"Optimizing Your Post-Surgical Scars: A Systematic Review on Best Practices in Preventative Scar Management"1.

Background: Scar management is critical for every plastic surgeon's practice and, ultimately, the patient's satisfaction with his or her aesthetic result. Despite the critical nature of this component of routine post-operative care, there has yet to be a comprehensive analysis of the available literature over the last decade to assess the best algorithmic approach to scar care. To this end, a systematic review of best practices in preventative scar management was conducted to elucidate the highest level of evidence available on this subject to date. Methods: A computerized MEDLINE search was performed for clinical studies addressing scar management. The resulting publications were screened randomized clinical trials that met our specified inclusion/exclusion criteria. Results: This systematic review was performed in May 2016. The initial search for MeSH term "cicatrix" and modifiers "therapy, radiotherapy, surgery, drug therapy, prevention and control" yielded 13,101 initial articles. Applying our inclusion/exclusion criteria resulted in 12 relevant articles. All included articles are randomized, controlled clinical trials. Conclusions: Optimal scar care requires taking into account factors such as incisional tension, anatomic location, and Fitzpatrick skin type. We present a streamlined algorithm for scar prophylaxis based on contemporary level I and II evidence to guide clinical practice. (C)2017American Society of Plastic Surgeons

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