Technological innovations in the mechanism and reduction of surgical incision scars based on the mechano-chemo-biological theory

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 collectively drive scar development. We emphasize that sustained tension control following wound closure is crucial to prevent scar widening and hyperplasia. Current tension-reducing methods have limitations: intraoperative sutures provide only short-term support; external tension-reducing devices (e.g., tension-reducing tape or zipper) are prone to detachment, may cause skin irritation, and suffer from poor patient compliance; 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 clinical observations suggested that this scheme provided sustained tension reduction of surgical wound and, when combined with fractional laser therapy, showed potential for synergistic improvement in scar width, overcoming the shortage of conventional methods. Moving forward, further research will optimize this technique, validate its efficacy and safety, and promote its standardization and widespread adoption. Ultimately, we aim to promote the ideal healing of surgical incisions.