Mechanisms of surgical incision scar and technological innovations for scar tension reduction based the mechano-chemo-biological theory

Lyu Kaiyang; Li Yashu

doi:10.3760/cma.j.cn501225-20251013-00424

Volume 42 Issue 2

Feb. 2026

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2026 > 42(2): 133-142

Lyu KY,Li YS.Mechanisms of surgical incision scar and technological innovations for scar tension reduction based the mechano-chemo-biological theory[J].Chin J Burns Wounds,2026,42(2):133-142.DOI: 10.3760/cma.j.cn501225-20251013-00424.

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Mechanisms of surgical incision scar and technological innovations for scar tension reduction based the mechano-chemo-biological theory

doi: 10.3760/cma.j.cn501225-20251013-00424

Lyu Kaiyang^,,
Li Yashu

Department of Plastic Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China

Funds:

General Program of National Natural Science Foundation of China 81772091

Shanghai Oriental Talents Program-Outstanding Technical Leaders Project BJKJ2024024

More Information

Corresponding author: Lyu Kaixiang, Email: lvkaiyang@hotmail.com
Received Date: 2025-10-13

Abstract

Abstract

Surgical incisions often heal with linear scars, which may further develop into hypertrophic scars or keloids. Research indicates that biomechanical factors, particularly mechanical forces and matrix stiffness, regulate scar formation by influencing cellular behavior and extracellular matrix remodeling. Our team proposes that the dynamic coupling and synergistic interactions among mechanical, chemical, and biological factors jointly regulate scar development. We emphasize that sustained tension control following wound closure is crucial to prevent scar widening and hyperplasia. Currently used tension-reducing methods have limitations: the effect of intraoperative sutures is short-lived; external tension-reducing devices (e.g., tension-reducing tape or zipper) are prone to falling off and causing skin irritation, and patient compliance is low; fractional laser may still cause the scar to widen when used alone in high-tension areas. Therefore, our team proposes a scheme utilizing an intradermal suturing technique based on slow-absorbing sutures with in-situ backstitch, which aims to achieve long-term and effective tension management. Preliminary results from clinical applications showed that this scheme achieved continuous tension reduction in surgical incisions, and its combination with fractional laser therapy is expected to synergistically improve scar width, overcoming the shortcomings of conventional methods. Moving forward, further research will optimize this scheme and promote its standardization and widespread adoption, and gradually establish a scar prevention system centered on continuous tension reduction, ultimately promoting the ideal healing of surgical incisions.
- Cicatrix,
- Surgical wound,
- Wound closure techniques,
- Biomechanics,
- Mechanical tension,
- Tension-reducing suture,
- Horizontal buried intradermal suture,
- Fractional laser,
- Wound repair

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References(74)

References

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