Inclusion and Exclusion Criteria

Inclusion criteria for the study include (1) greater than or equal to 18 years of age; (2) able to give informed consent and willingness to participate in follow-up; and (3) undergoing any plastic surgery procedure involving excision of skin lesions. Exclusion criteria include those requiring re-excision through the original wound and undergoing injectable corticosteroid therapy into the scar.

The patients will be randomly allocated to receive either the deckled incision or the straight line incision for their surgery. In patients with multiple (two or more) separate lesions requiring separate incisions, each lesion will be randomly allocated to receive either the deckled or straight line incision. Only the treating surgeon will be aware of which incision was used and the patient will be blinded to the type of incision. The surgeon will document in the operation note the number and site of lesions, whether they were deckled or not, the precise length of the scar, and whether the procedure was carried out by a registrar or consultant.

The patient will be followed-up in the outpatient clinic. Standard post-operative care with micropore tape will be given to both groups with respect to scar minimization. The scar and compliance with standard post-operative scar reduction will be assessed at 1 week, 3 months, and 6 months post-operatively using the POSAS [5]. The 6-month cut off was chosen as scars have usually matured by 6 months to reflect their final life-long appearance and to avoid a large number of patient attrition over a longer follow-up period (Figure 1).

Study flow chart.