【 文献重点摘要 】
 

Background: A large proportion of scars in clinical practice represent good candidates for surgical revision by virtue of their unfavorable characteristics and relative orientation with respect to skin relaxed tension lines. W-plasty is a very popular excisional revision technique, which involves breaking up the scar margins into small triangular components, which are advanced and interdigitated without any rotation or transposition.

Methods: We performed an extensive literature search using Pubmed MEDLINE, Web of Science, and Embase using the following keywords [W-plasty] AND [scar] AND [revision]. We retrieved 13 articles pertinent to the indications, geometrical design, and technical evolution of the W-plasty scar revision variants. We formulate indications for the use of isosceles/equilateral as opposed to scalene triangle W-plasty and integrate our experience with regards to the choice of geometrical design for different bodily regions.

Conclusions: W-plasty represents a popular technique in reconstructive plastic surgery practice. We believe that the exact W-plasty design should be guided by the relaxed skin tension line definition and to this effect propose 2 main variants of geometrical design pertinent to the index anatomical site.

背景：在临床实践中，由于瘢痕的不良特性和相对于皮肤松弛张力线的相对取向，临床上有很大比例的瘢痕是手术翻修的良好候选者。W成形术是一种非常流行的切除矫正技术，它将瘢痕边缘分解成小的三角形成分，这些三角形成分是向前推进的和交错的，没有任何旋转或移位。

方法：应用Pubmed MEDLINE、Web of Science和Embase检索文献，检索词分别为[W-Plastic]、[SCAR]和[Revision]，检索词为[W-Plastic]、[SCAR]和[Revision]。我们检索到13篇与W-成形术瘢痕翻修变体的适应症、几何设计和技术进展相关的文章。我们制定了使用等腰/等边的适应症，而不是斜角三角形W成形术，并结合我们在选择不同身体区域的几何设计方面的经验。

结论：W成形术在整形外科实践中是一种流行的技术。我们认为，准确的W成形术设计应该以松弛的皮肤张力线定义为指导，为此，我们提出了两种与索引解剖部位相关的几何设计的主要变体。