scar

Surgical scar, that is, the scar left on the skin surface after operation. The choice of surgical incision will affect the surgical effect and the shape, size and depth of surgical scar, so choosing the correct surgical incision during operation will lay a good foundation for eliminating surgical scar in the future.

Etiology of surgical scar

1, skin tension, including external tension caused by the degree of skin tissue defect and internal tension of skin tissue itself. Hypertrophic scars easily occur in areas with high tension and mobility, such as mandible, anterior sternum, deltoid muscle, upper back, elbow, hip, knee, ankle and instep. 2. Age (young people are prone to hypertrophic scars, especially 10-20 years old, mainly due to the vigorous growth of adolescent tissues, strong post-traumatic reactivity and high skin tension); 3, skin pigment (colored people have more pigment cells and are easily stimulated. The incidence of black keloids is 9 times that of whites; It is easy to occur during the physiological activities of pituitary gland, such as adolescence and pregnancy); 4, infection (repeated infection, long-term exposure of wounds, excessive proliferation of granulation tissue, prone to hypertrophic scars or keloids); 5. Foreign bodies fall into the wound (dust, talcum powder, fibers, hair follicles, sebaceous glands, sweat glands, etc. can cause tissue reactions, leading to scar hyperplasia); 6. Other factors (the angle between the incision and the skin is perpendicular to the incision of the skin, and the scar is the thinnest after healing; The greater the inclination angle, the wider the dermal scar and the more obvious the skin deformity. And the depth of the wound and the healing time of the wound).

Symptoms of surgical scar

Scar constitution shows that the surface scar continues to increase after wound healing, local pain, redness and itching, scar contraction, and also affects functional movement. But because there are few people with scar constitution, there is also a saying that people with keloids are called scar constitution.

Keloid is characterized by outward growth of scar, protruding skin surface, hardness, and red pain after wound healing, but it will not continue to expand after growing to a certain extent. Generally, surgical needle scar belongs to hyperplastic scar, which is red and hard, and some have tingling and itching. This shows that the scar is not stable, and it is still in the recovery period of tissue, so it can't be treated immediately. For the new scars in this period, careful care is needed, and pressure therapy and external drug repair can be used for anti-scar treatment.

Because of individual differences, it usually takes 3-6 months for the scar to stabilize quickly, and it may take several years for the scar to stabilize slowly. How to care for new scars in this period requires careful care, which can effectively prevent scar hyperplasia and promote tissue recovery. For example, if the skin is damaged and needs to be stitched, it should be stitched in a regular hospital; During the recovery period, organizations should eat less stimulating foods such as seafood, tobacco and alcohol; If the scar has a tingling and itchy feeling, it can be cold-compressed. In short, we must strictly follow the doctor's advice after operation. It is best to wait for the scar to stabilize and go to a regular hospital for treatment. After surgical scars and other scars are stabilized, they generally have the characteristics of hard texture, redness and hardening.

Surgical scar examination

It's a superficial wound of the skin, which only affects the skin. It begins with epithelial cells of hair follicles and sebaceous glands and heals through simple epithelial formation. After repair, the structural integrity and skin function can be completely restored. The other is the deep injury of dermis and subcutaneous tissue, which is repaired by scar. After any part of the body is injured, people with scar constitution can have infinite scar proliferation like keloids, but some parts of normal people will have keloids or scar healing caused by some reasons. In other words, keloids are an inevitable manifestation of scar constitution, and people with keloids do not necessarily belong to people with scar constitution. This kind of person after the wound heals. The increasing scar on the surface not only affects the appearance, but also affects local pain, redness and itching, and scar contraction also affects functional movement. Generally, patients with hypertrophic scars and keloids can be judged as cicatricial constitution; Generally speaking, it is a scar that protrudes from the skin after trauma and is larger than the wound area. People with scar constitution are prone to form hypertrophic scars or keloids with obvious symptoms after surgery, burns and trauma. At present, medical science can only diagnose the scar constitution according to the individual's performance, and can't really detect whether a person is a scar constitution by which detection index. In fact, there are very few people with real scar constitution. The diagnosis of scar constitution should be judged, and the treatment should be very cautious. Sometimes after treatment, the loss outweighs the gain.

Treatment of surgical scar

At present, the treatment of surgical scar at home and abroad mostly adopts local drug blocking, surgical excision and skin grafting, lens scar grinding, balloon dilatation, antibody injection, radiotherapy, compression therapy, hormone therapy, silica gel therapy and so on. Clinically, it is not very mature, some are time-consuming and painful, and many are not satisfactory.

According to different surgical scars, different repair schemes need to be formulated, so as to achieve effective repair treatment. According to experts, the treatment of scars should suit the remedy to the case, and different treatments should be done in different periods. After the operation, the scar should wait until 3-6 months after the scar is formed, that is, the scar tissue is gradually stable before plastic surgery can be carried out, and the effect is the best. You can also stabilize the scar as soon as possible through drug treatment before scar cosmetic surgery. Otherwise, surgical treatment in the unstable period of scar, improper postoperative care, personal physique and other aspects will lead to more serious changes in scar, and doctors did not diagnose the specific situation of stable scar before operation, so it is very risky to rush into surgery. However, if there is dysfunction or scar hyperplasia, you should go to the hospital for professional plastic surgery early. Although the causes of scar formation are the same, different surgical sites, surgical trauma, everyone's physique and repair ability are different, and finally everyone's scar degree is different.

Surgical scar diet

Eat a light diet, eat more foods rich in essential amino acids and collagen, such as eggs, lean meat and pigskin, as well as fresh vegetables and fruits.

Eating more alkaline foods such as kelp can effectively prevent scar hyperplasia. In addition, try to eat less peppers, ginger, garlic and seafood, and don't smoke, drink alcohol or drink coffee or strong tea.

First, don't eat indiscriminately: If you are a scar, and the scar is accompanied by itching, pain, hyperplasia or contracture, then you should pay special attention to your diet. Those fried moxibustion products; Fat, sweet and greasy; All spicy and dry foods should be banned. Because these foods will make the spleen and stomach stagnate and the health function will be abnormal. It will also increase blood flow and create conditions for scar deterioration.

Second, don't overeat: overeating refers to overeating; Eating too much is easy to damage the spleen and stomach to the deficiency of qi and blood biochemistry; Overeating can lead to malnutrition and deficiency of qi and blood. It will lead to the lack of healthy qi and the proliferation of evil spirits.

Third, not partial eclipse: Chinese medicine believes that medicine and food are homologous. Food also has four characteristics: cold, hot, warm and cool, and tastes sour, bitter, sweet and salty. If you are partial eclipse, it will easily lead to the imbalance of nutrients absorbed by the body, which is not conducive to the regression of scars. Therefore, in the usual diet, maintaining a balanced intake of nutrients is conducive to scar repair.

Prevention of surgical scar

It is best to reduce the activity of the wound after operation, otherwise it will affect the wound healing and stimulate the formation of scars, which is also the reason why the scars at the joints of limbs are usually obvious. In addition, it is effective to use silica gel tablets to prevent surgical scar hyperplasia. Apply silica gel to the scar for eight hours on the first day, and after the skin gradually adapts, it can be increased to 12 hour, and the effect is good in six months. As for the mechanism of action of silica gel tablets, Quinn thinks that it is the chemical action of continuous release of silica gel, and Swada and Son think that it is the physiological action of hydration and occlusion that causes scar inhibition.

1, the first step to prevent scars is correct wound care. No matter trauma, burn, skin infection or surgery, scars will be generated after wound healing. Correct wound care can avoid abnormal scars.

2. After the stitches are removed or the wound is initially healed, massage therapy and compression therapy are started as appropriate.

3. Stick the cosmetic (chin) tape or silicone sheet on the healed wound. Beauty (chin) tape needs to be pasted for 24 hours, and silicone tablets need to be pasted for about 12 hours. To be effective, the pasting range must be larger than the wound itself and include the surrounding normal skin.

4. Compression therapy can reduce the outward stretching force of the wound and make the scar flat and thin.

5, massage therapy can soften the hard scar, and has the function of tissue expansion, which can improve the scar with bulging or contracture tendency.

6, for a large area of wounds, you can consider the compression treatment of tight elastic clothes.