

The "Sea" should not be operated on in scar revision for "Island-Like" scars. / Nagasao, Tomohisa; Hamamoto, Yusuke; Tamai, Motoki; Kudo, Hiroo; Ensako, Toshiya; Kogure, Tetsukuni; Takano, Naoki; Tanaka, Yoshio.

In: Medical Hypotheses, Vol. 85, No. 2, 2015, p. 215-218.

Research output: Contribution to journalArticle

Nagasao, T, Hamamoto, Y, Tamai, M, Kudo, H, Ensako, T, Kogure, T, Takano, N & Tanaka, Y 2015, 'The "Sea" should not be operated on in scar revision for "Island-Like" scars', Medical Hypotheses, vol. 85, no. 2, pp. 215-218. https://doi.org/10.1016/j.mehy.2015.04.026
Nagasao, Tomohisa ; Hamamoto, Yusuke ; Tamai, Motoki ; Kudo, Hiroo ; Ensako, Toshiya ; Kogure, Tetsukuni ; Takano, Naoki ; Tanaka, Yoshio. / The "Sea" should not be operated on in scar revision for "Island-Like" scars. In: Medical Hypotheses. 2015 ; Vol. 85, No. 2. pp. 215-218.
@article{ee34e22b234346bd88f4be58e346bc1a,
title = "The {"}Sea{"} should not be operated on in scar revision for {"}Island-Like{"} scars",
abstract = "Scars developing on body surfaces not only restrict body movement, but are also problematic from a cosmetic standpoint. Hence, revision is conducted by removing the scar and re-suturing the resultant defects. In performing scar revision, care should be taken to prevent the re-sutured wounds from developing hypertrophy again. Scars often present a pattern where hard, red parts are separated by soft parts in between. As the hard and soft parts may be analogized as islands and seas respectively, we call this the {"}Island-Like{"} scar. Two strategies can be taken to treat scars of this type. The first is to remove the entire scar-including both hard and soft parts; the second is to remove only the hard parts and leave the soft parts untouched. The authors conducted a biomechanical study using finite element analyses and found that as a body moves, greater stresses occur in the peri-wound regions with the first strategy than with the second strategy. A wound's likelihood to develop hypertrophy increases as the stresses working on it increase. Hence, it is hypothesized that the second strategy carries less risk of the operated wounds developing re-hypertrophy than the first strategy. Based on this logic, in performing scar revision for scars consisting of hard and soft parts, it is recommended only to remove only hard parts and not to operate on soft parts in between.",
author = "Tomohisa Nagasao and Yusuke Hamamoto and Motoki Tamai and Hiroo Kudo and Toshiya Ensako and Tetsukuni Kogure and Naoki Takano and Yoshio Tanaka",
year = "2015",
doi = "10.1016/j.mehy.2015.04.026",
language = "English",
volume = "85",
pages = "215--218",
journal = "Medical Hypotheses",
issn = "0306-9877",
publisher = "Churchill Livingstone",
number = "2",

}

TY - JOUR

T1 - The "Sea" should not be operated on in scar revision for "Island-Like" scars

AU - Nagasao, Tomohisa

AU - Hamamoto, Yusuke

AU - Tamai, Motoki

AU - Kudo, Hiroo

AU - Ensako, Toshiya

AU - Kogure, Tetsukuni

AU - Takano, Naoki

AU - Tanaka, Yoshio

PY - 2015

Y1 - 2015

N2 - Scars developing on body surfaces not only restrict body movement, but are also problematic from a cosmetic standpoint. Hence, revision is conducted by removing the scar and re-suturing the resultant defects. In performing scar revision, care should be taken to prevent the re-sutured wounds from developing hypertrophy again. Scars often present a pattern where hard, red parts are separated by soft parts in between. As the hard and soft parts may be analogized as islands and seas respectively, we call this the "Island-Like" scar. Two strategies can be taken to treat scars of this type. The first is to remove the entire scar-including both hard and soft parts; the second is to remove only the hard parts and leave the soft parts untouched. The authors conducted a biomechanical study using finite element analyses and found that as a body moves, greater stresses occur in the peri-wound regions with the first strategy than with the second strategy. A wound's likelihood to develop hypertrophy increases as the stresses working on it increase. Hence, it is hypothesized that the second strategy carries less risk of the operated wounds developing re-hypertrophy than the first strategy. Based on this logic, in performing scar revision for scars consisting of hard and soft parts, it is recommended only to remove only hard parts and not to operate on soft parts in between.

AB - Scars developing on body surfaces not only restrict body movement, but are also problematic from a cosmetic standpoint. Hence, revision is conducted by removing the scar and re-suturing the resultant defects. In performing scar revision, care should be taken to prevent the re-sutured wounds from developing hypertrophy again. Scars often present a pattern where hard, red parts are separated by soft parts in between. As the hard and soft parts may be analogized as islands and seas respectively, we call this the "Island-Like" scar. Two strategies can be taken to treat scars of this type. The first is to remove the entire scar-including both hard and soft parts; the second is to remove only the hard parts and leave the soft parts untouched. The authors conducted a biomechanical study using finite element analyses and found that as a body moves, greater stresses occur in the peri-wound regions with the first strategy than with the second strategy. A wound's likelihood to develop hypertrophy increases as the stresses working on it increase. Hence, it is hypothesized that the second strategy carries less risk of the operated wounds developing re-hypertrophy than the first strategy. Based on this logic, in performing scar revision for scars consisting of hard and soft parts, it is recommended only to remove only hard parts and not to operate on soft parts in between.

UR - http://www.scopus.com/inward/record.url?scp=84942825577&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942825577&partnerID=8YFLogxK

U2 - 10.1016/j.mehy.2015.04.026

DO - 10.1016/j.mehy.2015.04.026

M3 - Article

VL - 85

SP - 215

EP - 218

JO - Medical Hypotheses

JF - Medical Hypotheses

SN - 0306-9877

IS - 2

ER -