Differences in elasticity and vascularity between incisional hypertrophic scar and normal skin:a comparative study using objective evaluations
Objective To explore the use of shear wave elastography(SWE)and optical coherence tomography angiography(OCTA)to measure and compare the differences in biomechanics and vascular microstructure between incisional hypertrophic scar and normal skin.Methods From September 2022 to December 2023,twenty-five patients with incisional hypertrophic scar after cesarean section and thy-roidectomy were collected from the Department of Plastic and Reconstructive Surgery,the First Medical Center of PLA General Hospital.The basic information of the patients was collected.The vancouver scar scale(VSS)and the patient and observer scar assessment scale(POSAS)were used to evaluate the basic situation of the scar,and the objective assessment methods,including SWE and OCTA,were used to quantify the thickness,stiffness,vascular density,vascular diameter,and vascular complexity of scar and its surrounding skin,so as to estimate the differences between scar and its surrounding skin.Results Compared with normal skin,the thickness[(0.212±0.074)cm:(0.116±0.025)cm,P＜0.001)and stiffness[(42.032±23.825)kPa:(10.879±3.436)kPa,P＜0.001]of incisional hypertrophic scar were significantly increased.For the micro-vascular situation,the vascular density of scar was larger than that of normal skin[(0.394±0.073):(0.339±0.090),P＜0.05],and the average and maximum diameter of vessels were significantly increased[(109.303±19.187)μm:(88.288±12.425)μm,P＜0.001;(524.118±120.964)μm:(438.805±70.193)μm,P＜0.05],but there was no significant difference in vascular com-plexity between scar and normal skin[(0.405±0.087):(0.451±0.090),P=0.06].Conclusion SWE and OCTA can objectively and quan-titatively evaluate the incisional hypertrophic scar and its surrounding normal skin.Compared with the normal skin around the incision,the incisional hypertrophic scar is thicker and harder,and the blood vessel diameter is thicker and the blood vessel density is larger.There is no significant difference in the complexity between the both of them.
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