Post-Surgery Concerns: Managing Knee Scar Tissue and Healing Process

Postoperative issues

Hello Dr.
Ke, I previously had hypertrophic scars on my knee and received scar injections.
Due to some reasons, a wound developed on my knee, and because the wound was too large, the doctor performed suturing and also removed some scar tissue.
I would like to ask you a few questions:
1.
After the knee wound was sutured, I feel a bit of tightness when bending it.
Will this gradually improve over time?
2.
After suturing, will hypertrophic scars form again? If so, is there a way to prevent this?
3.
After suturing, is there a possibility that instead of hypertrophic scars, keloids will develop?

Zhang, 20~29 year old female. Ask Date: 2022/06/11

Dr. Ke Fangxu reply Surgery

1.
Can.
2.
Avoiding friction and irritation can reduce the formation of hypertrophic scars.
3.
Keloids and hypertrophic scars are different issues; although they may appear similar, they are not the same.

Reply Date: 2022/06/11

More Info

Hello! Thank you for your questions regarding your knee surgery and the concerns surrounding scar tissue and the healing process. It’s great that you’re seeking information to better understand your situation. Let’s address your questions one by one.

1. Tightness When Bending the Knee: After a surgical procedure, it’s common to experience tightness in the area, especially when bending the knee. This tightness can be attributed to several factors, including swelling, inflammation, and the healing process of the tissues. As the healing progresses and the swelling decreases, you should notice an improvement in the tightness. Engaging in physical therapy and following your rehabilitation program can significantly help in regaining flexibility and reducing the sensation of tightness. Gentle stretching and strengthening exercises, as recommended by your physical therapist, will be crucial in this phase.

2. Risk of Hypertrophic Scarring: Hypertrophic scars can develop after surgery, especially if the wound is large or if there is tension on the scar during the healing process. While it’s difficult to predict whether a hypertrophic scar will form, there are several strategies you can employ to minimize the risk. Keeping the scar moisturized, using silicone gel sheets, and massaging the area can help in preventing excessive scar formation. Additionally, protecting the scar from sun exposure is essential, as UV rays can worsen the appearance of scars. If you have a history of hypertrophic scars, discussing this with your surgeon or dermatologist may lead to tailored preventive measures.

3. Possibility of Keloid Formation: Keloids are a type of raised scar that extends beyond the original wound site and can be more pronounced than hypertrophic scars. The risk of developing keloids can vary based on individual predisposition, skin type, and the location of the scar. If you have a history of keloids, it’s essential to inform your healthcare provider. They may recommend specific treatments or preventive measures, such as corticosteroid injections or pressure therapy, to minimize the risk of keloid formation after surgery. Regular follow-ups with your surgeon can help monitor the healing process and address any concerns promptly.

In addition to these points, it’s important to maintain open communication with your healthcare team. They can provide personalized advice based on your specific situation and medical history. If you notice any unusual changes in your scar or experience increased pain, swelling, or redness, don’t hesitate to reach out to your doctor.

Lastly, remember that the healing process takes time, and patience is key. Adhering to your rehabilitation program, staying active within your limits, and following your doctor's recommendations will contribute significantly to your recovery. Best wishes for a smooth healing process, and I hope you achieve the best possible outcome from your surgery!

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