Healing After Surgery
How Wounds Heal
Ways To Enhance Healing
Scar Formation and Treatment
Healing After Surgery
Every person heals differently and at different rates after a surgical procedure. The doctors and staff of The Metropolitan Institute for Plastic Surgery will provide specific post-surgery instructions so that you can enhance the healing process after your procedure.
How Wounds Heal
The healing of wounds is a complex, delicate process that can be influenced by many factors, many of which you can affect. There are three phases to healing: the inflammatory phase, the proliferative phase, and the remodeling or maturation phase. The inflammatory phase begins immediately and lasts two to six days. During this time, bleeding stops, white blood cells fight bacterial infection, and collagen formation begins; collagen is what scars are made of and what holds wounds together. In this phase, the wound is usually warm, red swollen, and painful.
The proliferative phase is next and continues for three to four weeks. During this phase, collagen continues to be produced, pulling the edges of the wound together, and new capillaries are formed to aid in the healing process. This healing can cause visible thickening of the skin edges and new red bumps can appear in the shrinking wound. Cells that help to keep the wound clean can cause the wound to be wet, to weep, or to have a white or yellowish appearance.
The last phase of the healing process is the maturation phase. This phase continues for a period of several weeks to several years. This slow process includes the formation of even more collagen to strengthen the wound and then scar "remodeling" to break down excess collagen in the scar tissue. Scar remodeling is what changes a thick, raised, red scar to a thin, flat, white scar over a period of months to years.
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Ways to Enhance Healing
There are several things you can do to give your wound the best chance of healing:
· Nutrition: With your doctor's consent, taking a multi-vitamin supplement and additional vitamin C the day before surgery and for several weeks after surgery can aid in the healing process.
· Fluids: It is very important that after surgery, you drink enough caffeine-free, alcohol-free fluids to prevent dehydration and dangerous electrolyte imbalances. When you urinate, the color should be clear or very pale yellow.
· Smoking: Nicotine in any form (cigarettes, patch, gum, or chewing tobacco) causes the blood to constrict and decreases the delivery of oxygen to your tissues, preventing enough nutrients from being delivered to allow for adequate healing.
· Movement: Too much movement can cause fluid accumulation
(swelling) and prevent cross-linking of collagen and fibrin,
which are necessary to hold the wound together. The doctor
may limit your mobility with special instructions or post-surgery
garments to speed healing.
· Stress: Studies have shown that your mood and stress level affects your ability to heal. Staying optimistic and positive after surgery and avoiding unnecessary stress can help your wound heal more quickly. Getting adequate sleep can also aid in wound healing.
· Sun Exposure: Sun exposure can cause darkening and thickening
of scars for up to a year after surgery. Therefore, your
incisions and healing wound should be blocked from sunlight
for the first year after your surgery. Generally, sun block
can be applied two weeks after surgery, but check with the
doctor for specific instructions.
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Scar Formation and Treatment
Normally, the body stops collagen production in a healing scar when adequate strength is obtained. However, sometimes collagen production does not shut down and abnormal scars may form. Generally, there are two types of abnormal scars. A hypertrophic scar is an overgrown scar that stays within the area of the wound, but is thickened and raised. A keloid scar reaches out from the wound like small fingers and extends well beyond the area of the wound. Keloid scars are more common in people with dark skin.
Both hypertrophic and keloid scars can cause itching, burning, shooting nerve sensations, and an undesirable appearance. They also tend to darken as the area is exposed to sunlight, especially in darker skinned people.
There are several treatments for resolving or improving
both hypertrophic and keloid scars. Covering the scar with
a silicon dressing or a piece of tape, applying pressure,
and injecting steroid into the scar are the most common
techniques used in scar management. Lasers and scar excision
and re-healing are also used. The doctors and staff at The
Metropolitan Institute for Plastic Surgery will work with
you to make sure you are pleased with the way your surgical
site heals.
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