(1), skin grinding: for some smooth and soft surface keloid scars, mechanical dissection can be used to restore the skin to a better color and achieve the purpose of treatment.
(2), scar release local reshaping surgery: for smaller striated and webbed scar with tension, the scar can be excised, and then the normal skin tissue around it can be used to form a flap to repair the skin defect in the scar area by cross transposition.
(3) Scar excision suture: It is a common surgical method in scar treatment and can be used for smaller area of keloid scars. Depending on the size, nature and location of the scar, excision sutures can be divided into four ways: direct excision sutures, staged excision sutures, intra-scar excision sutures, and scar epidermal excision sutures.
(4) Skin grafting: Skin grafting is a relatively simple and commonly used method for repairing skin defects. In order to achieve better appearance and functional results, skin slice grafting can be used when the scar is not suitable for local flap repair and cannot be directly sutured after excision. According to its thickness, it can be divided into superficial, medium-thickness, full-thickness skin graft, etc.
(5) Flap grafting: Like flap grafting, flap grafting is one of the important means to cover the wound after scar excision. A flap is a piece of skin and subcutaneous tissue with its own blood supply, relying on its tip to supply its nutrition, transferred from one part of the body to another. It is indicated for repairing exposed wounds of bones, joints, tendons, large blood vessels, nerves, organ reconstruction, cavernous defects, radioactive ulcers, decubitus ulcers and unstable scars close to the bone surface. According to the transfer mode, they are generally divided into rotary flap, advancement flap, translocation flap, flip flap and cross flap.
(6) Abrasion: Abrasion is a surgical procedure to grind the epidermal layer and the dermal papillae layer to improve the irregular part of the skin surface and make it smooth and flat and color approximation. It is suitable for superficial scar left after acne, smallpox, chickenpox, herpes zoster, eczema, trauma, burns or surgery. If necessary, it can be performed at the same time as surgical excision, and its effect is better than that of simple grinding.
(7) Application of dilators: Skin soft tissue dilatation is a new technique that has emerged and rapidly promoted and developed in the field of plastic surgery in the past two decades. It is an indispensable means of repairing soft tissue defects and deformities in plastic surgery treatment. It is most often used in the repair of defects after scar excision. Soft tissue dilation is the surgical implantation of a dilator made of medical silicone under the skin or muscle, which is regularly injected with saline to expand and enlarge the skin and other tissues covering its surface, providing excess skin, subcutaneous tissue or muscle tissue for the purpose of repairing defects and reconstructing organs. It is suitable for tissue defects caused by scar excision, tumor excision, tattoo excision, etc. for various reasons; congenital soft tissue and organ defects and repair of deep defects as an adjunctive procedure.
(8) Microsurgery in scar surgery: The indications are similar to local flaps, but when no local flap is available, a free flap graft is needed to repair the defect. This surgical method involves transplanting a piece of normal skin tissue together with their nutrient vessels and nerves to the site of the excised scar under the operating microscope, where the vessels and nerves are re-anastomosed and the transplanted skin tissue survives to replace the scar tissue that affects the function and to achieve the purpose of restoring the function.