Reducing Surgical Excision Scar Formation

Gloved hands preparing to make first incision on forehead of patient (Photo by Universal Images Group via Getty Images)
The efficacy of skin tension reduction device (SWTRD) plus ablative fractional carbon dioxide laser (CO2-AFL) for preventing facial scar formation in children is assessed.

A prospective cohort study found that a dual therapy of ablative fractional carbon dioxide laser (CO2-AFL) with a skin tension reduction device (SWTRD) improved scar appearance and reduced wound pain after surgical excision. These findings were published in Clinical, Cosmetic and Investigational Dermatology.

Pediatric patients (N=25) aged 5 to 14 years of age undergoing surgical excision for facial cutaneous lesions from congenital melanocytic nevus (CMV) or sebaceous glans nevus (SGN) at the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University in China were recruited from  2019 to 2021. After surgical excision performed by 2 experienced surgeons, patients received CO2-AFL surgery at suture removal and 1, 3, and 3 months. At 2 months after suture removal, a SWTRD device was applied over the scar. The preoperative skin lesion size was compared with final scar appearance and sensitization.

Patients were 72% girls, aged mean 9.88±2.77 years, 68% had CMV, 32% SGN, lesion length was 23.54±12.55 mm, and lesion width was 11.72±7.13 mm.

The patients wore the SWTRD for 78.80±9.12 days.

At 7 days after surgery, the average wound width was 0.28±0.10 mm. At month 2, the width of the scars had increased to 1.62±0.68 mm, remaining a similar size through 6 months (mean, 1.68±0.70; P =.079).

The median global Vancouver Scar Scale (VSS) score decreased from 6 at 2 months to 1 (P =.000) at 6 months. Stratified by VSS components pigmentation (median, 1 vs 1; P =.000), vascularity (median, 2 vs 0; P =.000), height (median, 1 vs 0; P =.000), and pliability (median, 2 vs 0; P =.000) components all decreased significantly from 2 to 6 months, respectively

Similarly, the median University of North Carolina 4P Scar Scale (UNC4P) global score decreased from 3 at 2 months to 0 at 6 months (P =.000). Stratified by the UNC4P components, by 6 months there were significant improvements to the pliability (median, 1 vs 0; P =.000), pruritus (median, 1 vs 0; P =.000), pain (median, 1 vs 0; P =.002), and paresthesia (median, 0 vs 0; P =.003).

Adverse reactions to this treatment included red rash (n=1) and blisters (n=1).

The limitations to this therapy included discomfort while wearing the device and the unsightliness of the SWTRD. In addition, some areas, like the nose, were difficult to apply the device to, the researchers noted.

The investigators suggest that their study findings found that a CO2-AFL and SWTRD dual therapy improved scar appearance and reduced scar sensitivity.


Xu H, Li J, Zhou Z, Bi J, Li X, Huo R. Skin Wound Tension Reduction Device Combined with Ablative Fractional Carbon Dioxide Laser to Reduce Scar Formation After Excision of Pediatric Facial Skin Lesions: A Prospective Cohort Study. Clin Cosmet Investig Dermatol. 2022;15:283-292. doi:10.2147/CCID.S347065