Full-Thickness Skin Graft according to Surrounding Relaxed Skin Tension Line Improves Scar Quality in Facial Defect Coverage: A Retrospective Comparative Study

Area of Science:

• Plastic Surgery
• Dermatology
• Regenerative Medicine

Background:

• Full-thickness skin grafts (FTSGs) are standard for small skin defects.
• Conventional FTSGs can result in poor scar quality, including contour, color, and texture mismatches.
• The relaxed skin tension line (RSTL) concept offers a potential method for improving FTSG outcomes.

Purpose of the Study:

• To evaluate the impact of aligning FTSGs with RSTLs on scar quality after facial skin cancer excision.
• To compare scar outcomes between RSTL-matched and RSTL-unmatched FTSGs.

Main Methods:

• Retrospective review of 21 patients undergoing facial skin cancer excision and FTSG.
• Patients were divided into RSTL-matched and RSTL-unmatched groups.
• Scar assessment at three months post-surgery using Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS).

Main Results:

• Significant differences in VSS and POSAS scores between RSTL-matched and RSTL-unmatched groups.
• RSTL-matched FTSGs demonstrated superior aesthetic outcomes, including better integration with surrounding tissue and a more natural appearance.
• Improved scar quality was observed in the RSTL-matched group.

Conclusions:

• Aligning FTSGs with RSTLs is a valuable strategy for enhancing scar quality in facial reconstruction.
• RSTL-matched FTSG offers an improved aesthetic option for covering facial skin and soft tissue defects.
• This technique addresses common FTSG limitations, leading to more natural-looking results.