Scar Removal Surgery (Scar Revision) in Mumbai

Diagnosis 

Before using any type of scar removal method, the surgeon needs to examine the scar. A full assessment is required to determine the type of scar and its severity.

There are several scar-measuring devices available that facilitate data collection to quantify the scar objectively. These devices assess parameters such as pliability, color, perfusion, thickness, 3-D topography, firmness, etc. Scar scales are used for subjective scar assessment. It helps to quantify the scar appearance in response to the treatment. These scales are-

• Vancouver Scar Scale (VSS)- Used for burn scar assessment. It assesses vascularity, height, thickness, pliability, and pigmentation.
• Manchester Scar Scale (MSS)- This scale attributes scores of various parameters, including scar color, skin texture, relationship to the surrounding skin, margins, size, and the number of scars.
• Patient and Observer Scar Assessment Scale (POSAS)- This assessment test evaluates the scar from a patient’s and an observer’s perspective. It assesses vascularity, pigmentation, thickness, pliability, relief, and surface area of the scar. It further incorporates the patient’s symptoms, i.e., pain, itching, color, stiffness, thickness, and relief.
• Visual Analog Scale (VAS)- It is a photograph-based scale that assesses pigmentation, vascularity, acceptability, observer comfort, and contour of the scar.
• Stony Brook Scar Evaluation Scale (SBSES)- This scale is used to assess how the scar is likely to respond to the treatment in the short term.

The surgeon picks one of the multiple assessments to identify the best method to improve the appearance of the scar.

Procedure 

There are three different techniques of skin graft surgery- Split-thickness skin graft (STSG), Full-thickness skin graft (FTSG), and Composite graft. The following steps are involved in the procedure-

• The anesthetist administers general anesthesia to numb the body and put the patient to sleep.
• Both donor and recipient sites are sterilized. An air-powered dermatome will be used to harvest the graft from the donor site. Epinephrine is used to reduce blood loss at the donor site.
• The skin graft is cleaned or placed in a saline solution until the recipient site is ready.
• At the recipient site, the scar is cleaned and the skin graft is placed over the area. Sutures or staples are used to stitch the graft on the scar.

The entire procedure takes approximately 1 or 2 hours to complete depending on the size of the scar. Skin grafting surgery is usually done on an outpatient basis. Thus, the doctor will monitor your health for a few hours after surgery and then discharge the patient accordingly.