Recovering from Surgery - Scar Care

As Leonie deals with the day to day effects of her surgery one of the most pressing issues is the minimisatoin of the subsequent scar tissue.

Scarring is the body's way of repairing broken skin...whether it be from injury, surgery or as a reaction to changes in body shape (eg stretch marks).

Scarring is a natural and normal part of life and something we don't always worry about - remember back to our skinned knees as children...then scars were a trophy something to be proud of! As we grow older and as we acquire more significant and obvous scars we often look to ways to minimise the scar tissue or diminish their appearance.

Anatomy of a Scar: A scar is the resulting connecftive tissue that forms when any body  tissue is damaged and subsequently heals. Scars are made up of  collagen that forms as connective tissue to repair this damamge.
Just as healing is very individualised so is the subsequent scarring, it is dependent on the extent and nature of theinjury, the individuals bodily response to the injury and any complications that might arise.  

When the collagen used for tissue mending matures, it is referred to as scar tissue. It forms to fix the continuity of the tissue, but it is approximately 20 per cent weaker than the original tissue. And because of its different physical makeup, scar tissue presents as red or purple in the beginning stages. As it matures, it becomes white and glistening. 

The best case scenario when healing damaged skin is where the two surfaces of the skin can be brought together in close proximity using stiches, tape, staples or the like.  In these cases, because oof the minimal amount of collagen required to repair the tissues, often times the resulting scar is minimal, and fades to a fine line over time. This is called primary healing.

Secondary healing occurs when the surfaces of the tissues to be repaired is not in close proximity, are too large or complex.  This means that extra collagen is required to heal over the wound and a more complex scar results.

Every Scar Is Not Created Equal

When ample scarring occurs, a contracture or shortening of the connective tissue can occur. The result is tissue that cannot adequately lengthen, which can greatly reduce motion of the area. Usually lengthening can be restored with proper exercise or stretching of the area. Irreversible contractures, when fibrous tissue or bone replaces the connective tissue, can result in permanent loss of motion. Motion can only be restored by surgical intervention.
Occasionally, these shortened or contracted areas will produce adhesions.An adhesion is a cross-link of the collagen-based connective tissue in a random pattern. It is usually treated with massage techniques and stretching protocols. Chronic inflammation however, can cause fibrotic adhesions, which can severely restrict motion. Fibrotic adhesions are very difficult to diminish.

Sometimes chronic inflammation and abnormal healing can result in what is called proud flesh. This is the red, raised scarring from collagen formation that is disorganized. These scars are more likely to become damaged since normal healing will not occur over these elevated welt-like scars. Sometimes, surgical intervention may be necessary to remove the abnormal tissue to give way to proper healing.

A scar that extends beyond the boundaries of the damaged area is referred to as a keloid. A keloid is excessive collagen forming in a random pattern, which may continue to grow for several years. 

What can we do to minimise scarring? 

As you can see the formation of scars from collagen is a normal bodly function.At Moon Haven we are often asked how we can help minimise the formation of scar tissue or how to assist scars to fade.   

As you can imagine it is often easier to help minimise scarring as the scars are being formed as opposed to dealing with an already formed scar.

Firstly with new wounds it is important to not over stretch the wounds and consequent scarring as it forms.  Tearing of stitches and scars can lead to wider and more ugly scars and are more difficult to resolve. 

We recommend that you wait until wounds have healed over before applying a good rose hip based massage oil (see MH's Most precious Scar Care Oil) and always ask your doctor when you can begin light massage.. you don't want to start so early that you undo the good surgeon's work!

Massage should be light and gentle...there is no need to "break down' the scar tissue.  By gently massaging scar tissue with a good rose hip based oil you help mobilise the collagen which has gathered in the scar tissue.

While scar tissue is best dealt with early this oil can still be helpful in the case of older scars ... patience and perserverance is required in these cases but even old acne scars have been improved with massage.