Influence of Fitzpatrick skin type on Scar maturation following transcutaneous infraorbital approach: a prospective comparative clinical study.

Background: This study evaluated the impact of Fitzpatrick skin type on postoperative scar esthetics following infraorbital fracture reconstruction using a transcutaneous subtarsal approach, with emphasis on long-term scar maturation and patient complexion.

Methods: A prospective clinical study was conducted on 27 patients undergoing open reduction and internal fixation of infraorbital rim fractures via the subtarsal approach. Fitzpatrick skin typing was performed preoperatively and categorized into three groups: Group I (Types I-III), Group II (Types IV-V), and Group III (Type VI). Scars were evaluated at day 10, 1 month, and 12 months using a 10-point Visual Analogue Scale (VAS), independently rated by a blinded maxillofacial surgeon and dermatologist. Statistical analyses included the Wilcoxon signed-rank test, Kruskal-Wallis H test, and Cohen's kappa for inter-rater reliability.

Results: Out of 27 patients, 23 completed the 12-month follow-up. All groups demonstrated improvement in VAS scores over time; however, Groups II and III showed significantly better esthetic outcomes at 12 months (mean VAS scores: 9.81 and 9.83, respectively) compared to Group I (8.60) (p < 0.05). Group I exhibited slower scar integration and greater long-term visibility. Inter-rater agreement was excellent (κ = 0.84). No cases of keloid or hypertrophic scar formation were observed.

Conclusion: Fitzpatrick skin type significantly influences scar maturation following infraorbital surgery. Darker skin types (IV-VI) demonstrate superior esthetic outcomes. Integrating skin phototyping into preoperative assessment may guide personalized surgical planning and optimize scar-related patient satisfaction.