Xuwen Tang, Yang Liu, Dongyun Yang, Yong Zhang

Department of Chongqing Kewei Scar Medical Institute/Dongshang Medical Aesthetic Clinic, Chongqing 400010, China

Keywords:Linear scar Micro-compound tissue grafting Excision and suture

ABSTRACT This study explored the clinical application and therapeutic effect of micro-compound tissue grafting(MCTG)for linear scars.In February 2019,one patient received MCTG treatment and the recovery at 20 months postoperative was observed.The patient was completely satisfied with the results.The MCTG technique is simple and reliable and can significantly improve scar appearance.This technique may be an effective method for treating linear scars, but it requires further validation in large samples.

1.Introduction

Linear scars are very common, and surgical excision and suture and laser treatment are common treatment methods.However, the improvement provided by surgical excision and suture is relatively small,and the possibility of leaving a threadlike incision is highly likely.Laser treatment can offer improvement,but its effect is limited and will make the threadlike incision look wider.Although the skin becomes flat,“mirror-like skin”that is smooth and reflects light may occur.

To solve this problem, the author adopted a new technology, microcompound tissue grafting (MCTG), that was inspired by hair transplantation technology.1,2The surgical procedures are as follows: (1)Perform skin preparation,draping,and local infiltration anesthesia;(2)A hidden area is chosen as the donor site.In this case,the hairline behind the ear was selected and micro-compound tissues were removed using a trephine.(3)Cut a hole with a trephine every 1.0 mm in the linear scar3;(4) Implant micro-compound tissues into the holes; (5) Apply Vaseline gauze in the surgical area.

2.Case presentation

A female patient in her thirtes had three scars on her nose: one was not obvious, so she chose not to undergo treatment; another linear scar was wide and treated with surgical excision and suture; and the third linear scar was thin and treated with MCTG because of limited improvement(Fig.1A).The scar at the tip of the nose(Fig.1)was treated with MCTG.The patient volunteered to participate in this study.According to the preoperative agreement, she did not receive any photoelectric treatment after surgery.Fig.1B shows the recovery results at 20 months postoperative.The patient was very satisfied with the results.The untreated areas remain the same.In the area treated with surgical excision,the linear scar was greatly improved,but a threadlike incision was faintly visible.Linear scars treated with MCTG nearly achieved a “scarfree”appearance to the naked eye.

3.Discussion

Treatment of linear scars is difficult.If a linear scar has a small diameter, a surgical incision is generally not considered, as a new threadlike incision will form postoperatively.In clinical practice, photoelectric treatment is generally used to treat thinner linear scars.However,for line scars exceeding 0.5–1.0 mm,the improvement afforded by laser treatment is often limited.4Although the skin becomes flat,there is a chance that it will become smooth and reflect light.

The concept of MCTG comes from hair transplantation.After using this transplantation technology,no scars are visible in the hair donor or recipient areas.Therefore,we used this principle to transplant the microcompound tissue into linear scars,hoping to achieve the best result.The main difference between MCTG and hair transplantation is that the drilled micro-compound tissue generally does not contain hair follicles.Of course,hair follicles can also be transplanted when necessary,such as in the upper lip for men.5

Fig.1. Application of MCTG technique for treating linear scars.(A) Appearance preoperative.(B) Appearance at 20 months postoperative.MCTG, micro-compound tissue grafting.

With the improvement in living standards, an increasing number of people are paying great attention to scar revision,and new technologies are being used for its treatment in anticipation of scar treatment to obtain better results.6This study believes that the MCTG technique is simple to operate and has a good application effect in the preliminary phase with a short course.It can significantly improve the appearance of linear scars and even achieve a scar-free appearance.MCTG may also be an effective means to treat threadlike incision scars after surgical excision and suture.Of course, these assumptions about MCTG require confirmation by further clinical applications.

MCTG shows better performance for linear scar treatment when combined with laser therapy.

4.Conclusion

It is currently challenging to treat the appearance of scar skin in the clinical setting, especially linear scars.With MCTG technology, transplanting the micro-compound tissues from hidden areas to linear scars is a feasible treatment that has achieved good results.Liner scars treated with MCTG nearly achieved a scar-free appearance to the naked eye.

Ethics declarations

Ethics approval and consent to participate

The need for ethical approval was waived, as it is a case report.Written informed consent was obtained from the participant.

Consent for publication

The patient provided written informed consent to publish the data contained within this study.

Competing interests

The authors declare that they have no competing interests.

Authors’contributions

Tang X: Writing-Original draft.Liu Y: Data curation.Yang D:Conceptualization, Methodology.Zhang Y: Writing-Reviewing and Editing.