Defect Closure In Areas With Tissue Limitations Due To Abnormal Scarring

Almas Mirza Murastomo

Abstract

Introduction: The management of defect closure in anatomical regions affected by abnormal scarring—such as keloids or hypertrophic scars—poses substantial surgical challenges, largely due to the restricted extensibility of tissue and compromised vascular supply. These conditions frequently result in both functional limitations and aesthetic concerns, thus requiring the development of advanced reconstructive techniques.

Case Report: We describe the case of a 21-year-old man who presented with a post-traumatic soft tissue defect on the left anterior cruris, further complicated by extensive hypertrophic scarring. The patient’s medical history was notable for delayed wound healing and repeated unsuccessful attempts at primary closure. A customized reconstructive plan utilizing local advancement flaps, supplemented by adjunctive therapies, was implemented.

Results: A thorough preoperative evaluation was conducted, including clinical assessment, ultrasonographic measurement of scar thickness and vascularity. The surgical intervention consisted of meticulous excision of hypertrophic scar tissue, followed by the design and transposition of local tissue flaps while conserving adjacent healthy tissue.

Conclusion: Effective closure of defects in scarred regions necessitates individualized strategies tailored to overcome inherent tissue limitations and prevent recurrence. Combining local flap techniques with adjunctive therapies, together with preoperative preparation, is essential for optimal outcomes.

Keyword: Abnormal scarring, defect closure, tissue limitation, local flap

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References

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DOI: https://doi.org/10.20961/mshmj.v3i1.107170

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