11-Year Follow-Up Showing Almost No Visible Scar
Hello,
I am Dr. Hirotaka Kohrita,
Director of Kohrita Hiro Orthopedic & Plastic Surgery Clinic,
located in Shin-Osaka, Yodogawa-ku, Osaka, Japan.
In this article, I would like to introduce
a case of a chin laceration in a 2-year-old child,
which was treated without suturing,
and for which we were able to confirm the outcome 11 years later.
Treatment Options Explained to the Parents
Chin lacerations are injuries for which suturing is commonly selected in many cases.
At the initial visit, we carefully explained the following
two treatment options to the parents:
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Treatment with suturing
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Treatment without suturing, using tape fixation
Suturing itself is not an incorrect treatment.
However, suturing requires local anesthesia, which inevitably causes pain.
For a 2-year-old child, both the anesthesia
and the procedure can be a significant burden.
On the other hand, based on our clinical experience, we explained that
if the wound edges can be properly approximated and fixed,
a laceration may heal beautifully even without suturing.
After discussion, the parents chose treatment without suturing, using tape fixation.
Treatment Course
After thorough wound cleansing,
a hydrocolloid dressing was applied to gently approximate the wound edges,
and treatment was initiated using Natsui-style moist wound healing.
Chin laceration at the initial visit. The wound was managed without suturing using Natsui-style moist care.
11 Years Later
Eleven years after treatment with Natsui-style moist care. The chin laceration scar is barely noticeable.
Eleven years later, the patient visited our clinic for an unrelated reason.
The child had grown into a 13-year-old young adolescent.
When shown photographs from 11 years earlier and asked,
“Do you remember this injury?”
he replied, “No, I don’t remember it.”
His mother, however, clearly remembered the event and said:
“It healed completely.
I can’t even tell where he was injured anymore.
I had almost forgotten how it looked back then.”
At 11 years after treatment, the scar was barely noticeable in daily life.
Discussion
When wound edges are properly approximated and a suitable hydrocolloid dressing is applied,
even widely opened lacerations can sometimes heal with excellent cosmetic results.
Of course, suturing is also an excellent treatment option,
as it provides stable wound closure and high reliability.
In contrast, the greatest advantage of tape fixation is that
the procedure causes minimal pain, making it particularly suitable for young children.
At our clinic, we place great importance on:
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Clearly explaining the advantages and disadvantages of each treatment option
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Allowing patients and families to make an informed choice
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Respecting that choice and providing the best possible care regardless of the option selected
Message to Parents
When a child falls and sustains a facial laceration,
many parents naturally worry:
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“Will it leave a scar if it isn’t sutured?”
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“Is it really safe not to suture?”
However, not all wounds require suturing.
If the wound is properly assessed, accurately approximated, and kept in a moist environment,
many lacerations can heal beautifully without sutures.
That said, there are certainly wounds for which suturing is the best choice.
What matters most is not which treatment is “correct,”
but understanding the characteristics of each option and choosing the one that feels right.
At our clinic, we do not impose a single treatment approach.
Instead, we work together with children and their families to select
the least burdensome and most appropriate treatment.
Frequently Asked Questions (FAQ)
Q1. My child cut their face. Is it really okay not to use sutures?
It depends on the size, depth, and location of the wound.
If the wound edges can be properly approximated, it may heal well without sutures.
However, some wounds are better treated with suturing, so medical evaluation is essential.
Q2. Won’t the scar be more noticeable without suturing?
Not necessarily.
By preventing drying and maintaining a moist healing environment,
scars may be less noticeable even without sutures.
In this case, the scar was barely visible 11 years later.
Q3. What is Natsui-style moist wound healing?
It is a treatment approach that avoids excessive disinfection and drying,
and instead supports the skin’s natural healing ability by maintaining a moist environment.
It is widely applied to everyday injuries such as lacerations and burns.
Q4. What are the advantages of suturing and tape fixation?
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Suturing: stable wound closure and high reliability
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Tape fixation: minimal pain and reduced burden for young children
The choice should be based on wound condition, age, and family preference.
Q5. Will my child be properly treated regardless of the method chosen?
Yes.
We respect the treatment choice itself and always provide the best possible care.
(However, suturing is limited to patients who can tolerate local anesthesia.)
Our Treatment Philosophy:
Natsui-Style Moist Wound Healing
Natsui-style moist wound healing was established by Dr. Mutsumi Natsui,
a Japanese plastic surgeon widely recognized as a pioneer in moist wound care.
This method promotes healing while minimizing pain
by avoiding disinfectants and gauze and maintaining a moist wound environment.
At our clinic, we practice wound management based on Dr. Natsui’s principles.
▶ Dr. Natsui’s official website: “New Wound Treatment”
Author Information
Author: Dr. Dai Kohrita
Director, Kohrita Hiro Orthopedic & Plastic Surgery Clinic
Specialties: Orthopedics, Plastic Surgery, Burns, Epidermoid Cysts,
Moles, Warts, Ingrown Toenail Surgery
Experience:
Over 6,000 surgical cases, primarily epidermoid cyst surgery
(approximately 500 cases per year).
More than 1,000 clinical cases involving injuries, burns,
punch excision, and Natsui-style moist wound healing are published on our blog.
All cases are personally examined, treated, and followed up by the clinic director.
