Scar Management and Scar Protocol

There are many types of scars and many different ways to manage scars. Scars may be traumatic, post-surgical, stretch marks, hypertrophic scars or keloid scars.

It is important to have a scar assessment by a plastic surgeon and devise and appropriate treatment plan.

The treatment plan generally compromises re-excision to give a fresh new perfectly stitched scar, following a scar protocol, applying pressure, steroid injections as needed, V-Beam treatment, Laser treatment, hyaluronic acid fillers, fat fills and external radiation in cases of chronic keloid scaring.

The scar protocol I generally follow is as follows:

It is important to keep scars clean and dry during the first two weeks post-surgery.

We would recommend that you attend our dressing clinic once a week for the first 2 to 3 weeks after surgery. During this time our specialist wound care sisters will make sure that your wounds are healing as expected.

-Please keep all wounds clean and dry. Wounds and dressings are not to get wet during the first 2 weeks or until we allow you.

-Please keep wounds and linen clear of household pets especially dogs. Our wound care specialist Master Sister Sheila has seen many a severe infection associated with “dogs in the bed”

-During the first 2 weeks your wounds will be taped with flesh-colour Micropore tape and covered with a sterile waterproof dressing.

Taping should continue for as long as possible, up to six months if possible.

During the wound healing process, the cells that promote healing, deposit collagen as a material of scar healing. If the collagen is deposited in clumps rather than straight lines, the scar healing proceeds in a non-pleasing manner. Thus by applying the tape an external force is applied to the wound, mechano-transduction stimulates the fibroblast to deposit collagen in a straight line and thus facilitate better scar healing.

Once the wound edges have healed satisfactory, usually about 2 weeks, start applying Scarscience. ScarScience is a scientifically formulated ointment that promotes wound healing available from Dischem or from our consulting rooms. I attended a congress in Switzerland where the surgeon showed his results of using Scarscience over a number of years. The results were remarkable.

It is important to apply Scarscience only once the wound edges have healed. Scar Science contains silicone and if applied to an open wound it could result in a mild superficial infection due to silicone being entrapped in he wound.

Clean the wound nicely saltwater ,Dettol or Savlon and dry with clean dry cloth. Next spray with Opsite spray available from a pharmacy or consulting rooms. The Opsite spray allows the tape to stick. Next apply the flesh-colour Micropore tape and the Scarscience over the tape. The tape is porous thus allowing the Scarscience to seep through to the wound.

The longer you tape the wound and apply Scarscience the better your wound will heal. If the taping is too time consuming please apply the Scarscience only. Sometimes your skin may become sensitized to the taping in which case I would recommend leaving the tape for a couple of days until the redness have disappeared but to continue with the Scarscience if possible. You may also leave the tape for a couple of days while showering and bathing and just apply the Scarscience on top.

The taping of the wound and applying Scarscience should continue while the scar has reddish appearance. Once the scar is white the taping and Scarscience are unlikely to work.

Rubbing and massaging the scar facilitates the wound healing process by the manners described above. In reality Bio-oil and other scar ointments will also work as massaging of any form facilitates the process of aligning the scar as describe above. I would recommend massaging the scar 10 times in the morning , 10 times in the afternoon and 10 times in the evening.

In Conclusion

I prefer Scarscience as I have seen studies indicating superior scar healing.

Should you develop any redness itching or pain please consult us immediately. There will always be a specialist wound sister to check all wounds.

It is normal to feel sharp shooting pains during the healing process of any wound. To understand it simply: during an operation nerves are cut, during the healing process the nerve start looking for its partner end. In doing so it sends out electrical impulses looking for the other end. These electrical impulses are perceived by us as sharp shooting pains. This process may continue for 12 to 18 months, the duration of wound healing.

The above are pointers to facilitate scar healing. In addition I wound recommend that you follow a laser scar protocol combining two types of laser treatments. I would recommend the best protocol to you once I have assessed your wound. I laser treatment protocol is to start 4 to 6 weeks after complete wound healing. Laser definitely improves the result dramatically.

I hope you find these suggestions informative and that you would follow them rigorously.



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