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Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions
BACKGROUND: Acne keloidalis nuchae is a debilitating condition mainly affecting the occipital region or nape of the neck. Surgical approaches are limited in aesthetic outcomes. Three innovative surgical approaches based on selection criteria are presented for enhanced and more predictable wound heal...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571336/ https://www.ncbi.nlm.nih.gov/pubmed/31333947 http://dx.doi.org/10.1097/GOX.0000000000002215 |
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author | Umar, Sanusi David, Consuelo V. Castillo, Jason R. Queller, Jenna Sandhu, Sophia |
author_facet | Umar, Sanusi David, Consuelo V. Castillo, Jason R. Queller, Jenna Sandhu, Sophia |
author_sort | Umar, Sanusi |
collection | PubMed |
description | BACKGROUND: Acne keloidalis nuchae is a debilitating condition mainly affecting the occipital region or nape of the neck. Surgical approaches are limited in aesthetic outcomes. Three innovative surgical approaches based on selection criteria are presented for enhanced and more predictable wound healing and posterior hairline cosmesis. METHODS: “Bat excision” and secondary intention healing are shown for 2 of 37 representative patients and confined to the area between the occipital protuberance superiorly and posterior hairline inferiorly. Lesions with ≤3 cm vertical width were required to be in the lower one-half portion of this zone. The same procedure was aided by the use of tension sutures for lesions with >3 cm vertical width area within the defined zone. It was also suitable for breaches of the 2 horizontal lines defined above but generally located in the nuchal area. Debridement of premature epithelizing granulation tissue is shown in 2 additional patients. RESULTS: Use of these procedures with debridement in selected patients allowed fine control over the hairline shape and resulted in narrower scars. The mean maximum sagittal width of excised lesions was 5.4 cm. Excised lesion width ≥6.5 cm was highly predictive of >2.5 cm wide scar (P = 0.001). CONCLUSION: Innovative procedures based on selection criteria can extend the approach of acne keloidalis nuchae excision with secondary intention healing to better control the final hairline shape and minimize scarring. |
format | Online Article Text |
id | pubmed-6571336 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-65713362019-07-22 Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions Umar, Sanusi David, Consuelo V. Castillo, Jason R. Queller, Jenna Sandhu, Sophia Plast Reconstr Surg Glob Open Special Topic BACKGROUND: Acne keloidalis nuchae is a debilitating condition mainly affecting the occipital region or nape of the neck. Surgical approaches are limited in aesthetic outcomes. Three innovative surgical approaches based on selection criteria are presented for enhanced and more predictable wound healing and posterior hairline cosmesis. METHODS: “Bat excision” and secondary intention healing are shown for 2 of 37 representative patients and confined to the area between the occipital protuberance superiorly and posterior hairline inferiorly. Lesions with ≤3 cm vertical width were required to be in the lower one-half portion of this zone. The same procedure was aided by the use of tension sutures for lesions with >3 cm vertical width area within the defined zone. It was also suitable for breaches of the 2 horizontal lines defined above but generally located in the nuchal area. Debridement of premature epithelizing granulation tissue is shown in 2 additional patients. RESULTS: Use of these procedures with debridement in selected patients allowed fine control over the hairline shape and resulted in narrower scars. The mean maximum sagittal width of excised lesions was 5.4 cm. Excised lesion width ≥6.5 cm was highly predictive of >2.5 cm wide scar (P = 0.001). CONCLUSION: Innovative procedures based on selection criteria can extend the approach of acne keloidalis nuchae excision with secondary intention healing to better control the final hairline shape and minimize scarring. Wolters Kluwer Health 2019-05-16 /pmc/articles/PMC6571336/ /pubmed/31333947 http://dx.doi.org/10.1097/GOX.0000000000002215 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Special Topic Umar, Sanusi David, Consuelo V. Castillo, Jason R. Queller, Jenna Sandhu, Sophia Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions |
title | Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions |
title_full | Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions |
title_fullStr | Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions |
title_full_unstemmed | Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions |
title_short | Innovative Surgical Approaches and Selection Criteria of Large Acne Keloidalis Nuchae Lesions |
title_sort | innovative surgical approaches and selection criteria of large acne keloidalis nuchae lesions |
topic | Special Topic |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571336/ https://www.ncbi.nlm.nih.gov/pubmed/31333947 http://dx.doi.org/10.1097/GOX.0000000000002215 |
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