How your surgical wounds heal early on is important in the final appearance of the scar.
Prior to suture removal
Keep the surgical site dry and as clean as possible. Leave the dressing intact until it’s time to remove the sutures. The dressings used are usually waterproof. You will usually be given an antibiotic ointment to apply to the wound if a dressing can’t be applied to the surgical site (ie over hair bearing skin). Apply this cream 3 times a day until sutures are removed.
Avoid too much movement in the vicinity of the surgical site especially if the wound is close to a joint (ie elbows, shoulders, neck, back). Infection if it is to occur generally occurs 4 or more days after surgery, and is heralded by increasing pain, redness and swelling around the surgical site. Allergies to the dressing/skin glue can also cause a similar appearance. Contact Dr Teh’s rooms for further help if these symptoms occur.
To maximise wound healing, ensure that your diet is well balanced (see nutritional tips to improve healing in this link). If diabetic, less than ideal blood sugars will impede healing as will smoking. Reduce your intake of coffee and chocolates as caffeine has been shown to be a negative influence on wound healing. Other factors impacting healing include obesity, chronic diseases, poor vascular supply and medications such as immunosuppressants.
Allowing the wound to ‘air out’ and dry is not recommended as wounds heal best in a moist enviroment.
Sutures are generally removed 6-8 days in facial areas and 10-14 days elsewhere.
After suture removal
Wounds are most at risk of coming apart for a week after removal of sutures. During this time, keep the wound taped and avoid trauma to the area of the wound.
If possible the wounds should be supported by a breathable dressing (ie Fixomull or Hyperfix) for a period of 6 weeks to reduce the risk of the scar stretching. Scars are most prone to stretch over mobile areas (ie back), in younger patients (skin is more elastic) and where wound closure was tight (ie in trauma where there is loss of skin or after excision of a large tumour).
Longer term scar management
In the long term, less than ideal healing may cause scars to become stretched, discolored (hyperpigmentation), or thickened.
After the period of taping, it is generally advised to keep the scar away from sun for 12 months to avoid hyperpigmentation. Apply moisturisers if the area is dry and massage if the scar feels thickened. Some scars will continue to thicken over time (hypertrophic scar) and may even grow like a tumour beyond the original limits of the surgery (keloid scars). Mild scar thickening is best treated with a silicone based gel (Kelo-cote, Startaderm, Giovene) or tape initially. Treatment needs to be continued for 6 weeks. The gel is applied twice daily during this time and if you are using the silicone tape, this needs to be on your scar at all times except when having to clean under it. Please contact Dr Teh’s rooms and arrange to be seen if the scar remains unsatisfactory.