Prevention and treatment of scars after surgery

Photo: Li Jingyu Zhejiang Provincial People's Hospital

Reviewer: Wu Sufan, Chief Physician, Zhejiang Provincial People's Hospital

For many patients, undergoing surgery to treat a disease always brings an unpleasant "byproduct" - scars. When the disease is cured, the surgical scars will affect the beauty of the skin, and sometimes even scar hyperplasia, scar adhesion and keloids will occur, affecting the patient's activities or causing pain, itching and other discomfort.

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If you want the scar to recover well after surgery, the "golden" recovery time from the removal of stitches to half a year after surgery is very important. Scar prevention emphasizes "prevention before it happens". Simply put, it means keeping the scar at the "flat and small" state just after the surgery, and not "widening or becoming convex". Because "treating scars" is much more difficult than "preventing scars", "prevention before it happens" is the most cost-effective and effective approach.

Here are some common ways to prevent postoperative scars:

1. If you have just removed the stitches after surgery, you can try the following methods to prevent scars

1. Scar patch/scar ointment

The main ingredient of the most common scar patch or scar ointment is silicone. Users can choose one according to their needs and take care of it at home. It is generally used until about 6 months after the stitches are removed and the scab falls off after surgery. It has a certain scar prevention effect. The principle is that silicone has an inhibitory effect on scars.

2. Pressure bandage

Use elastic bands to apply moderate pressure bandages to scar areas suitable for pressure bandages, which compresses the blood vessels in the scars to prevent scar hyperplasia. This is a very economical and self-operable scar prevention method. After the doctor's guidance and teaching, patients can perform the care themselves, which has a good scar prevention effect.

3. Laser treatment

The most commonly used treatment is dye laser (also known as red laser), which can block the increased capillaries in the scar, thereby inhibiting the excessive growth of the scar and allowing the scar to recover more quickly and enter a stable period. After the stitches are removed and the scab falls off, if the patient's incision becomes obviously red, laser treatment is suitable, which has a significant scar prevention effect.

4. Tension reducer/tension reducer

Skin tension is a factor that causes scar hyperplasia. For some areas with greater skin tension, the use of tension reducers/tension-reducing patches can reduce and loosen the tension around the scar and avoid scar hyperplasia.

5. Botulinum toxin injection

If the surgical incision is located at the site of facial muscle contraction, the contraction force of the muscle and its pulling force on the incision can be reduced by injecting botulinum toxin, which can significantly reduce the formation of scars. In addition, recent studies have shown that directly injecting botulinum toxin into scars can also reduce scars.

2. If you have already developed scar hyperplasia, there are also the following treatment methods

1. Intra-scar drug injection

By injecting a small amount of glucocorticoids and other drugs into the scar site to treat hyperplastic scars, the scars can be softened and symptoms such as pain and itching can be improved.

2. Shallow electron beam irradiation

For patients with scar-prone constitution who have a history of keloids or severe scar hyperplasia, it is recommended to undergo superficial electron beam irradiation treatment immediately after surgery, which can achieve a good preventive effect. If the patient has already developed severe keloids, superficial electron beam irradiation treatment can also be performed after excision.

3. Fractional CO2 laser therapy

For uneven scars such as hypertrophic scars and depressed scars, fractional laser can restart the skin's self-repair process and improve the scar's smoothness, texture, and color.

In short, although scar problems vary, there are usually appropriate prevention or treatment options. If you are not sure what prevention and treatment methods to choose, please go to a regular hospital for help!