Pre-, Intra- and Post-Operative Factors Influencing Scar Widening: A Prospective Study

Abstract

Background: Facial scars can have a profound socio-psychological effect on patients and have a high tendency to widen over time due to tension on immature collagen fibres during normal healing caused by frequent movement of facial muscles. While the mechanisms of scar widening are well-documented, the degree and progression over time remain poorly studied. This study aimed to quantify scar widening over a 12-month period and identify key influencing factors. Methods & Results: A prospective study of 30 patients with facial lacerations requiring primary closure was conducted. Data collected included demographics, injury characteristics, suture technique (interrupted vs. continuous), material (absorbable vs. non-absorbable), and operator grade. Laceration alignment with Langer's lines and number of sutures per centimeter were evaluated using Adobe Photoshop. Post-operative care adherence was assessed via questionnaire. Scar width was measured at 1, 6, and 12 months, and statistical analysis was performed using SPSS. Alignment with Langer's lines, interrupted sutures, and consultant-led closures resulted in narrower scars. Non-smokers and patients adhering to post-operative protocols exhibited reduced scar widening. Conclusion(s): Scar widening progresses significantly within the first-year post-closure. Factors such as alignment with Langer's lines, suture technique, and post-operative care strongly influence outcomes. These findings can guide surgical planning and inform optimal timing for revision procedures to achieve better aesthetic results.Copyright © 2025