Scar Management in Hand and Wrist Surgery

Managing scars after wrist and hand surgery Sydney

Any surgical procedure will inevitably leave a scar, and hand and wrist surgery is no exception. Patients are sometimes worried about their scars. While surgical technique is important in creating a good scar, your care in the postsurgical period is the most important factor in determining what the final scar will be like.

How can you manage scars after hand and wrist surgery? What can you expect as your surgical wound heals?

How long does it take for surgical scars to heal?

Usually, the surgical wound will close within 7 to 10 days, although it sometimes takes a bit longer. This process tends to happen a little more quickly on the arm, and a little more slowly on the hand, especially on the fingers. This is because tissues with greater blood flow are able to heal more quickly.

Once the wound itself closes, there will no longer be a break in the surface of the skin. However, healing is still not complete. The initial scar is raised and pink, because the body puts down a large amount of scar tissue as quickly as possible at the beginning. Although there’s a lot of it, this tissue is relatively disorganized on a microscopic level.

Over the next few months, the scar tissue will gradually be reorganized. Eventually, the scar will usually become flat or slightly indented, and narrower than it was at first. It will also lose its pink color and become somewhat paler than the skin around it. This process usually takes about 6 to 12 months, although the scar tissue may continue to reorganize for up to two years after surgery.

How can you care for your scar after surgery?

It’s crucial to prevent infection of your incision after surgery. An infection in a surgical wound can spread, and can potentially even become dangerous to your overall health if left untreated. In addition, an infection interferes with the process of healing. Ultimately, it will have an impact on the appearance of your scar.

In order to prevent infection, you’ll need to ensure that you keep your incision clean and dry. This is especially crucial in the first few days after surgery, when there’s still a break in the surface of the skin. Antibiotics may be used to decrease the risk of infection; if you receive a prescription for antibiotics, make sure that you take them as directed and finish the entire course of treatment. It’s also essential to ensure that the area is only handled with clean hands. Whenever your bandages are being changed, make sure that you or your caregiver wash hands first.

Another important factor is physical activity. When you exercise, you raise your blood pressure. This can lead to increased swelling in your surgical incisions, as well as a risk of bleeding. Swelling increases the pressure in the area around the scar and can interfere with the healing process, leading to a final scar that’s wider than it would otherwise be. It can also delay the healing of the deeper tissues, which can have an impact on your results from the surgery. Make sure to stay away from sports and restrict your activity to light walking until you’ve been told that it’s safe to resume exercise.

Another important factor in reducing swelling is keeping your hand and arm elevated. It’s best to keep the area where you had your surgery above the level of your heart as much as possible. You can sleep with your arm on a pillow, and try to use cushions and armrests throughout the day to keep your arm elevated.

What scar treatments are available?

In order to minimize the risk of problems with your scar, there are a few treatments that may be helpful. These treatments will not begin until after the surgical wound has closed and the sutures have been removed. We can then discuss using one or more of these techniques to facilitate healing of your scar.

• Hand therapy. To prevent the deeper layers of tissue from becoming adhered to the skin by scar tissue, it’s important to ensure that the area is moved regularly. Of course, it’s also important to keep this movement within a healthy range, to avoid damaging tissues and affecting your surgical results. Your hand therapist will help you to learn the right movement techniques to prevent adherence.

• Scar massage. Regularly massaging the area also helps to prevent different layers of tissue from becoming adhered to each other. Your hand therapist will show you the right massage scar techniques for your particular situation. Being diligent about performing scar massage regularly will help to ensure that your scar is soft and mobile after it heals.

• Silicone treatments. Silicone can be applied to the scar either in the form of sheets or as a liquid. This increases hydration of the outer layer of the skin, which promotes healing and ultimately helps to create a flatter, softer scar. It also decreases the likelihood of a hypertrophic scar or keloid, which is an abnormal scar that remains thick and raised. Some people are prone to developing these, due to genetics.
• Vibration and texture therapy. These therapies can help to desensitize the scar, so that it’s less painful. For vibration therapy, a small vibrating device is applied over the scar, and the amount of vibration is gradually increased. For texture therapy, a material with a slightly abrasive texture is rolled, rubbed, or tapped over the area. Once this feels tolerable, a slightly more abrasive texture can be used. This helps the skin and nerves become able to tolerate the forces of daily living. It can take several months to complete this process of desensitisation.

In most cases, the scar will heal well with these techniques. Because scar reorganization can take up to a year or even longer, we need to wait at least that long before considering additional options. If the scar is still bothersome at that time, then you may be able to consider injections or surgical scar revision. We can discuss your options if this happens.

Managing scars after wrist and hand surgery Sydney

Your postsurgical care is the most important factor in determining how well your scar heals. Ensuring that you’re diligent about following all postsurgical instructions will help to reduce your risk of complications, such as thick and raised scars, mobility limitations due to your scars, or excessively sensitive scars.

If you have any questions about the best way to manage your scars, please contact our front desk to consult with your care team. Dr. Sungaran and all of our staff are committed to supporting each one of our patients through the entire healing period, to help you get the best possible results from your hand or wrist procedure.