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Applying external fixators or distractors is a common method used to manage complex fractures [1]. Although good alignment and bony union are important, prolonged pin placement may cause epidermal ingrowth and tethering of soft tissues to the underlying bone [2]. These can result in retracted and depressed scars in the site where the pins passed through the skin, and these scars do not resolve or improve spontaneously [1-5]. Several methods have been introduced to manage these scars [3-5]. A surgical method combining W-plasty and a buried dermal island was introduced in 1994 [4,6]. Subsequently, a procedure involving blind dissection under the scar tissue using sharp scissors with a 1-cm longitudinal incision was introduced [5]. In another study, it was found to be possible to improve the appearance of a pin-site scar by performing subcisions with a 16-gauge needle and fat injections [3]. However, if these methods do not resolve a scar, it may be necessary to try another method. Acellular dermal matrix (ADM) has been used for soft tissue replacement in skin grafts, facial augmentations, and other reconstruction procedures [7,8]. The implantation of ADM can enable much of the original augmented volume to be retained over time, making it useful for volume replacement procedures [7-9]. Therefore, we describe a case of pin-site scars that resolved after use of an effective method based on ADM implantation and subcisions.

Pin-site scar revision with subcisions and acellular dermal matrix