Treatment with Tissue Expander and Lambda Incisions for Wrist-cutting Scars

Abstract

　Wrist cutting is a common form of self-harm. Extensive scarring of the forearm develops by repeated self-harm acts. Five patients with wrist cutting scars underwent surgical reconstruction using a tissue expander to reproduce the color and texture. However, it is difficult to expand the skin of the forearm and the expanded skin becomes contracted. Therefore, a long time was needed to expand the skin, with an average of 136 days. We also used lambda incisions of the lateral wall of the expanded cuboid to make the most of the expanded skin. This made it possible to apply expanded skin and reconstruct extensive scars. Most scarring was removed in one reconstruction in 3 patients, whereas the others who had extensive scarring on the entire forearm required 2 reconstruction procedures. There were no complications due to lambda incisions. Lambda incision is an effective method for applying expanded skin and covering extensive skin defects.