The Comparison of the Scar of Collar Incision in Thyroidectomy Surgery Using Under- or Over-Platysma Flap with or without Muscle Repair

The main treatment for thyroid cancer surgery is total thyroidectomy based on neck incision, and then, detachment of platysma flap; but this incision causes a long scar that can affect patients' satisfaction and impair their quality of life. In this study, we aimed to compare the scar of collar incision in thyroidectomy surgery using under- or over-platysma flap with or without muscle repair.

 In this clinical trial study, 160 patients selected in Alzahra and Imam Reza hospitals, Isfahan, Iran, during 2017-2018, were divided into four groups using randomized blocks method. In groups A and B, platysma flap was used; in groups C and D, subcutaneous flap was used on the platysma; in groups A and C, platysma muscle was repaired; and in groups B and D, platysma muscle was not repaired. Then, these four groups were followed up according to Vancouver standard score, and patient satisfaction with the beauty of the scar was assessed after 6 months.

Vancouver score with subcutaneous flap did not show a significant difference, as a result of platysma flap; but platysma repair showed significant difference. We found that at the end of the study, the levels of patient satisfaction (through five Likert rankings) were significantly correlated with their Vancouver scores.

 Both flaps are effective, but it is better to repair platysma muscle for patient satisfaction.