Scar excision following previous surgery is often difficult leaving ragged skin edges that ultimately lead to untidy wound closure and further scarring. We describe a simple technique that obviates this problem. Prepare and drape the surgical field as per protocol. With the skin under gentle tension, hold two identical scalpel handles side by side and make a longitudinal incision along the scar (Fig. 1), creating two neat parallel incisions. The distance between the blades can be adjusted by spacers, such as suture packets, or use of bigger or smaller handles. Marking the scar with a pen will assist accurate excision. A single scalpel tapers the two incisions' ends. At completion of surgery, the freshly cut skin edges are repaired.
Figure 1.
The two-knife scar excision technique.
SECTION EDITOR'S COMMENT
I have used this technique for over 30 years and would recommend it. I point this out to draw attention to the fact that both specialist reviewers and I sometimes note that techniques are not novel or original, but they are accepted to publicise variations in technique which may not be well known.