Evaluation of 50 Donor Scars Undergoing Hair Restoration Using a New Cosmetic Surgery Scar Assessment Scale

Abstract

The donor area scar is of utmost importance in strip-harvest hair restoration procedure. The proper assessment of the scar is important for the subsequent sessions. This study was undertaken to evaluate the quality of scar using a new Cosmetic Surgery Scar Assessment Scale (CSSAS). The study was conducted at a private hair restoration clinic. The patients undergoing first session were included. The width of the strip ranged from 15 to 20 mm. The donor wound was closed primarily using single-layer nonabsorbable 3-0 polypropylene suture and incorporating trichophytic closure. The stitches were removed on 11th postoperative day. The scars were assessed in daylight. The patients’ scars were assessed at 12th month using a self-developed scar scale which is comprised of 10 characteristics, each subdivided into 4 points (1-4), with a minimum score of 10 and maximum of 40. The higher scores represented poor scar, whereas the low scores represented good quality scar. A total of 50 patients were included. The mean age was 27.8 years. Most of the patients (56%) aged 31 years or more. The baldness pattern varied from Norwood type III to VII. The scars were assessed using the daylight. The average scar score was 14.3 out of 40. Majority of the patients (78%) had average score which was 15 or less. The maximum scar score achieved by the patients was 23 (4%). The newly developed CSSAS is very simple. It incorporates key features including the width and mobility of scar as well.