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New Technology and Improved Techniques Arm Dermatologists With Tools to Minimize Facial Scars From Skin Cancer Surgery
Date:2/3/2008

ntinuous stitch that weaves in and out similar to the stitching on a baseball -- causing the barbs to catch onto the connective tissue of the wound. In essence, the barbs on the stitches anchor themselves to the deep tissue of the wound and gradually close the wound together without tying knots.

"The barbed stitch technique was recently introduced and, in my experience, the technique has proven successful in closing complicated wounds very quickly and efficiently," said Dr. Nguyen. "Since the patient's operation time is greatly reduced because multiple stitch knots are avoided, their risk of surgical complications is theoretically less -- as longer surgeries are associated with greater risk of infection and other complications."

In addition, Dr. Nguyen explained that since the barbed stitch is thick, it works best for large wounds in areas of thicker skin and with high resistance that are hard to stretch -- such as the rigid scalp area. This procedure is not recommended in areas where the skin is thin, for instance on the nose or eyelids. He added that patients with thick skin on their cheeks may also be good candidates for the technique.

Dermabrasion and Lasers

All surgeries will leave scars and a "scar less" surgery is unrealistic. One approach that comes close is immediate sanding (dermabrasion) of the incision line. In this method, which was developed by dermatologists, a wound is closed with deep stitches first to bring the skin edges together. Sanding is then performed with either a mechanical abrasive device or a laser (intense beam of light energy) to remove the epidermis (the skin's outer layer) all along the entire incision line. This sanding is done at the time of surgery rather than several months afterwards, which is when traditional dermabrasion is completed. Once the epidermis is sanded down, the dermatologist places the top stitches and seals the wound.

Over the course of about seven to 10 days, the cells in the are
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SOURCE American Academy of Dermatology
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