Identifying and managing problem scars.
A scar is a mark left in the skin by the healing of injured tissue. Outcome depends on the type of trauma causing the scar and how well it is repaired and managed initially. In most people, a scar heals to a fine line, but in others, the scar may grow in all directions, is elevated and remains hyperaemic. Excessive scar tissue is classified either as hypertrophic or keloid. Unfortunately, it is not always easy to predict those patients who will develop problematic scars that require referral to specialist scar management clinics. This article describes the development of a new universal scar risk assessment and management pathway. The pathway was designed specifically to assist practitioners in identifying patients who are at risk of developing problem scars after surgery and to clearly set out evidence-based standards of care that will assist and guide the management for those patients at risk.