Wound-to-Scar™

Why the scar begins before the first stitch

A wound can be closed correctly and still leave a poor scar. The difference rarely lies in a single stitch. It lies in a chain of decisions that begins before any instrument is picked up: what kind of wound this is, how deep it goes, whether it should be closed now, later or not at all, how the tissue is treated, and what happens in the weeks after the patient leaves.

Those decisions are usually learned in fragments, from different teachers at different stages of training. Wound-to-Scar™ is designed to bring them together. It integrates clinical judgment, wound management, surgical technique and aesthetic principles, with particular emphasis on knowing not only how to close a wound, but when to intervene, how to preserve tissue, when not to close, and when specialist referral is required.

From the first assessment to the final scar

The six modules follow the phases of the Rafiee Educational Approach. The program opens with assessment: classification, depth, anatomy and tissue involvement, special wounds such as animal bites, and the first priorities of a minor emergency, including bleeding control. The second module is dedicated to the decisions that come before closure: whether to close immediately, delay closure, allow secondary healing or refer.

Cleaning, antisepsis, hemostasis and tissue handling follow, together with the management of contaminated and infected wounds. Only then does the program turn to the aesthetic closure of facial and body wounds: skin tension lines, dermal edge alignment, suture and needle selection, intradermal closure, adhesives and strips. The fifth module follows the repair after the patient leaves, through aftercare, scar prevention, common mistakes and the correction of poorly closed wounds. The final module brings everything together in clinical cases, simulation and practical assessment.

How it is designed to be taught

The program follows the Academy’s teaching progression, from foundational knowledge and demonstration to simulation, supervised practice, case-based learning, feedback, assessment and continued development. Technique is designed to be rehearsed on simulation models before it is performed under supervision, and case discussions are designed to train the judgment that surrounds it: the decision to close, to wait or to refer.

Wound-management skills will be assessed across knowledge, technical skill, clinical judgment, patient safety and decision-making, following the Academy’s assessment framework, which is itself in development.

Where it sits in the curriculum

Wound-to-Scar is one of four core programs, and the others meet it at defined points. Physicians without procedural experience are advised to begin with Foundations of Clinical & Minimally Invasive Procedural Medicine, which teaches basic sutures and knots as fundamentals. Wound-to-Scar builds on them with wound management and aesthetic closure, and Aesthetic Surgical Skills for Physicians takes surgical technique further, into advanced aesthetic work.

Clinical Simulation, Procedural Skills & Assessment, a planned advanced program, will examine how skills like these are learned and assessed across the curriculum. The biology of healing and scarring belongs to a separate research line, Wound Biology, Genetics & Regenerative Medicine, which is not taught.

Current status

Wound-to-Scar is the flagship program and is in development. It is built on the Rafiee Educational Approach, whose framework has been developed; its pilot implementation and evaluation are in development, and their methods and results will be reported on the research page. Format, dates and venue have not been announced and will be published on this page.