SURGERY
After an injury or surgery you may feel you are in a constant battle with scar tissue. The earlier action is taken to minimize scar, the better the outcome will be.
Scars are a natural response after an injury or surgery; however, it is a lot like the body’s own super glue. Scar tissue may only involve the superficial skin or it may attach to deeper tissues such as tendons, ligaments or nerves making the healing process problematic. The location and amount of scar tissue may influence the impact on functional activities. Scars can cause pain, decrease range of motion and impair functional mobility.
“THE BATTLES”
PHASES OF HEALING
There are four phases to the healing process
Phase 1
The skin and deeper tissues are healing. This is typically when there is still an open wound or sutures may be in place. At this phase the scar is not mature enough to work with and needs to be cared for gently to avoid infection or delayed healing.
Phase 2
During this phase you will really start waging war on the scars. During weeks 4-8, the scar will often become enlarged and reddened. This is usually when the scar is most active
Phase 3
Usually lasting 2-3 months, this is when the ‘rebuilding’ phase for a wound takes place. New tissue is being created along with a new network of blood vessels
Phase 4
During this final phase the scar will become softer and more pliable and usually the color will continue to fade. A scar will fully mature 12-18 months after the injury or surgery.
“STRATEGIC DEFENSE”
SCAR MANAGEMENT
Scar management can play an important role in your full recovery. If you have a scar that is causing pain or limiting your function, some of the following treatments may be helpful:
· Scar massage: Normal skin can be lifted and moved in all directions. Massaging a scar helps it to move like the normal surrounding skin. After three weeks your scar may be massaged in circles, side to side, and up and down with enough pressure applied to cause blanching of the scar. These patterns of movement will stretch the skin in all directions decreasing tightness of the skin while it is healing. Massage will also help to decrease sensitivity of the skin. An unscented lotion may be rubbed into the scar.
· Desensitization: When a scar is hypersensitive vibration and rubbing the tissue with various textures can help to decrease sensitivity. This process can take up to 4 months but can be started as soon as the skin has healed.
· Scar pads and tape: Silicone sheets help keep the skin stay hydrated which may soften the skin encouraging the tissue to form a flatter less adherent scar. A silicone sheet is applied like a post-it note sticker to the skin and can be washed and re-used. Tape such as Kinesio or paper tape can also be used to help model the scar, improve glide of the tissue beneath the skin and protect it from sun exposure.
· Compression: Pressure can help smooth and flatten the scar tissue. Depending on the location of your injury a pressure garment might be recommended.
· Early controlled exercise: “Motion is lotion!” Motion is essential to keeping skin pliable, especially across joints. Movement also prevents superficial scar from adhering to deeper structures. Early movement, when indicated, is best for preventing joint stiffness and keeping tendons gliding under the skin.
· Avoid Sun: scars are more susceptible to damage from harmful UVA/UVB rays. Sun exposure can make scars appear darker and possibly become thicker. Use sunscreen or cover with silicone or tape.
Keep in mind scar can take a year or more to fully mature! If you have concerns about your scar, talk to your doctor or therapist for recommendations on how best to decrease your symptoms.
