Clinical efficacy of expanding flap for large hyperplastic scar on scalp

Abstract

Objective To observe the efficacy and safety of implantation of tissue expanders for large hyperplastic scar on scalp. Methods Between June 2011 and April 2013, a total of 23 patients with large hyperplastic scar received treatment with 31 tissue expanders. The scar size varied from 5.5 cm × 4.0 cm to 17.5 cm ×9.5 cm. The capacity was 50-400 ml for expanders, with the shape of kidney or ellipse. After tissue expansion for 6 to 8 weeks, the expander was removed and hyperplastic scars were resected, followed by the repair of defect with expanded flaps. Further more, the patients received postoperative superficial isotope irradiation after the surgery. Follow-up varied from 6 to 12 months. Results Thirty expanders, except l expander pocket that was removed ahead of time due to infection, were implanted successfully during the whole course of treatment. The main complication was expander exposure in 4 patients, which showed no significant influence on secondary surgery. Twenty patients reported relief of symptoms and achieved satisfactory outcomes, while 3 patients showed great suture tension and experienced delayed stitch removal, followed by the recurrence of hyperplastic scar after the operation. Conclusions The implantation of tissue expanders under the scalp skin is an ideal treatment option for large hyperplastic scar on scalp. Regional suture tension is a direct contributor to the recurrence of hyperplastic scar formation after surgical excision. Key words: Flap; Scalp; Dilatation; Hyperplastic scar