Internal scar after surgery

As is known, the formation of a scar after damage to the skin during injuries and operations is a biological pattern and is perceived by both surgeons and patients as an inevitable evil. For practice, it is important that the final formation of the scar is completed only 6-12 months after the operation is performed, and at the same time the quality of the scar begins to be assessed by the patient.

Surgical treatment of injuries or life-threatening conditions is one thing; then the surgeon first of all thinks not about the beauty of the future scar, but about uncomplicated wound healing. In this case, as a rule, no complaints are made against the operating specialist, and this is generally fair.

Another thing is aesthetic surgery, when the main goal of the surgeon is to improve the patient’s appearance and minimize scars. By agreeing to the operation, the patient also agrees to the appearance of scars after it. But in this case, their characteristics become the most important indicator of the quality of the doctor’s actions, who, even before the intervention, is obliged to inform the patient in detail about the possible nature of future scars. This information allows the patient to agree or refuse the operation, and after it, if dissatisfied with the characteristics of the scars, to make a claim to the surgeon.

How does wound healing normally occur?

Wound healing is a biological process that lasts about a year and ends with the formation of a mature scar. However, subsequently the tissues that form the scar can change, although to a minimal extent.

Stage 1 of healing – postoperative inflammation and epithelization of the wound (1-10 days after surgery). A distinctive feature of this stage is the connection of the edges of the wound with granulation tissue, and not with a scar. Therefore, when the sutures are removed on days 7-10, the wound can easily open under the tension of the surrounding tissues. To obtain a minimal scar width in the future, this tension must be eliminated or neutralized by applied sutures.

Stage 2 – active fibrillogenesis and the formation of a fragile scar (10-30 days after surgery). Young granulation tissue quickly matures, which is accompanied by a decrease in the number of vessels and cellular elements, on the one hand, and an increase in the number of collagen and elastic fibers, on the other. At the end of this stage, the edges of the wound are already connected by a young, fragile scar, which is relatively easy to stretch and is clearly visible due to the large number of vessels it contains.

Stage 3 – formation of a durable scar (30-90 days after surgery). The number of fibrous structures in the scar increases significantly, and their bundles acquire a certain orientation in accordance with the dominant direction of load on the scar. The number of cellular elements and vessels in the scar tissue is significantly reduced, the scar becomes less bright and less noticeable. During this phase, external forces have a significant influence on the characteristics of the scar. Thus, with longitudinal stretching of the scar, additional formation and clearer orientation of collagen and elastic fibers occur in its tissue, and to a greater extent, the stronger the stretching. If in a patient the processes of fibrillogenesis are initially enhanced and prevail over collagenolysis, hypertrophic and even keloid scars may form, regardless of the direction of stretching.

Stage 4 – final transformation of the scar (3-12 months after surgery). It is characterized by increasingly slow maturation of scar tissue with the almost complete disappearance of small blood vessels from it. The scar fades even more. It is important to note that in most cases, it is in the middle of the 4th period (usually after 6 months) that skin scars can be assessed as formed and the possibility of their correction can be determined.

What determines what the scar will be like?

The external characteristics of the scar are influenced primarily by the following factors:

- the location of the wound and, in particular, the degree to which its long axis corresponds to the force lines of the skin (in short, along wrinkles and natural folds the scar will be thinner and less noticeable);

— method of surgical wound closure and the quality of its implementation, including the experience of the surgeon;

— efficiency of drainage (for extensive and complex-shaped wounds).

The patient’s age, immune status, and heredity play a role.

As a rule, scars normally do not cause any physical sensations in their owner. The appearance of signs of tissue irritation in the scar area (tingling, burning) is typical for hypertrophic (protruding above the skin), and especially for keloid (overgrown) scars. But unpleasant subjective sensations acquire practical significance only if they reduce the patient’s quality of life. In such cases, treatment is indicated - scar correction.

Treatment of scars after surgery

In recent years, many attempts have been made to find a way to non-surgically correct scars: from injections of aloe or vitreous to topical treatment of scars with pepsin with hydrochloric acid, thiosinamine, salicylic acid, hydrocortisone and its analogues, or creazote oil. Unfortunately, neither approach showed significant results.

But it still makes sense to use additional methods that improve the quality of scars in the postoperative period. First of all - peace and absence of irritating movements. Under resting conditions, a scar of smaller volume and with more favorable characteristics is formed. It would be advisable to fix the edges of the sutured wound with strips of adhesive plaster, which can well keep this area of ​​skin from stretching for quite a long time (up to 2-4 weeks). This will prevent early expansion of the developing scar. Depending on the specific conditions, the patch strips can be used during the entire period of formation of a durable scar (3-6 months from the date of surgery). They are changed by the patient himself when the patch begins to peel off. In this case, the skin should be washed with soap, wiped dry and sealed with a new strip of plaster. If signs of irritation appear on the skin, stop using the patch until the skin condition is completely normalized.

In order to improve the quality of scars during their formation, special silicone coatings, silicone plates, patches and medicinal gels can be used (for example, Contractubex to prevent the formation of pathological scars).

If signs of hypertrophic or keloid scar formation appear, therapeutic methods such as injection injection of glucocorticosteroids into scar tissue (drug "Kenalog-40").

Unfortunately, the personal experience of every surgeon indicates that it can be difficult, and sometimes impossible, to achieve a significant effect in the correction of scars even through surgery. At this stage of development of medicine, its methods are not able to completely eliminate the scar, or radically influence the general mechanisms of the formation of human scar tissue. The surgeon has the opportunity to exclusively locally influence individual characteristics of the scar, and often with very limited effectiveness. The doctor can only excise the scar and sew it up again, this time in a more qualified manner. For large scars, transplant a skin flap or use dermotension to create excess skin and cover the scar with it.

The doctor makes a decision about scar correction only after assessing the likelihood of treatment effectiveness. A positive decision is made by the surgeon after obtaining the patient’s informed consent, taking into account his psychological status and realistic expectations. An important role in this process is played by detailed informing the patient about the future appearance of the scar with demonstration of similar scars on the monitor screen.

When a surgeon, for one reason or another, cannot offer the patient surgery to improve the quality of the scar, a way out can sometimes be applying a camouflage tattoo to a scar. But this solution is not suitable for everyone, although it is used quite often. And in some cases, tattooing gives excellent results, since the scar is replaced by decoration. But you shouldn't get a tattoo on your cesarean scar if you're going to have another child.

If surgical excision of the scar is not necessary, you can try to smooth the surface of the scar using conservative methods.

Conservative correction of tissue relief disorders in the scar area

A scar is noticeable not only because its tissue differs in appearance from the surrounding skin. Very often, the leading role in the occurrence of an aesthetic defect is played by disturbances in the relief of tissues. It is the unevenness in the damaged area that can make even a small scar more noticeable and thereby significantly worsen the aesthetic characteristics of the appearance. How to make a scar less noticeable?

Disturbances in the microrelief of the scar can be corrected by medicinal, physiotherapeutic methods and biological fillers.

Medicines to make the scar less noticeable

Corticosteroids. Intraruminal steroids remain the mainstay of scar treatment. Corticosteroids reduce scar formation by reducing the synthesis of collagen, glycosaminoglycans, inflammatory mediators, and fibroblast proliferation during wound healing. The most commonly used corticosteroid is triamcinolone acetate at a concentration of 10-40 mg/ml Kenalog, administered into the injured area by needle injection at intervals of 4-6 weeks. The effectiveness of such an introduction as a monomodel and as an addition to the scar excision procedure is very high. Topical corticosteroids are also widely used, which are applied daily directly to the formation. Complications of corticosteroid treatment include atrophy, telangiectasias, and pigmentation disorders.

Immunomodulators. A new method in the treatment of keloid and hypertrophic scars is interferon therapy. Interferon injected into the suture line after excision of a keloid scar can prophylactically prevent relapses. It is recommended to administer 0.5–1.0 million IU every other day for 2–3 weeks, then 0.1–0.5 million IU 1–2 times a week for three months.

Drugs that reduce hyperproliferation of connective tissue cells. A classic remedy for the treatment of scars is hyaluronidase; it breaks down the main component of the interstitial substance of connective tissue - hyaluronic acid, which is a cementing substance of connective tissue, and thus increases tissue and vascular permeability, facilitates the movement of fluids in the interstitial spaces. Hyaluronidase reduces tissue swelling, softens scars and evens out their surface, preventing the formation of scars. Preparations containing hyaluronidase: Lidaza and Ronidase. Lidase solution (1 ml) is injected near the site of the lesion under the skin or under scar tissue. Injections are made daily or every other day; the course of treatment consists of 6–10–15 or more injections. If necessary, repeat courses are carried out at intervals of 1.5–2 months.

Another enzyme-based drug is Longidaz a. "Longidase" is a chemical compound of hyoluronidase with polyoxidonium. The combination of the enzymatic activity of hyaluronidase with the immunomodulatory, antioxidant and moderate anti-inflammatory properties of polyoxidonium provides a wide range of pharmacological properties. It is most effective to use the drug "Longidaza" by ultraphonophoresis or phonophoresis. For ultraphonophoresis, Longidase 3000 IU is diluted in 2–5 ml of gel for ultrasound therapy. The impact is carried out with a small ultrasonic emitter (1 cm 2), with an ultrasound frequency of 1 MHz, intensity 0.2–0.4 W/cm 2, in continuous mode, exposure time 5–7 minutes, course of 10–12 procedures daily or every other 1 day. Using the phonophoresis method (1500 Hz), 3000 IU of Longidase is administered daily (total exposure time 5 minutes, course - 10 procedures). It is also possible to administer the drug inside the scar:

— for small keloid and hypertrophic scars: Longidaza 3000 IU once every 7 days for a total course of 10 injections into the scar;

- for keloids and hypertrophies with a large area of ​​damage: Longidase 3000 IU 1 time in 7 days inside the scar in a course of 8-10 injections, at the same time intramuscular administration of Longidase 3000 IU No. 10.

A well-known drug that inhibits the pathological proliferation of connective tissue cells and at the same time has an anti-inflammatory effect is the Contractubex gel. "Contractubex" is used in surgery and cosmetology in the treatment of postoperative and post-burn scars, including rough scars that impede movement and keloids, as well as stretch marks (striae) after childbirth or after sudden weight loss. Apply to the scar area, 0.5 cm of gel on a scar surface with an area of ​​20-25 cm² on average 2 times a day.

An enzyme preparation of 9 collagenolytic proteases, Fermenkol cream is a fundamentally new proteolytic preparation. The anti-scar effect of Fermenkol is based on the reduction of excess extracellular matrix in scar tissue.

The effect when using anti-scarring agents is observed approximately 3 weeks after the start of use of the product and the optimal result is usually achieved after 2-3 courses of electrophoresis or phonophoresis, 10-15 sessions or applications for 30-60 days.

Physical and physiotherapeutic procedures to make the scar less noticeable:

Resurfacing will give a positive result for small superficial scars or pinpoint scars due to the consequences of acne. A scar with a smooth surface is much less noticeable than a scar with micro-elevations or depressions.

Laser grinding. The surface treated with a laser beam becomes smoother after epithelialization. Laser resurfacing has all the advantages due to the selectivity and precision of its impact on small areas of the skin (up to 1 sq. mm). The operation is usually performed under general anesthesia, since local administration of even a minimal volume of anesthetic solution can radically change the surface texture of the skin in the scar area. A surgical erbium laser is used. Epithelization of the treated surface occurs within 5-7 days.

Cosmetic procedures, aimed at external correction of the defect (peelings, mesotherapy, dermabrasion) do not give a noticeable result on large scars, but they can make small scars less noticeable.

Silicone plates and bandages. Allows you to smooth the surface of a small scar. Ineffective on hypertrophic scars and keloids.

X-ray therapy (Bucca rays). It is based on the action of ionizing radiation on connective tissue, causing swelling and destruction of collagen fibers and fibroblasts. X-ray therapy is prescribed up to 6 radiation sessions with an interval of 6–8 weeks at a single dose of up to 15,000 R.

Cryosurgery. Cryosurgical agents, such as liquid nitrogen, attack the microvasculature and cause cell death through the formation of intracellular crystals. Typically, 1–3 freeze-thaw cycles of 10–30 seconds are sufficient to achieve the desired effect. It is used only for hypertrophic and keloid scars.

With a formed scar with a duration of up to 12 months, it is possible to carry out treatment with all methods, and with a long-existing scar (more than 12 months), only aggressive methods are effective: injection of corticosteroids into the affected area, excision, radiation therapy, Bucca therapy, laser therapy.

Severe disturbances in the relief of the skin surface in the scar area are clearly visible and are most often caused by the following reasons:

1. Inaccurate comparison of the edges of the wound when applying sutures. Small inaccuracies will smooth out over time. In other cases, surgical correction with precise alignment of the wound edges is necessary.

2. Reducing the fat layer at the level of the scar with its deepening. Options to solve the problem:

- liposuction of the tissues surrounding the scar (fat tissue next to the scar is removed),

— lipofilling in the area of ​​the depression (a layer of adipose tissue is added under the scar),

- introduction of gels and other fillers (the effect is good, the disadvantage is that the gel can migrate and is gradually eliminated from the body),

- plastic with local fabrics.

3. A deep tissue defect at the level of injury, forming a significant depression. Here, depending on the conditions, tissue complexes with a non-axial type of nutrition (on a wide tissue pedicle), as well as island or free flaps can be used.

Moving the scar to a hidden area

The surface of any scar differs from normal skin, and the severity of this problem is most pronounced when the scar is located on open areas of the body. In the vast majority of cases, it is impossible to move the scar to another place, however, there are exceptions to this rule. Thus, during plastic surgery of the anterior abdominal wall, the removal of a significant area of ​​skin along with the scars located on it (for example, after surgery for appendicitis, interventions on the abdominal and pelvic organs) leads to the fact that a new horizontal scar is located in an already relatively hidden area - in the lower abdomen. A prerequisite for performing such operations is the presence of significant excess skin on the abdomen (for example, in women who have given birth).

An important argument in the patient’s consent to surgery is the simultaneous improvement in the shape of the torso.

In general, normotrophic (properly healed) scars generally do not require surgical correction, unlike hypertrophic (protruding) and keloid scars.

Correction of hypertrophic scars

In order to reduce the width of the hypertrophic scar (along with excision), to eliminate functional limitations and reduce unpleasant subjective sensations, it is used z-scar plastic surgery. Due to the fact that the main local cause of hypertrophy of scar tissue is longitudinal stretching of the scar, the main principle of its surgical correction is to change the direction of the scar through plastic surgery with opposing triangular flaps, also known as z-tissue grafting. The scar is excised and triangular flaps are formed along each edge of the wound, after moving which the wound takes on a zigzag shape. When the shape of the wound changes, it lengthens, which sharply reduces the influence of the longitudinal stretch factor. At the same time, a compensatory counter movement of the edges of the wound occurs, which increases their tension in the transverse direction.

Injections of the drug "Kenalog-40" with lidocaine into the tissue of the developing scar have a direct effect on the mechanism of scar formation, reducing the intensity of fibrillogenesis. It is advisable to start administering the drug from the 3rd week after the operation, the effect will be most pronounced. However, even at a later date you can get a good effect. The course of treatment is 3-4 injections, which are repeated at intervals of 5-7 days. Possible complications - when the drug spreads to the tissues adjacent to the scar, atrophy of the subcutaneous fatty tissue and skin may develop with the formation of depressions.

For small hypertrophic scars, conservative treatment is used - the above listed physical and physiotherapeutic methods, medications.

Correction of keloid scars

Due to the fact that the main reason for the formation of keloid scars is the body’s abnormal reaction to injury, expressed in a special course of wound healing processes with the formation of a keloid, attempts to influence a keloid scar only by surgical methods, unfortunately, are ineffective.

If we talk about excision of keloid scar, then it is possible, but only if the surgeon has sufficient knowledge and practical skills.

The most effective treatment method in this case is injection into the scar tissue drug "Kenalog-40", which allows you to significantly reduce the volume of the outer part of the scar (sometimes to normal size). In the postoperative period, an additional course of glucocorticosteroid therapy is advisable in all cases.

Can also be carried out locally X-ray therapy (Bucca rays), which in itself can give positive results in the treatment of keloid scars.

Can also be used in the complex treatment of patients with keloid scars. gel "Kontraktubeks" and balneotherapy.

Of great importance immobilization of keloid scar, including the use of special silicone coatings.

Thus, at present, keloid scars remain one of those diseases for which treatment with known methods is not sufficiently effective.

One can only hope that in the near future medicine will find ways to influence these processes so that they result in the formation of normal tissue.

Postoperative scars: complications and treatment

A scar is a dense formation consisting of connective tissue. Postoperative scars are a side effect of any surgical operation that involved violation of the integrity of the skin or internal organs. For most men, scars on their body are not a serious tragedy, and there is even a popular saying that scars adorn a man. But for women, the presence of a scar can be a real disaster, since the generally accepted canons of female beauty exclude their presence on the body or face.

If the wound was properly cared for after surgery, the scars will be light in color and have smooth edges, making their presence less noticeable. Over time, the scars gradually dissolve, and after a few years they become barely noticeable or completely invisible. If, during the healing process, an infection penetrates into the postoperative wound, a foreign object gets into it, or inflammation develops, then dangerous complications arise that require immediate treatment. The postoperative scar in this case will be large and deformed.

Classification of complications of postoperative scars

The following complications can lead to deformation of the postoperative scar:

A hematoma may appear due to increased pressure in the patient immediately after the operation or if he has a disease that leads to decreased blood clotting. A hematoma is characterized by redness or blueness of the skin, swelling and pain.

Infiltration of the postoperative scar is manifested by the accumulation of pus, inflammation and swelling. The patient is bothered by aching pain in the area of ​​the scar, and the body temperature rises. Due to the formation of infiltrate, blood circulation in the area of ​​the postoperative wound is disrupted, and its healing process is greatly slowed down.

Suppuration is a consequence of advanced infiltration, hematoma or infectious process. Suppuration is manifested by pain and swelling in the affected area, headache, chills and fever. Most often, suppuration occurs 5 days after surgery.

Granuloma of a postoperative scar (formation of granulations in tissue) may appear after surgery if the suture material is not absorbed in the body (to avoid this, you can use hypoallergenic self-absorbable suture material). Also, this complication can result from the penetration of talc or starch into the wound, which is used to treat medical gloves (this is possible if the doctor does not strictly adhere to all aseptic measures).

A seroma is an abnormal collection of lymph fluid. A seroma forms in cases where the wound surfaces are loosely positioned relative to each other and shift when moving. Men are more susceptible to this complication. Very often, seroma appears after a liposuction procedure.

Endometriosis of a postoperative scar is overgrown tissue in the internal organs. In most cases, this complication develops during obstetric and gynecological operations due to the implantation of pieces of the endometrium into the edges of the surgical wound. Complications can also occur after gastric resection, appendectomy, removal of breast fibroadenoma, or facial plastic surgery. The endometrium can enter the area of ​​postoperative scars with the flow of lymph or blood, which can be facilitated by childbirth, abortion, diagnostic curettage of the uterus or menstruation. Endometriosis can develop in the scar after gynecological surgery within 1-3 years and much later (in some cases even several decades) after operations on organs other than the reproductive system. Endometriosis of postoperative sutures can negatively affect the course of pregnancy, provoke miscarriage or uterine rupture.

Treatment of complications

Treatment of various complications leading to deformation of the postoperative scar is carried out with the help of surgery, but sometimes conservative treatment methods can also help. So, hematomas in most cases go away on their own, leaving no traces. But in some cases, their removal can be carried out using punctures (a needle is inserted into the postoperative scar and excess fluid is removed from it through the needle) or through surgery (if the hematoma grows, but during a repeat operation the source of bleeding is identified and stopped). To speed up the resorption of the hematoma, you can use Arnica cream after obtaining permission from your doctor.

Physiotherapy methods are used to treat infiltration, as well as antibacterial therapy and bilateral novocaine blockade according to Vishnevsky. Complete resorption of the infiltrate with adequate treatment should occur in 10-12 days. If this does not happen, the abscess is opened, and pus is removed from it using a double-lumen tube or cotton swab.

In order to cure suppuration of a postoperative scar, you need to remove the sutures from it and thoroughly clean the wound of pus and dead tissue, rinse and drain it. If the suppuration has spread greatly, all dead tissue must be excised. After such a procedure, the wound requires especially careful care.

In case of formation of a granuloma of a postoperative scar, the scar tissue is excised, all granulomas and non-absorbed suture material are removed. In the first three months after removal of the granuloma, it is necessary to ensure that the wound is clean and dry. Subsequently, after consultation with a doctor, you can use Contractubex or Mederma cream, which will speed up the resorption of the scar.

Postoperative scars with seroma can be treated with puncture, when excess serous fluid is sucked out through an inserted needle. After this, a bandage is applied to the scar, and after 3-5 weeks, repeated punctures may be required.

Treatment of endometriosis in post-surgical scars can be done with hormones, surgery, or a combination. Synthetic progestins are used for hormonal treatment. Surgical treatment is often combined with preoperative hormonal therapy.

Treatment and prevention

The development of complications of postoperative scars can be triggered by various factors that are associated not only with compliance with the rules of asepsis and postoperative wound care. Therefore, the patient must constantly listen to his feelings, and if any symptoms of complications of postoperative scars occur, seek advice from a doctor.

After the postoperative wound has healed, you can consult with your doctor about how to quickly remove the scar. In order to remove postoperative scars, the following are used: creams, ointments, gels, silicone plates, cosmetic procedures (laser exposure, peelings) or surgical excision. The product is selected depending on the size of the scar, its type and age.

Getting rid of a postoperative scar, especially on exposed skin, is not easy. Self-medication in this case helps little. Only the use of modern medical and cosmetic procedures makes scars a thing of the past for more patients.

Stages of formation

Scars after surgery can be present on any part of the body, varying in size and depth. Typically, healing of a suture after surgery and formation of a scar takes from 1 month to 1 year.

After surgery on the face or other part of the body, two processes begin in the skin - the formation of connective tissue and its splitting. The duration of this biological mechanism depends on many factors: the location of the suture and its size, the characteristics of the patient’s body.

From the moment of surgery until complete healing, certain changes occur in the tissues, which are divided into 4 stages:

1. First– period from 1 to 10 days. At this stage, the edges of the wound are connected by granulation tissue rather than scar. If sutures are removed or the muscles are strained excessively, the wound may rupture.
2. Second– the period of fibrillogenesis and the formation of a fragile scar, takes from 10 days to 1 month. Granulation tissue is formed, the number of collagen and elastic fibers increases. By the end of the stage, a fragile scar with a large number of vessels appears at the suture site.
3. Third– formation of a durable scar, formed in the period from 30 to 90 days. The number of fibrous structures increases, and there are practically no cellular elements and vessels left in the scar tissue. With proper healing, the scar becomes less bright and less noticeable.
4. Fourth– scar transformation lasts from 3 months to 1 year. The scar tissue matures completely with the disappearance of blood vessels. In some cases, the scar is almost invisible. You can determine the possibility of scar correction and the prognosis for its complete elimination.

Types of scars

It is difficult to remove scars after abdominal surgeries such as appendicitis, umbilical hernia, cesarean section or other abdominal surgeries. The mark remains for life, and the scar can only be partially removed. Be careful when treating a scar after heart surgery, since any hardware intervention can disrupt the functioning of the organ.

In surgery, there are several types of scars:

1. Physiological– is formed during normal healing and the absence of postoperative complications. The seam is almost invisible, the color is close to the color of the skin. Such scars are formed on the back with small and shallow incisions.
2. Atrophic – appears during superficial incisions, after unsuccessful removal of a mole or papilloma. Outwardly, it resembles a small depression in the skin with uneven edges. Its appearance indicates insufficient collagen production in the body.
3. Hypertrophic– formed after burns, suppuration, lacerations or skin trauma. Also, the cause of its appearance may be appendectomy (removal of appendicitis) or a predisposition to connective tissue proliferation. Externally, the seam protrudes above the surface of the skin and has a pink tint.
4. Keloid– looks like a tumor. Localized in the navel area, on the face, chest. Its formation is caused by burns, tattoos, removal of appendicitis, or trauma after soft tissue rupture. The scar has a bright red or bluish color and is firm to the touch. Over time, it fades and may sink into the skin.

Proper care of a postoperative scar

Removal of scars after surgery is carried out only after a certain time. Do not take any measures immediately after surgery. Methods of exposure should be chosen by the attending physician.

It is important to properly care for the suture after surgery. Initially, care is carried out in a hospital setting by medical workers and is aimed at eliminating inflammation or suppuration. Rules for caring for scars depend on their location and the size of the stitches.

After the operation it is strictly prohibited:

1. apply warm compresses to the suture area;
2. take a hot bath or visit a sauna for 3 weeks;
3. use scrubs or a hard washcloth;
4. scratch the wound;
5. touch the scar with your hands;
6. peel off the crust that appears;
7. use aggressive antiseptics.

Your doctor will give you more detailed advice on caring for your suture. In order for the scar to decrease in size and heal, it is important to behave correctly at home. How long a suture heals after surgery depends on its size and depth, but in any case you need to care for it daily.

If an umbilical hernia, appendicitis has been removed, or a postpartum suture is present, lifting heavy objects is strictly prohibited and physical exertion should be avoided.

Removal methods

There are two medical indications for scar removal. Firstly, if a suture is present on the face, and when it heals, deformation of the mouth or eyelid occurs. Secondly, when the seam causes psychological discomfort and is a pronounced cosmetic defect.

To ensure that scar resorption after surgery is successful and that no visible marks are left on the body, doctors recommend several effective methods of treatment.

Drugs

The pharmaceutical industry offers a large selection of drugs that can remove scarring on the skin. These medications are available in the form of ointments or gels. What to apply to the seam and for how long will depend on the size and depth of the damage.

Among the effective drugs are the following:

1. Contractubex– combined gel based on onion extract. Its use relieves inflammation, inhibits cell growth, and softens scar tissue. Promotes wound healing, is well tolerated and has a rapid healing effect.
2. Gel and spray Kelo-kot – a preparation with silicone and polysiloxane. After application, a film appears in the seam area, which prevents the growth of scar tissue. It allows you to restore the water balance in the tissues, eliminates itching and a feeling of tightness. The drug is not applied to a healing postoperative wound.
3. Skargard– cream for scars after surgery. It has a resolving effect, reduces the scar after a month of treatment. The composition contains hydrocortisone, which has a pronounced anti-inflammatory effect.
4. Gel Fermenkol– consists of enzymes that break down collagen. The enzyme compound of the drug allows it to be used both in the early postoperative period and to eliminate old scars.

Cosmetology procedures

Scars can be treated using cosmetic procedures in a dermatocosmetologist's office. The following procedures are effective:

1. Dermabrasion– involves grinding the surface of the skin and removing excess connective tissue. Often used for hypertrophic scars. The procedure can be carried out using various substances and components - diamonds, lasers, mechanical means.
2. Grinding– allows you to remove a scar after several procedures, but is carried out only on the recommendation of a doctor. You cannot treat damaged skin surfaces on your own.
3. Cryodestruction(cold exposure) is a common method for removing scar tissue. Unlike grinding, it is carried out under the influence of low temperatures. The procedure reduces the likelihood of fibrous tissue enlarging and growing.
4. Beech therapy – used to remove an old suture by irradiating the affected area. It has a complication in the form of a hyperpigmented stripe, which occurs after the procedure in 60% of patients.

Hardware and surgical methods

Postoperative scars can be removed surgically or using hardware. The procedures are performed in a hospital setting, where the patient remains under medical supervision for several days.

Plastic surgery provides the following opportunities:

1. Z-plasty – allows you to change the direction of the seam, making it more natural. Appendicitis is the main indication for the procedure, as are stitches on the face.
2. Flap surgery – a complex procedure for removing scars. There is interference not only in adipose tissue, but also in blood vessels and muscles.
3. Expander plastic – carried out to remove large scars. Expanders are placed in the area of ​​the removed scar, i.e. silicone bags that prevent the skin from sagging.

There are other methods, but any intervention has certain risks that need to be excluded during consultation with a doctor.

Scars after surgery cause some discomfort, especially if they are present on the face or other visible part of the body. You can really cope with the problem if you don’t self-medicate after surgery. Polishing or healing ointments - a consultation with a cosmetologist or surgeon will help you make the right choice.

Author: Mariana Zyatyk, doctor,
especially for Dermatologiya.pro

Useful video on how to remove scars after surgery