Post-Surgery Wound Care: How to Prevent Scarring After Healing

What are the follow-up care steps for a scab after surgery?

In mid-June of this year, I underwent thoracoscopic surgery due to a pneumothorax.
One of the incision sites was not sutured upon discharge, and it has not healed since.
I later returned to the surgical clinic, where the doctor discovered necrotic tissue.
After removing the dead tissue, I was prescribed an ointment to apply daily and cover with a bandage.
The wound has slowly begun to scab over, but I am very concerned about the possibility of a large scar forming.
What should I do now that the wound is scabbing to prevent scarring? Should I wait for the scab to fall off on its own before starting to use silicone gel sheets (or adhesive strips)? I do not have a history of keloid formation, and I have already been using silicone gel sheets on the other two small incisions from the thoracoscopic surgery.
Is it necessary for me to use them, given that I do not have a keloid tendency? Will using silicone gel sheets really make the scars less noticeable? Previously, I had a fibrocystic tumor removed from my breast using traditional surgery, and I did not use silicone gel sheets at that time.
Although I have small red scars now, they are not raised.
I would appreciate your guidance on this matter.
Thank you!

Lin Xiao Miao, 30~39 year old female. Ask Date: 2017/07/30

Dr. Li Zhonghuai reply Surgery

Hello! After the scab falls off, you can apply scar gel! Take care! Changhua Hospital cares about you!

Reply Date: 2017/07/30

More Info

Post-surgery wound care is crucial for minimizing scarring and ensuring proper healing. Given your experience with a thoracoscopic surgery and the subsequent issues with your wound, it’s understandable to be concerned about scarring. Here’s a comprehensive guide on how to care for your wound and reduce the likelihood of scarring.

Understanding Wound Healing
Wound healing occurs in several stages: hemostasis, inflammation, proliferation, and remodeling. The scarring process primarily takes place during the remodeling phase, which can last for months to years. Factors such as the depth and size of the wound, your skin type, and overall health can influence the final appearance of the scar.

Immediate Post-Surgery Care
1. Keep the Wound Clean and Moist: After your wound has formed a scab, it’s essential to keep it clean. Use mild soap and water to gently cleanse the area. Avoid scrubbing, as this can disrupt the healing process. Keeping the wound moist can help prevent the formation of a thick scab, which can lead to more noticeable scarring.

2. Avoid Picking at Scabs: It’s tempting to pick at scabs, but doing so can increase the risk of infection and lead to more pronounced scarring. Allow the scab to fall off naturally.

3. Use Recommended Ointments: If your doctor has prescribed an ointment, continue to apply it as directed. These ointments can help keep the wound moist and promote healing.

After the Scab Falls Off
Once the scab has fallen off, you can start using silicone gel sheets or silicone gel (often referred to as "beauty tape" or "scar tape"). Here’s how to proceed:
1. Timing for Silicone Products: It’s generally recommended to wait until the scab has completely fallen off and the skin has closed before applying silicone gel sheets. This usually occurs within a week or two after the scab forms. Silicone products can help flatten and soften scars, making them less noticeable.

2. Application: Apply the silicone gel sheets or tape to the scarred area for at least 12 hours a day. Consistent use over several weeks to months can yield the best results.

Additional Tips for Scar Management
1. Sun Protection: Protect your healing skin from sun exposure. UV rays can darken scars, making them more noticeable. Use a broad-spectrum sunscreen with an SPF of at least 30 on the scarred area when exposed to sunlight.

2. Moisturization: Keeping the area moisturized can help in the healing process. Use a fragrance-free moisturizer to keep the skin hydrated.

3. Massage: Once the wound has healed completely, gentle massage of the scar tissue can help break down collagen fibers and improve the appearance of the scar. Use a moisturizing lotion or oil during the massage.

4. Healthy Lifestyle: Maintain a balanced diet rich in vitamins and minerals, particularly vitamins C and E, which are known to support skin health. Staying hydrated and avoiding smoking can also promote better healing.

When to Seek Medical Advice
If you notice any signs of infection (increased redness, swelling, warmth, or discharge), or if the scar appears to be raised or discolored significantly, consult your healthcare provider. They may recommend treatments such as laser therapy or corticosteroid injections for hypertrophic scars or keloids.

Conclusion
While it’s natural to worry about scarring after surgery, following these guidelines can significantly improve your chances of achieving a less noticeable scar. Remember, patience is key, as scar maturation can take time. If you have specific concerns about your healing process or scar management, don’t hesitate to reach out to your healthcare provider for personalized advice.

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