Principles to minimize scars include attention to a multitude of intrinsic and extrinsic patient factors preoperatively, operatively, and postoperatively. Preoperatively the goal is to maximize the treatment of patient specific comorbidities and limit the usage of medications that can have negative effects on healing. Operatively, the focus is on proper incisional planning, meticulous surgical technique and hemostasis, judicious use of prophylactic antibiotics, and focus on tensionless closures. Postoperatively, we must maximize the healing environment by keeping the wound well hydrated and closely monitoring and intervening early in high-risk wounds. We also have the responsibility to provide evidence-based recommendations, to the best of our ability, regarding the myriad of over-the-counter products. The field of scar prevention is ever changing and the new frontier focuses on controlling the microenvironment of wounds and altering signaling molecules to promote near scarless healing.
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