Scar Conditions and Fibrosis of Skin
Conditions
Keywords
scar, head and neck reconstruction, dermabrasion, aesthetics
Brief summary
The purpose of this study is to evaluate the aesthetic benefit and safety of serial dermabrasion for free flap skin paddles and donor site scars in head and neck reconstruction.
Interventions
DEVICEDermabrasion
This is the only intervention. Free flap scars will be split and half treated, half untreated then outcomes graded.
Sponsors
Milton S. Hershey Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Adults aged 18 years or older. 2. History of successful free flap reconstruction with a cutaneous skin paddle in the head and neck region. 3. Patients with benign (eg. osteoradionecrosis, trauma) or malignant (eg. squamous cell carcinoma) diagnoses requiring free flap reconstruction. 4. Benign free flap patients must be a minimum 3 months post-operative to ensure flap maturity. Malignant free flap patients must be a minimum of 3 months post-operative or post-radiation with no further cancer treatment (eg. radiation, surgery, chemotherapy) planned at that time. 5. Flap skin paddle must be of sufficient size and external to allow for split-treatment design (minimum 4 cm in diameter). Donor site scar must also be sufficient size (minimum 6 cm in length) 6. Patients must have ability to provide informed consent. 7. Willingness and ability to comply with the treatment and follow-up schedule.
Exclusion criteria
1. Inability to give informed consent. 2. Evidence of active flap or radiation skin complications (e.g., infection, partial necrosis, wound breakdown). 3. Completion of head and neck radiation therapy within 3 months of first dermabrasion treatment date. 4. Uncontrolled diabetes mellitus (HbA1c \> 8.0%). 5. Current antibiotic use or known immunocompromised state. 6. History of keloid formation or hypertrophic scarring. 7. Fitzpatrick skin type VI or higher (due to increased risk of pigmentary changes). 8. Use of isotretinoin medication within the past 3 month (known to induce photosensitivity). 9. Current use of blood thinners that cannot be safely paused. 10. Known photosensitivity disorders. 11. Active malignancy requiring ongoing treatment. 12. Inability or unwillingness to avoid sun exposure during the treatment period. 13. Inability to perform or adhere to prescribed wound care. 14. Inability or unwillingness to attend follow-up visits.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Aesthetic grading of treated area compared to untreated | 1, 3, and 6 months post-treatment | Aesthetic improvement of the treated half of the free flap skin paddle/donor site scar, as compared to the untreated half. This will be measured through blinded evaluations of standardized clinical photographs. Each side of the skin paddle or donor site scar will be labeled as side 1 or 2. |
Contacts
Primary ContactJessyka G. Lighthall, MD
Backup ContactCaia Hypatia
Outcome results
None listed