Clinical efficacy of the Magpie-bridge Microskin Grafting in treating linear white scars

Tang Yuchen; Zhang Zheng; Zhang Yixin

doi:10.3760/cma.j.cn501225-20250213-00057

Volume 41 Issue 4

Apr. 2025

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2025 > 41(4): 333-340

Tang YC,Zhang Z,Zhang YX.Clinical efficacy of the Magpie-bridge Microskin Grafting in treating linear white scars[J].Chin J Burns Wounds,2025,41(4):333-340.DOI: 10.3760/cma.j.cn501225-20250213-00057.

Citation:

Tang YC,Zhang Z,Zhang YX.Clinical efficacy of the Magpie-bridge Microskin Grafting in treating linear white scars[J].Chin J Burns Wounds,2025,41(4):333-340.DOI: 10.3760/cma.j.cn501225-20250213-00057.

Citation:

Tang YC,Zhang Z,Zhang YX.Clinical efficacy of the Magpie-bridge Microskin Grafting in treating linear white scars[J].Chin J Burns Wounds,2025,41(4):333-340.DOI: 10.3760/cma.j.cn501225-20250213-00057.

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Clinical efficacy of the Magpie-bridge Microskin Grafting in treating linear white scars

doi: 10.3760/cma.j.cn501225-20250213-00057

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Funds:

General Program of National Natural Science Foundation of China 82172222, 82272266

Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support 20152227

More Information

Corresponding author: Zhang Yixin, Email: zhangyixin6688@163.com
Received Date: 2025-02-13

Abstract

Abstract

Objective To evaluate the clinical efficacy of the Magpie-bridge Microskin Grafting (hereinafter briefly referred to as Magpie-bridge surgery) in treating linear white scars (LWS). Methods This study was a retrospective cohort study. From October 2022 to December 2023, 37 LWS patients were treated with the Magpie-bridge surgery at the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, including 9 males and 28 females, aged 25 (17, 36) years. All scars were <2 mm in width and 1–10 cm in length before surgery. Magpie-bridge surgery procedure: an electric punch was used to excise scar tissue at intervals to form wounds and harvest microskin grafts of the same size and thickness as the removed scar tissue from behind the ear or axillary apex. The microskin grafts were implanted at the wound sites and fixed with tension-reducing adhesive tape. The donor area wounds were treated with routine dressing changes. Twelve months after the first surgery, the efficacy was evaluated based on the degree of reduction in scar white area compared with that before the first surgery, and the treatment effectiveness rate was calculated. Before the first surgery and 12 months after the first surgery, the melanin scores of the normal skin area surrounding the scar and the scar area were evaluated using a skin imaging analysis system, and the difference between the two was calculated. Six of the aforementioned patients requested a second Magpie-bridge surgery in pursuit of better therapeutic effects. The white scar tissue left untreated during the first surgery (hereinafter referred to as untreated scar tissue) and the tissue from the site at 12 months post scar removal and microskin transplantation (hereinafter referred to as the recipient skin tissue at 12 months after the first surgery) were collected. The tissue structure, melanin quantity and distribution were examined by using hematoxylin eosin staining and Masson-Fontana staining, and the activity of tyrosinase positive melanocytes was observed by using immunofluorescence staining. Results At 12 months after the first surgery, the results of efficacy evaluation showed that 24 cases were cured, 11 cases were improved, 1 case was ineffective, and 1 case was in a worsened condition, yielding a 94.6% (35/37) treatment effectiveness rate. The melanin score difference between the surrounding normal skin area of scar and the scar area was 0.45 (0.10, 1.65) at 12 months after the first surgery, which was significantly less than 2.50 (1.40, 5.96) before the first surgery (Z=-5.02, P<0.05). Six patients had untreated scar tissue with flat epidermis and a flat junction between dermis and epidermis; the collagen fiber bundles in the dermis were thick and unidirectionally parallel; no skin appendages such as hair follicles were observed; the basal layer of the epidermis showed deposition of melanin particles, but no extensive depigmentation was observed. Compared with those of untreated scar tissue, the epidermal thickness increased, and epidermal protrusions appeared at the junction of dermis and epidermis of the recipient skin tissue at 12 months after the first surgery; hair follicles and sebaceous glands were visible, and collagen fibers in the dermis were arranged vertically and horizontally in an orderly manner. Melanin particles were deposited in the basal layer of the epidermis, and the melanin content per unit area of tissue was increased. Tyrosinase-positive melanocytes in untreated scar tissue and in the recipient skin tissue at 12 months after the first surgery were mainly located at the basal layer of the epidermis, with normal cell activity and no significant difference. Conclusions The Magpie-bridge surgery can significantly improve the appearance of LWS in patients, with definite therapeutic effects and value for clinical promotion; the improvement of LWS appearance by Magpie-bridge surgery may be related to the increase of melanin content per unit area of tissue and the normalization of tissue structure.
- Cicatrix,
- Skin transplantation,
- Melanocytes,
- Linear white scar,
- Magpie-bridge Microskin Grafting,
- Tissue structure

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References(40)

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