Final answer:
For a 3 cm by 1 cm wound after lipoma excision, direct primary closure is often the best management option if the edges can be brought together without tension. If there's tension, a rotational flap may be needed. Other options like skin grafts are usually for larger or more complex defects.
Step-by-step explanation:
The best option for managing the wound measuring 3 cm by 1 cm following an excision of a lipoma from the scapula would depend on several factors, including the condition of the wound edges, the patient's general health, and the availability of additional tissue for closure. Often, for wounds these dimensions, direct primary closure is an excellent choice, as it allows the edges to be brought together with sutures to promote healing with minimal scarring. This method is applicable provided the wound edges are clean and there is enough skin to close without tension. If tension is a concern, a rotational flap may be required to bring additional tissue into the area to close the wound without tension. This involves cutting a section of skin nearby and rotating it over to cover the wound, still attached at one end to maintain its blood supply. Delayed primary closure might be chosen if there's concern about infection or if the wound needs more time to become clean before it's closed. However, skin grafts (pedicled, free flap) are typically reserved for larger defects or when primary closure isn't possible.