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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  >  > Accepted Manuscript
Ma Fuxin,Zhang Yuheng,Dong Yuchen,et al.Clinical efficacy of W-plasty resection combined with remote tension-reducing suture in upper limb scars revision[J].Chin J Burns Wounds,2026,42(4):1-9.DOI: 10.3760/cma.j.cn501225-20241226-00507.
Citation: Ma Fuxin,Zhang Yuheng,Dong Yuchen,et al.Clinical efficacy of W-plasty resection combined with remote tension-reducing suture in upper limb scars revision[J].Chin J Burns Wounds,2026,42(4):1-9.DOI: 10.3760/cma.j.cn501225-20241226-00507.
shu

Clinical efficacy of W-plasty resection combined with remote tension-reducing suture in upper limb scars revision

doi: 10.3760/cma.j.cn501225-20241226-00507
  • 1.

    Department of Burn and Plastic Surgery, the Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China

  • 2.

    Department of Orthopedics, Western Theater Air Force Hospital, Chengdu 610011, China

  • 3.

    Department of Burn and Plastic Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710038, China

Funds:

General Program of National Natural Science Foundation of China 82272291

Key Research and Development Program of Shaanxi Province-Critical Core Technology Research Project 2024SF-GJHX-20

More Information
  • Corresponding author: Li Jing, Email: lijing02@fmmu.edu.cn
  • Received Date: 2024-12-26
    Available Online: 2026-03-31
    Abstract
  •   Objective  To investigate the clinical efficacy of W-plasty resection combined with remote tension-reducing suture in upper limb scar revision.  Methods  This study was a retrospective cohort study. From June 2023 to December 2023, 69 patients with upper limb scars who met the inclusion criteria were admitted to Department of Burn and Plastic Surgery of the Second Affiliated Hospital of Air Force Medical University. According to the scar revision technique adopted, the patients were divided into the W-plasty suture group of 36 cases (6 males and 30 females, aged (28±4) years) and conventional tension-reducing suture group of 33 cases (5 males and 28 females, aged (29±6) years). Patients in W-plasty suture group received W-plasty resection combined with remote tension-reducing suture, and patients in conventional tension-reducing suture group received conventional fusiform excision followed by local tension-reducing suture. Before surgery and at 6 and 12 months after surgery, the patient and observer scar assessment scale (POSAS) scores, Vancouver scar scale (VSS) scores, and width of scars were recorded. The independent influencing factors for the POSAS and VSS scores at 12 months after surgery in patients with upper limb scars were screened. Surgery-related complications were recorded within 12 months after surgery.  Results  At 12 months after surgery, the POSAS and VSS scores of scars in W-plasty suture group of patients were 31.6±2.0 and 3.3±0.8, respectively, which were significantly lower than 33.5±2.7 and 4.0±1.6 in conventional tension-reducing suture group (with mean differences of -1.9 and -0.7, 95% CI of -3.0 to -0.8 and -1.3 to -0.1, t values of 3.22 and 2.63, respectively, P<0.05). At 6 and 12 months after surgery, the POSAS and VSS scores of scars in both groups of patients were significantly lower than those before surgery (P<0.05). The POSAS score of scars in conventional tension-reducing suture group of patients at 12 months after surgery was significantly higher than that at 6 months after surgery (P<0.05), while the VSS scores of scars in both groups of patients at 12 months after surgery were significantly higher than those at 6 months after surgery (P<0.05). Multivariate linear regression analysis showed that the revision method was an independent influencing factor for the POSAS score of scars in patients at 12 months after surgery (with standardized regression coefficient of 0.38, t=3.26, P<0.05). The revision method, age, and preoperative scar width were the independent influencing factors for the VSS score of scars in patients at 12 months after surgery (with standardized regression coefficients of 0.32, -0.32, and 0.27, t values of 2.93, -2.86, and 2.49, respectively, P<0.05). At 12 months after surgery, the scar width in W-plasty suture group of patients was (1.04±0.27) mm, which was significantly narrower than (1.23±0.22) mm in conventional tension-reducing suture group (with mean difference of -0.19 mm, 95% CI of -0.31 to -0.07 mm, t=3.17, P<0.05). At 6 and 12 months after surgery, the scar widths in both groups of patients were significantly narrower than those before surgery (P<0.05). Within 12 months after surgery, the incisions in all patients of both groups healed, and no complications such as infection or significant scar hypertrophy were observed.  Conclusions  W-plasty resection combined with remote tension-reducing suture demonstrates superior efficacy in upper limb scar revision and more significant long-term efficacy, and both the patients' subjective symptoms and the scar appearance achieved better improvement.

     

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