Post-Surgery Concerns for Preauricular Sinus: Healing and Care

Preauricular sinus - postoperative issues!

Question: If the preauricular sinus is not sutured properly, will it bleed? If the wound is not completely closed, will the scar be unsightly in the future? Is a 7-day period for suture removal too long? Why is there swelling behind the ear after the surgery?

Tǎntè bù'ān, 10~19 year old female. Ask Date: 2010/07/08

Dr. Xu Jiazhen reply Otolaryngology

The preauricular fistula does not have a fixed trajectory, making it difficult to predict the suture location in advance.
The fistula resembles underground tree roots, which can extend in various directions.
When the physician removes the visible portion, they typically align the sutures with the direction of the facial skin to minimize the visibility of the scar in the future.
However, in clinical practice, there are many patients with severe inflammation who cannot have their wounds sutured in this manner, often due to significant infection.
In some cases, the wound may need to remain open until it is clean before closure.
Therefore, it is normal to have some drainage postoperatively, and it is advisable to follow up with your primary surgeon for clearer guidance.

Reply Date: 2010/07/08

More Info

Post-surgery concerns regarding a preauricular sinus, particularly after a surgical procedure like excision or closure, are quite common. It's essential to understand the healing process, potential complications, and proper care to ensure a smooth recovery.

Healing Process and Care
1. Wound Healing: After surgery, the body initiates a healing response. The surgical site may appear swollen, red, or bruised, which is a normal part of the healing process. The swelling behind the ear that you mentioned is likely due to inflammation and fluid accumulation, which can occur after any surgical procedure. This should gradually subside over time.

2. Bleeding Concerns: If the surgical site is not healing properly, there is a possibility of bleeding. However, if the surgical technique was sound and the wound is properly closed, significant bleeding should not occur. Minor oozing can happen, but if you notice persistent bleeding or a significant increase in blood, you should contact your surgeon immediately.

3. Scarring: The appearance of scars can vary based on several factors, including the surgical technique used, your skin type, and how well you care for the wound post-surgery. If the wound edges are not aligned properly, it may lead to a more noticeable scar. Following your surgeon's post-operative care instructions, such as keeping the area clean and moisturized, can help minimize scarring.

4. Suture Removal: The timeline for suture removal can vary. Seven days is a common duration for many surgical procedures, allowing adequate time for the initial healing of the skin edges. If the sutures are removed too early, it may lead to wound dehiscence (opening of the wound), while leaving them in too long can increase the risk of scarring. Your surgeon will assess the wound's healing progress before deciding on the timing for suture removal.

Post-operative Monitoring
- Signs of Infection: Be vigilant for signs of infection, such as increased redness, swelling, warmth, or discharge from the wound. Fever or increased pain can also indicate an infection. If you experience any of these symptoms, seek medical attention promptly.

- Follow-up Appointments: Regular follow-up appointments with your surgeon are crucial. They will monitor your healing progress, address any concerns, and provide guidance on when to resume normal activities.

Long-term Considerations
- Functional Outcomes: Most patients experience good functional outcomes after preauricular sinus surgery. However, if you have concerns about the appearance of the scar or any functional issues, discuss these with your surgeon. They can provide options for scar management or further interventions if necessary.

- Lifestyle Adjustments: After surgery, you may need to avoid certain activities, such as swimming or heavy lifting, for a specified period to allow for proper healing. Follow your surgeon's advice regarding activity restrictions.

In summary, while concerns about bleeding, scarring, and swelling are valid after a preauricular sinus surgery, most of these issues can be managed effectively with proper care and monitoring. Always communicate openly with your healthcare provider about your concerns and follow their recommendations for a successful recovery.

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