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Surgical Scar Prevention and Care
Scars are an aspect of surgery that isn’t often discussed. Whenever an incision is made in the skin – anywhere on the body – there is a possibility that these embarrassing marks will form. Though the skill of the surgeon can impact the degree of the scarring in the area, there are so many other factors involved that it’s far from the most important one.
Factors Beyond One’s Control
Certain scar risk factors cannot be influenced. Still, it helps to be aware of them before your surgery, since they will have an impact on your final surgical results.
Genetic Likelihood of Scarring: Unfortunately, some families are genetically predisposed to scar more easily. Those with relatives who frequently form scars should bring this up to their surgeon before any procedures.
Age: Over the years, our collagen production rate declines, making our skin less firm and elastic. We gradually lose fat from the subcutaneous fat layer, and the skin itself gets thinner. Because of this and other lifestyle-related factors, our skin’s ability to heal slows down and is less effective. Thus, healing incisions are more likely to scar as we age. One positive factor of aging skin is that certain age-related skin imperfections can sometimes camouflage scars.
Skin Healing Rate: Some patients heal more quickly than others. This varies from patient to patient and can be affected by issues such as illness.
Skin Tone: Keloid and hypertrophic scars – scars with more scar tissue than normal – occur more frequently in patients with darker skin. Though lighter-skinned patients are less likely to form these scars, the scars that do appear may be more noticeable on the skin.
Though the previously mentioned factors cannot be changed, there are many scarring risk factors that can be controlled. The best method of preventing and healing scars is by paying attention to these factors and following your surgeon’s recommendations.
Caring for Incisions: Using prescription ointments (and avoiding non-prescription ones) is a good example of practicing proper incision care. It will also be important to protect the area from getting infected. In the end, the best way to care for incisions is by diligently following your surgeon’s post-operative care directions.
Sun Exposure: Because healing skin is more sensitive to the sun, sun protection will be necessary in order to keep your scars healing nicely. This can include sunscreen and ointments, provided the incision is completely closed and the stitches have been taken out. Do your best to limit sun exposure.
Weight: In overweight patients, the subcutaneous fat layer can be an impediment to a surgeon’s ability to elegantly seal surgical incisions. This raises the chances of noticeable scars forming.
Smokers: Skin health is negatively impacted by smoking. Scarring becomes more likely, and the recovery process as a whole is slowed down. Quitting smoking for at least two weeks before your procedure will be very helpful for avoiding scar formation.
Incision Dimensions: Not only do deep, wide incisions require a longer recovery process, they are also more likely to become scars. It can also be more difficult to avoid agitating those wider scars, necessitating an even longer healing period. Variations on procedures can sometimes provide shorter incisions, so speak to your surgeon regarding your incision dimension options.
Staying Hydrated: To keep your healing process on track, be sure to be dutiful about drinking fluids. Dehydration affects health, causing your body to put resources towards maintaining homeostasis instead of healing scars. Keeping the body’s healing processes occupied with issues such as electrolyte imbalance and heart problems means incision healing may be incomplete. Drinking alcohol causes dehydration, so while you’re healing, stick with other beverages.
Being Gentle with Incisions: Many physical activities are harmful to healing incisions, and so these should be avoided during recovery from surgery. Bending, lifting, or any sort of heavy exercise is not recommended, since these can reopen wounds and even make scars larger that they would be otherwise.
Proper Diet: There are several elements to a nutritious diet, and protein is one factor that is very important for skin health. During your healing period, make sure to eat an adequate amount of beef, chicken, pork, dairy, seafood, and/or soy products to get the protein your skin needs to fight scarring.
Resting: It’s vital that a patient get enough rest following their procedure. If your body is exhausted, it will not be able to put all the necessary resources towards the wound-healing process. Make sure to follow your surgeon’s recommendations for staying home from work and avoiding strenuous activities.
Chronic Illnesses: Certain illnesses can exacerbate scarring. Patients suffering from chronic illnesses should do their best to keep these controlled during both the procedure and the healing period. The worse these illnesses are, the harder it can be for your body to focus on scar healing.
Infections: Do you know how to tell if your incision is infected? Learn about the signs and symptoms of infection before your surgery. The sooner you notice an infection, the better chance you have of avoiding healing issues and scar complications.
Post-Surgical Care Options
There are many treatments available for the prevention and care of scars, along with ways to keep them as small and inconspicuous as possible. Location of Incisions: Some surgeries have options when it comes to the location of the incision(s) used, and some incision locations provide more natural camouflage than others. Your surgeon will have an understanding of the best locations to hide scars, and you’ll be able to talk about this. Steroid Injections: Steroid injections are used to ward off keloid scars. Patients who tend to accrue these particular scars should speak to their surgeon about the possibility of receiving these injections. Massage: After the removal of sutures or staples and the closure of an incision wound, patients are advised to massage the scar. Scar massage is a way to potentially even out the area if bumps are left over after healing. A licensed massage therapist can also massage these scars. Silicone-Based Treatments: According to many studies, silicone is a substance that has a positive effect on the reduction of scarring. Gels, wound dressings, and more may be available; the best way to find out is by inquiring about these options with your surgeon.
Scar Management Program
Bio-Corneum+ Bio-Corneum+ (also known as BC+) is a silicone gel product that can prevent hypertrophic and keloid scars, aid in the healing of existing scars, and protect scars against sun exposure.
Once a patient’s stitches are taken out and the incision has fully closed up, this self-drying, self-adhering gel can be applied to the area in a very light layer. A three-inch area can be treated with a single drop.
BC+ should be applied to scars two times a day – once during the day and once at night – ensuring 24-hour protection. Use this gel for a minimum of twelve weeks. Those dealing with keloid and hypertrophic scars may benefit from longer usage, applying BC+ for a period of six months up to one year. Arnika Forte™ Arnika Forte™ is a capsule treatment that combines Arnica Montana and Bromelain – both at the highest strength available – to ameliorate bruising and swelling in post-surgical incision areas. Arnika Forte has no lactose or artificial colorants.
Arnika Forte offers these ingredients:
-Bioflavonoids- Grape Seed Extract – 240 mg and Rutin – 100 mg – Vasoprotectants that bolster the walls of the patient’s capillaries, minimize bruising, and help bruises fade faster.
-Homeopathic Arnica Montana 30 x – 1000 mg – An anti-inflammatory agent.
-Bromelain – 100 mg (2400 GDU) – A pineapple-based proteolytic enzyme that aids in bruise amelioration by breaking down proteins in the area.
-Vitamin C – 1000 mg/day – An anti-oxidant that protects from bruising.
Patients will either begin taking Arnika Forte the day of the procedure or the day prior to it. They will take two capsules every day for one week.
Signs of Infection
High-Grade Fever: If the patient has a temperature of 101 degrees Fahrenheit or greater and the symptoms of a fever, an infection may be present. Fever symptoms include a lessened appetite, dehydration, chills, and headaches. Keep in mind that a fever of 100 degrees Fahrenheit or lower can be typical after a procedure and is not in itself an indicator of infection. Worsening Fatigue: After procedures, many patients experience fatigue. They may be sleeping more than normal and may feel less energetic. If a patient is infection-free, the fatigue will lessen over time. If an infection is present, this fatigue may seem to be getting better and then become worse and worse. Pain: An increase in pain at the incision site may be caused by an infection. Typically, as a patient’s incisions close and heal, any pain they’ve felt at the site will decrease (though pain may increase as a patient takes less pain medication). When an infection is taking place, however, pain increases. Irritation: An increase in redness at the incision site over time may be an indicator of an infected wound. This may manifest in red streaks radiating from the site. Hardening or Swelling: Watch for surgical incisions that look puffy or swollen. Hardening tissues in the area can also be an indicator of inflammation. Heat: When the human body is combating an infection, blood cells travel to the infected area. This can produce a feeling of heat in the area. Discharge: An infected incision can produce thick or chunky drainage that is white, yellow, red, or green and has a bad odor.
If any of these signs of infection are present, contact the office of Dr. Moises Salama for assistance.