%0 Case Reports
%T Usefulness of direct W-plasty application to wound debridement for minimizing scar formation in the ED.
%A Min JH
%A Park KH
%A Choi HL
%A Park JS
%A Lee JH
%A Kim H
%A Lee BK
%A Lee DH
%A Lee TG
%J Am J Emerg Med
%V 35
%N 12
%D Dec 2017
%M 28587949
%F 4.093
%R 10.1016/j.ajem.2017.05.055
%X <B>OBJECTIVE: </B>A suture line placed with the same direction as the relaxed skin tension line leads to good healing, but a suture line with over 30 degrees of angle from the relaxed skin tension line leads to longer healing time and more prominent scarring. W-plasty is widely used to change the direction of the scar or to divide it into several split scars. In this study, we applied W-plasty to patients with facial lacerations in the emergency department.<BR><B>METHODS: </B>From June 2012 to December 2014, 35 patients underwent simple repair or W-plasty for facial lacerations. Patients in the simple repair group underwent resection following a thermal margin, and the W-plasty group was resected within a pre-designed margin of W-shaped laceration. We assessed prognosis using the Stony Brook Scar Evaluation Scale (SBSES) after 10 days (short-term) and six months (long-term), respectively, following suture removal.<BR><B>RESULTS: </B>Among 35 patients, 15 (42.9%) underwent simple debridement and 20 (57.1%) underwent W-plasty. In the W-plasty group, there was no difference between short-term and long-term follow-up showing high SBSES, but in the simple debridement group, long-term follow-up SBSES significantly decreased. W-plasty SBSES was higher than simple debridement at short-term as well as long-term follow-up.<BR><B>CONCLUSIONS: </B>We experienced good results of direct W-plasty application at six-month long-term follow-up. Therefore, W-plasty application is more effective in reducing scar appearance than a simple debridement method for facial laceration patients with an angle of 30 degrees or more to the relaxed skin tension line.