Comparison of cosmetic ef­fects after short longitudinal and transverse skin incision for carotid endarterectomy

Authors: T. Hrbáč 1;  D. Školoudík 2;  D. Otáhal 1;  T. Fadrná 1;  R. Herzig 3
Authors‘ workplace: Neurochirurgická klinika FN Ostrava 1;  Centrum vědy a výzkumu, Fakulta zdravotnických věd, Univerzita Palackého v Olomouci 2;  Neurologická klinika, Komplexní cerebrovaskulární centrum, LF UK a FN Hradec Králové 3
Published in: Cesk Slov Neurol N 2019; 82(2): 194-202
Category: Original Paper


Aim: Nerve injuries, wound complications and poor cosmetic results still have an important impact on the patient’s outcome after carotid endarterectomy (CEA). The study aimed to compare 30-day morbidity and cosmetic outcome between patients undergo­­ing CEA us­­ing short longitudinal incision (SLI) and transverse skin incision (TSI).

Patients and methods: All consecutive patients with internal carotid artery stenosis > 70% indicated for CEA were included in this monocenter prospective study and randomly al­located to the SLI or TSI group. Physical and neurological examinations were performed 30 and 90 days after surgery in all patients. Cosmetic results were evaluated us­­ing the Patient and Observer Scar As­ses­sment Scale (POSAS) 90 days after surgery.

Results: Out of 189 enrol­led patients, SLI was used in 102 (71 males; mean age 64.0 ± 7.1 years) and TSI in 87 patients (58 males; mean age 66.4 ± 7.2 years). Stroke or transient ischemic attack occur­red dur­­ing 30 days in 4 (3.9%) patients in the SLI group and in 2 (2.3%) patients in the TSI group (P = 0.689). The scar quality as­ses­sed us­­ing POSAS was higher in TSI than in SLI patients (12.4 vs. 16.6 points; P < 0.01). Patients in the TSI group did better than SLI patients with regards to scar pigmentation, thicknes­s, relief, pliability and surface area (P < 0.01 in all cases). No significant dif­ferences were found in the occur­rence of local complications (8.0% in TSI and 8.8% in the SLI group; P = 1.00).

Conclusion: Better cosmetic results were observed in patients after CEA us­­ing TSI than SLI. No dif­ferences in 30-day morbidity and in the occur­rence of local complications were observed between the groups.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.



神经损伤、创伤并发症和不良的美容效果对颈动脉内膜切除术(CEA)后患者的预后仍有重要影响。本研究旨在比较短纵切口(SLI)和横切皮肤切口(TSI) CEA术后30天的发病率和美容效果。




189名登记患者中,102名(71名男性;平均年龄(64.0±7.1岁)及TSI 87例(男性58例;平均年龄66.4±7.2岁)。SLI组4例(3.9%)、TSI组2例(2.3%)在30天内发生脑卒中或短暂性缺血发作(P = 0.689)。采用POSAS评估的TSI患者瘢痕质量高于SLI患者(12.4分vs. 16.6分;P < 0.01)。TSI组患者瘢痕色素沉着、厚度、缓解程度、柔韧性、表面积均优于SLI组(P < 0.01)。局部并发症发生率无显著性差异(TSI组8.0%,SLI组8.8%;P = 1.00)。






carotid endarterectomy – surgical incision – cosmetic surgery – morbidity – questionnaire


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