Wound Care
Wound Care
A guide to looking after your wound
Looking after your wound begins immediately after surgery and continues for a period of at least 3 months.
Swelling must at all-times be kept to a minimum. This is especially important in the first two weeks. This can be done by means of regular ice pack application as well as elevation of the affected limb. If swelling persists, then the swollen skin edges will pull on the stitches which will constrict and prevent a good blood flow which limits oxygenation and healing.
Another factor which limits blood flow is smoking. Smoking is absolutely not allowed. There are many surgeons who refused to operate on peripheral areas such as the feet because the wounds do not heal. Smoking also interferes with the healing of bone and may in fact cause a fracture not to unite.
Blood flow and oxygenation is the secret to quick and uncomplicated wound healing. This is another reason why diabetic patients may have wound healing problems with increased rates of infection. This is because uncontrolled diabetes results in closure of the small capillary blood vessels responsible for carrying oxygenated blood to individual cells.
In order for wounds to unite the body as to produce a tremendous amount of new proteins which are used as building blocks to repair all damaged tissue. In order to produce these proteins we require extra energy and basic building materials. I recommend that all patients take multivitamins and increase their protein intake for the first month following surgery.
When stitching my wounds, I do not used staples or external sutures except for very specific circumstances. In most cases the stitches are beneath the skin and absorbable. All my wounds will also have special skin tape (proxy strips) applied, which should help keep the tension off the actual wound and promote minimal scar formation. The wound is also initially sealed with skin glue. Dressings applied to the wound are all waterproof enough to allow showering only. All wounds require dressings for up to two weeks. Thereafter I recommend that one uses 24 mm wide Micropore or paper tape over the wound lengthwise and this should be reapplied weekly. You may bath, shower or swim with this tape, just dry as per normal. A topical cream may be applied directly onto the tape and massaged onto the wound 2 x a day, this is not essential. Most plastic surgeons recommend only the weekly taping for wound treatment, and this should continue for at least 1 month post-surgery, preferably 3 months.
While the wound is healing it is recommended that you minimize sun exposure to prevent permanent pigmentation.
You may have noticed that any wound will initially have some scabs, be slightly irregular and then will smooth out with a reddish colour or line. This redness will persist for 3-6 months before fading to a light line in most cases. REMEMBER while the wound is reddish this means there is active healing. This is also happening at a deeper level where the surgery was done. Be patient, take care and do not stress the area unnecessarily.