Aesthetic aspects thyroid gland surgery

Kruglyy V.V.

Scientific curator: Mescheriakov V.L.

Saratov State Medical University, department of surgery & oncology

Importance: The scar quality has very important place in patients life after surgery, being on the apparent place defines aesthetic peculiarity and even can cause emotional drama. Significant scar improvement is a very real problem

Goal: To determine optimal terms of forming and ways of improving cosmetic effect postoperational scar after operations on the thyroid gland.

Material & methods: For the research 100 patients from 30 to 50 ages were taken. In all cases similar suture material on the cutting needle was used. Base dynamic settings were: the height of the incision of the skin on the level of the jugular notch, incision's length, mass of subcutaneous tissue, performed coagulation, thread's diameter. The assessments carried out on 1st and 14th day with Vancouver Scar Scale, which has following criteria: pliability, height, vascularity, pigmentation. Total 0 points equal normal skin, 13 points equal gross not aesthetically acceptable scar

Results: Based on the research on the 14th day,with an average length of scar 7.5 cm (variation from 6 cm to 10 cm) following groups were formed:

1st (11 patients) - it is impossible to estimate the scar as of the 1st day, and on the 14-th in mind of the poor quality of haemostasis during the operation and the formation of a dense crust along the scar. Assessment of the scar will be held later.

2nd (74 patients) – pliability 1, height 0, vascularity 1, pigmentation 2, total 4 points.

3rd (15 patients) - with expressed hypodermic-fatty cellulose, and over 45 years: due to the tension of the tissues because of the incision close to jugular notch - deformation of the form of the scar. It is expected to increase the width of the scar, vascularization, pigmentation and density. Assessment of the scar will be carried out later.

Conclusions: It can be concluded that the large part of the assessment of scars depends on the level of the incision of the skin in the presence of an accompanying factor of obesity. Also, during the qualitative haemostasis, regardless of the drainage of the wound, you can achieve the best cosmetic effect. State of the postoperative scar in no small degree depends on suture material, overlay intracutaneously: thread 4-0 does not affect the height of a scar, but worse holds the edges of the wound under tension, which affects the width, thread 2-0 gives a good comparison of the edges of the wounds and their retention, but has prognostically unfavorable cosmetic outcome, leaving thickened scar. The Vancouver scale figures are not stable over time and may change before the moment of the final formation of the scar.