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1.

Discuss when to revise a scar.

Reference(s):

Thomas, J. R., & Somenek, M. (2012). Scar revision review. Archives of Facial Plastic Surgery, 14(3), 162–174.

2.

Relaxing skin tension lines and lines of Langer.

3.

Describe the technique of Z-plasty. Draw and calculate the effect of 30deg, 45deg, and 60deg Z-plasties.

4.

Demonstrate how to use a Z-plasty to lengthen a contracted scar, change the direction of a scar, break a straight line.

5.

Describe the concept of geometric broken line closure and draw its use in scar revision.

6.

Describe the technique of dermabrasion. Discuss its use in scar revision.  Limitations and complications of this technique.

7.

How is a keloid different from a hypertrophic scar? Normal scar?

8.

Discuss the non-surgical management of scars. Vitamin E, Silicone gel sheeting, Mederma, cocoa butter?

Reference(s):

Shih, R., Waltzman, J., & Evans, G. R. D. (2007). Review of over-the-counter topical scar treatment products. Plastic and Reconstructive Surgery, 119(3), 1091–1095.

Foo, C. W., & Tristani-Firouzi, P. (2011). Topical modalities for treatment and prevention of postsurgical hypertrophic scars. Facial Plastic Surgery Clinics of North America, 19(3), 551–557.

9.

Are silicone sheets effective in reducing scars and keloids?

Reference(s):

Hsu, K.-C., Luan, C.-W., & Tsai, Y.-W. (2017). Review of Silicone Gel Sheeting and Silicone Gel for the Prevention of Hypertrophic Scars and Keloids. Wounds : A Compendium of Clinical Research and Practice, 29(5), 154–158.

Monstrey, S., Middelkoop, E., Vranckx, J. J., Bassetto, F., Ziegler, U. E., Meaume, S., & Teot, L. (2014). Updated scar management practical guidelines: non-invasive and invasive measures. Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, 67(8), 1017–1025.

10.

When would you excise a keloid?  How would you prevent a recurrent keloid?

Reference(s):

Monstrey, S., Middelkoop, E., Vranckx, J. J., Bassetto, F., Ziegler, U. E., Meaume, S., & Teot, L. (2014). Updated scar management practical guidelines: non-invasive and invasive measures. Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS, 67(8), 1017–1025.

Naylor, M. C., & Brissett, A. E. (2012). Current concepts in the etiology and treatment of keloids. Facial Plastic Surgery : FPS, 28(5), 504–512.

11.

Discuss the effectiveness of steroid injection vs. radiation therapy as primary therapy for keloids.

Reference(s):

Shin, J. Y., Lee, J.-W., Roh, S.-G., Lee, N.-H., & Yang, K.-M. (2016). A Comparison of the Effectiveness of Triamcinolone and Radiation Therapy for Ear  Keloids after Surgical Excision: A Systematic Review and Meta-Analysis. Plastic and Reconstructive Surgery, 137(6), 1718–1725.

12.

How can lasers be used in scar revision?

Reference(s):

Sobanko, J. F., & Alster, T. S. (2011). Laser treatment for improvement and minimization of facial scars. Facial Plastic Surgery Clinics of North America, 19(3), 527–542.

Carniol, P. J., Meshkov, L., & Grunebaum, L. D. (2011). Laser treatment of facial scars. Current Opinion in Otolaryngology & Head and Neck Surgery, 19(4), 283–288.

13.

Your high maintenance cosmetic patient wants you to use the best suture for the prettiest wound.

Reference(s):

Coulthard, P., Esposito, M., Worthington, H. V, van der Elst, M., van Waes, O. J. F., & Darcey, J. (2010). Tissue adhesives for closure of surgical incisions. The Cochrane Database of Systematic Reviews, (5), CD004287.