A Split-Scar Study: Study of Surgical Scar Using Exosomes.

[BACKGROUND] Exosomes have emerged as a promising therapeutic agent for various dermatological conditions such as acne, atopic dermatitis, and wound healing. This study aims to evaluate exosome's efficacy in improving postoperative scars.

[METHODS] Ten patients underwent revision rhinoplasty with autologous costal cartilage, each with a 3 cm anterior chest incision scar were enrolled. Scars (mean 4.3 months postoperatively) were divided into medial and lateral halves; one half was treated with ASC-Exosome (experimental) and the other with hyaluronic acid (control). Outcomes were assessed using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS).

[RESULT] The experimental side treated with ASC-Exosome demonstrated improvements compared to the control side. Pigmentation improved significantly in the Observer Scar Assessment Scale (OSAS) group from week 3 onward, though no consistent changes were observed on the VSS. Pliability showed significant improvement in both OSAS and VSS, beginning at week 3 and persisting through week 8. Relief also improved in the OSAS group from weeks 4 to 8. While no vascularity differences were detected, one-year follow-up photographs confirmed superior improvements in scar height and thickness on the exosome-treated side. Patient Scar Assessment Scale (PSAS) indicated significant improvements in scar color by week 4, stiffness by week 3, and thickness by week 2. Irregularity showed significant differences at week 4 and week 8. No significant differences were noted in pain or itching between the sides.

[CONCLUSIONS] Exosomes significantly improved scar quality, particularly pigmentation, pliability, and relief, and can represent a valuable option for postoperative scar management.