Longitudinal Assessment of Facial Scars After Acellular Dermal Matrix Grafting Post-Skin Cancer Resection: Focus on Color and Contraction

Background: Skin cancer commonly affects the face, presenting significant reconstructive challenges, particularly for elderly patients who may benefit from minimally invasive techniques. Our team has employed acellular dermal matrix (ADM), as this technique provides a relatively simple alternative that reduces the complexity associated with autologous graft surgery. The objective of this study is to assess changes in color matching and the extent of scar contraction over time with this method. Methods: This retrospective study assessed 153 ADM grafts applied following skin cancer resection on the face. We quantified color disparity between the scar and adjacent skin using dE2000 scores and evaluated scar contraction by measuring scar areas. Additionally, we categorized the severity of distortion of nearby anatomical landmarks into three grades, from 0 to 2. We tracked changes in these three parameters immediately after wound healing and at 3, 6, and 12 months post-healing. Results: The dE2000 scores immediately post-healing, at 3 months, 6 months, and 12 months were 17.6±0.5, 14.3±0.5, 10.6±0.4, and 6.2±0.3, respectively (p<0.01). According to reference standards, the 12-month score was deemed "very good." Scar contraction increased from 50.5±1.2% immediately post-healing to 57.0±1.3% at 3 months, then decreased to 19.8±1.1% at 12 months (p<0.01). Average landmark distortion grades reduced from an initial 0.76±0.06 to 0.33±0.05 at 12 months (p<0.01). Conclusion: Scars following ADM grafting initially exhibit suboptimal results; however, marked improvements are evident by 12 months post-healing.