How stitches heal after facial surgery. stage: epithelialization of the skin wound. Seam care for special occasions

Clinical course and morphology of wound healing

From a practical point of view, several periods can be conditionally distinguished in this biological process, during which two main indicators change significantly, the most significant for both the surgeon and the patient:
1) strength and external characteristics of the skin scar;
2) the possibility of elongation and restructuring of deep scars under the influence of tissue movement (movement of muscles, tendons, etc.).

Table 12.1.1. Clinical and morphological characteristics of the stages of uncomplicated healing of a sutured surgical wound

A distinctive feature of this stage of the wound process is the fact that the edges of the wound are connected to each other by a very fragile granulation tissue, and not by a scar. Therefore, after the removal of the sutures on the 7-10th day, the edges of the wound can easily disperse under the influence of even a small load. In order to obtain a minimal width of the skin scar in the future, the edges of the wound must be held with sutures for a much longer period of time.

It is also very important that during this stage the sliding structures involved in the healing process of the wound (tendons, muscles, ligaments) remain mobile, however, their uncontrolled movements can enhance the process of postoperative inflammation and thereby worsen the quality of future deep scars.

Stage 2 - active fibrillogenesis and the formation of an unstable scar (10 - 30 days after surgery). During this period, young granulation tissue, located between the edges of the wound, the active formation of collagen and elastic fibers begins, the number of which increases rapidly. This tissue matures rapidly, which is accompanied by a decrease in the number of vessels and cellular elements, on the one hand, and an increase in the number of fibers, on the other. After this stage is completed, the edges of the wound are already connected by a scar, which remains stretchable and visible to others.

Deep scars during this period are still able to rebuild as much as possible when moving the sliding structures involved in the reparative processes. Therefore, it is at this time that surgeons begin to use special techniques aimed at restoring the mobility of tendons, muscles and joints. From this point of view, given period is the key to restoring the function of tendons that have a significant amplitude of movement and are located in canals with dense walls (flexor and extensor tendons of the fingers in the corresponding zones, capsule and ligaments of the joints).

Finally, this phase is different in that the tissues involved in the reparative processes are still sensitive to any additional trauma, including that caused by uncontrolled movements.

Stage 3 - the formation of a strong scar (30-90 days). This stage lasts for the 2nd and 3rd months after the injury (surgery). During this period, the number of fibrous structures in the scar increases significantly, and their bundles acquire a certain orientation in accordance with the dominant direction of the load on the scar. Accordingly, the number of cellular elements and vessels in the scar tissue is significantly reduced, which is manifested by an important clinical trend - the transformation of a bright and noticeable scar into a less bright and less noticeable one. It should be noted that under unfavorable initial conditions, it is at this stage that the hypertrophic growth of scar tissue begins.

At the 3rd stage, they are significantly strengthened and internal scars, which gradually lose their ability to rebuild and elongate. It should be noted that the formation of deep scars under conditions of complete 3-month immobilization of the limbs often does not leave patients with any chance of restoring the function of sutured tendons, especially if they have a significant amplitude of movement and are surrounded by dense tissues(e.g. finger flexor tendons). The joint capsule also loses its extensibility, especially after damage to its elements and the surrounding ligamentous apparatus. In these conditions effective rehabilitation involves appropriate surgical procedures.

On the other hand, upon completion of the 3rd stage, almost full load on the sutured tendons and ligaments can be resolved.

It is important that at the 3rd stage of wound healing, the intensity of reparative tissue regeneration processes changes significantly: from relatively high to very low. We also note that during this stage, a significant influence on the characteristics of the resulting scar is exerted by the effect of tensile forces on it. So, with longitudinal stretching of the scar, additional education collagen and elastic fibers in the zone of this constantly acting force, and to a greater extent than stronger stretching. If in patients the processes of fibrillogenesis are initially enhanced, then the result of early exposure to the scar in the phase of active fibrillogenesis is the formation of hypertrophic and even keloid scars.

Stage 4 - the final transformation of the scar (4-12th month). This stage is characterized by further and slower maturation of scar tissue with the almost complete disappearance of small blood vessels with further systematization of fibrous structures in accordance with the forces acting on this zone.

The result of a decrease in the number of vessels is a gradual change in the color of the scar: from bright pink to pale and less noticeable. At adverse conditions the formation of hypertrophic and keloid scars is completed, which sometimes significantly limit tissue function and worsen appearance patient. It is important to note that in most cases it is in the middle of the 4th stage that one can finally assess the skin scars and determine the possibility of their correction. During this period, the formation of internal scars also ends, and they are only slightly affected by the load.

Types of wounds and types of their healing. The main types of wounds

Scheme 12.2.1. The main types of wounds and options for their healing.

Surgical wounds are distinguished by the fact that in the vast majority of cases they are applied with a sharp scalpel. This determines their incised character and more favorable conditions for healing. Traumatic wounds treated by a surgeon are a special type of surgical wounds. Their scale, location and condition of the walls of the wound cavity are often determined not so much by the surgeon as by the nature of the primary injury.

Trophic wounds occur in violation of the venous outflow and (or) arterial inflow, as well as in some endocrine and other disorders. Their main feature is the gradual occurrence as a result of the slow death of tissues due to a violation of their nutrition.

Thermal injuries (burns and frostbite) have specific features, because wound surface can be formed simultaneously (flame burn) or gradually (with frostbite), in the process of forming a line of demarcation and rejection of dead tissues.

Other wounds. Sometimes there are more rare species wounds. These include wounds formed after self-opening of abscesses, deep abrasions, scratching, etc.

Types of wound healing

Wound healing by primary intention occurs when the edges of the wound are separated by no more than 5 mm. Then, due to edema and contraction of the fibrin clot, gluing of the edges of the wound may occur. Most often, this situation occurs when the edges of the wound are brought together with surgical sutures.

Second essential condition primary wound healing is the lack of suppuration. This happens if the edges of the wound are sufficiently close and viable, intrawound hematoma is small, and bacterial contamination of the wound surface is insignificant.

Primary wound healing has three implications for practice.

Firstly, it occurs in the shortest possible time, which, as a rule, means the minimum terms of inpatient treatment of the patient, his more fast rehab and return to work.

Secondly, the absence of suppuration during reconstructive operations creates favorable conditions in the wound for the subsequent functioning of structures restored by surgeons (in the area of ​​the tendon suture, the suture of vessels and nerves, the zone of osteosynthesis, etc.).

Thirdly, when primary healing, as a rule, a skin scar is formed with more favorable characteristics: it is much thinner and less likely to require correction.

Wound healing by secondary intention is characterized by a much slower course of the wound process, when gluing the edges of the wound cannot occur due to its large sizes. The most important features This type of healing is suppuration of the wound and its subsequent cleansing, which ultimately leads to gradual epithelialization of the wound in the direction from the periphery to the center. Note that peripheral epithelialization is rapidly depleted and can lead to spontaneous wound healing only if the wound is not too large (up to 2 cm in diameter). In other cases, the wound granulates for a long time and becomes non-healing.

Wound healing by secondary intention is unfavorable in all respects.

Firstly, this process lasts several weeks and even months. Treatment of the patient requires not only constant dressings, but also additional operations (imposition of secondary sutures, skin grafting, etc.). This increases the duration of the patient's stay in the hospital and the economic costs.

Secondly, when the wound suppurates, the outcomes of reconstructive operations (including those performed with open injuries). So, suppuration of the wound when applying a tendon suture in best case leads to blockade of the tendon with more pronounced scars, and at worst - to tendon necrosis.

The development of rough scars can block the regeneration of axons in the area of ​​the suture or nerve plasty, and suppuration in the area of ​​osteosynthesis usually ends with osteomyelitis. This creates new, often very difficult problems for the patient, surgical solution which may require several months, and sometimes even years, and the effectiveness of the measures taken is often low. Finally, after suppuration of the wound, as a rule, a wide scar is formed with a gross violation of the relief of the skin surface. There are frequent cases when suppuration of the wound leads to disability and even creates real threat the patient's life.

IN AND. Arkhangelsky, V.F. Kirillov

Treatment of postoperative sutures at home is a very important procedure that provides fast recovery dermis.

To speed up the healing process of wounds, you need to strictly follow the recommendations of the doctor.

The specialist will prescribe effective medications to treat the affected areas.

So, how to smear the skin in the area of ​​\u200b\u200bthe seams?

The healing process depends on human body. In some people, skin regeneration occurs quite quickly, in others it takes a long period of time.

To get a good result, you need to provide adequate care for postoperative wounds.. To do this, the doctor selects drugs for the healing of damaged areas.

The following factors influence the speed and characteristics of recovery:

• sterility;
• regularity of procedures;
• materials used for seams.

One of the key rules for caring for damaged areas of the dermis is compliance with the rules of sterility. Treatment of wounds is carried out exclusively with well-washed hands. For this purpose, carefully disinfected instruments must be used.

Depending on the characteristics of the damage, the seams are treated with such antiseptics:

1. Potassium permanganate solution - it is important to strictly adhere to the dosage. This will help prevent burns.
2. Medical alcohol.
3. Zelenka.
4. Fukartsin - the drug is rubbed off the surface with great difficulty. This can cause discomfort.
5. Hydrogen peroxide - may cause a slight burning sensation.
6. Anti-inflammatory ointments or gels.

In addition, you can treat the wound effective antiseptic- Chlorhexidine. In any case, before starting therapy, you should definitely consult a doctor.

To speed up the healing process, it is necessary to follow the wound treatment algorithm:

• disinfect hands and equipment to be used;
• carefully remove the bandage from the wound;
• by using gauze swab or cotton swab apply an antiseptic to the seam;
• apply a bandage.

Postoperative suture care requires certain conditions to be met:

• processing should be performed 2 times a day, but if necessary, this amount can be increased;
• it is important to systematically check the wound for inflammation;
• to avoid the formation of scars, do not remove dry crusts;
• during water procedures it is worth avoiding the use of hard sponges
• if complications occur in the form of redness, swelling or purulent secretion, you should immediately consult a doctor.

Many people are interested in how to process a postoperative suture for better healing. A variety of means can be used for this purpose.

Today you can find many effective local preparations that help solve the problem. Their use has a number of advantages:

• availability;
• wide spectrum of action;
• creating a film on the surface of the wound - this avoids excessive dryness of the tissues;
• nutrition of the dermis;
• ease of use;
• softening and lightening of cicatricial defects.

It is important to consider that wet wounds are not allowed to be treated with ointments. They are prescribed after the healing process has begun.

Depending on the nature and degree of damage to the dermis, the following types of drugs are used:

• simple antiseptics– suitable for processing deep wounds;
• drugs with hormonal ingredients - used for extensive damage, which are accompanied by complications.

Properly selected ointment for the healing of postoperative sutures allows you to achieve excellent results. To the most effective means include the following:

In addition, you can choose effective ointment or cream for resorption of postoperative sutures. The most effective tools in this category include the following:

A patch for healing postoperative sutures also helps to achieve good results . This tool is a plate that fastens the incision area and supplies the wound with the necessary substances.

Thanks to the use of a special patch, it is possible to achieve the following results:

• prevent the penetration of bacterial microorganisms into the wound;
• absorb discharge from the damaged area;
• ensure air flow to the seam area;
• make the seam softer and smoother;
• keep the necessary moisture in the scar area;
• prevent seam growth;
• avoid subsequent damage to the injured area.

All medications must be prescribed by a doctor. The specialist will definitely tell you how to care for the affected area.

Any self-treatment options are strictly prohibited, as there is a risk of wound suppuration and inflammation progression.

To speed up the healing process of the affected areas, you need to use folk recipes. Today there are quite a few effective tools:

To speed up the healing process of postoperative sutures, it is very important to provide good care behind damaged areas of the dermis. For this purpose, drugs are actively used and folk remedies.

Before using any product, be sure to consult a doctor. Self-medication can lead to dangerous consequences as severe inflammation.

After any operation followed by suturing, patients ask: "How long does the suture heal after the operation?" And any doctor will say that, although there are certain terms, this process takes place individually for everyone. In a word, in one patient the suture heals faster, while in another it takes longer.

In addition, there are certain factors that influence this process.

1. Patient's age. AT young age all processes in the body are faster, the recovery rate is higher, and the healing of sutures is faster than in older people.
2. Body mass. If a person is obese, then suture healing is a more difficult process for him, since adipose tissue has a poor blood supply and is more prone to injury and infection.
3. Food. The culture of nutrition largely affects the restoration of damaged tissues. After surgery, a person needs protein food and a diet rich in vitamins. If nutrition does not cover the needs of the body, then the stitches heal much longer.
4. Lack of water. With a shortage of water in organs and tissues, the load on internal organs, such as the kidneys and heart, increases, and metabolism also slows down. As a result, the area of ​​operation heals much longer.
5. Blood supply to the damaged area. The suturing site needs a good blood supply to a greater extent. Thanks to this healing the seam will pass faster.
6. immune status. With insufficiently strong immunity, if a person is infected with the immunodeficiency virus, recovery after surgical intervention will be much more difficult and slower. This category also includes people undergoing chemotherapy. For them characteristic complication is wound festering.
7. Chronic diseases. These include diseases such as diabetes. They increase the development of complications and slow down the healing process.
8. Sufficient amount of oxygen. The lack of oxygen in tissues and cells negatively affects wound healing, collagen synthesis and phagocytosis, the process of bacterial absorption, are reduced. Other nutrients come along with oxygen, their lack slows down the recovery and formation of new tissues.
9. Re-infection. This reason quite often spoils the recovery picture.

Healing time for sutures

The answer to the question after how many days the suture will heal after the operation is ambiguous. This is an individual process and depends on many factors. Basically, the wound after the operation is tightened for 9 days. After that, the sutures are removed if they were applied with non-absorbable materials. But in different parts of the body, the seams heal differently. Here are the approximate healing times:

• removal of appendicitis and laparoscopy - 6-7 days;
• extensive - up to 12 days;
• surgery in the sternum - up to 14 days;
• - up to 5 days;
• in the head area - up to 6 days;
• wounds after amputations - up to 12 days.

Ways to speed up the recovery process

How long the stitches take to heal depends largely on the patient. In order to speed up this process, you need to follow a few rules. Generally speaking, all these activities are aimed at strengthening immunity and preventing complications:

1. Physical activity within reasonable limits. On the one hand, during exercise, blood circulation improves, more oxygen enters the wound site and nutrients, which has a beneficial effect on the seams. But on the other hand, you need to be careful not to allow the seam to diverge.
2. Diet after surgery Nutrition should be aimed at replenishing required amount proteins to build new tissues, and prevent bowel disruption. Moreover, among negative effects course of taking antibiotics and many other drugs, just observed indigestion.
3. Application of traditional local funds. These include ointments and balms aimed at tissue regeneration.
4. Additional intake of drugs that increase immunity. These are various vitamins, supplements, enzymes and anti-inflammatory drugs.
5. Phytotherapy. The use of decoctions inside or the procedure for wiping and treating seams with collections of medicinal herbs.

The last point can be separated into a separate category. The use of herbal preparations in postoperative care behind the seams allows you to speed up recovery. Phytotherapy has long been singled out as a separate technique, but is still used mainly with traditional treatment. Doctors prescribe such therapy and recognize its beneficial effect.

Often such treatment is used directly to accelerate the healing of wounds and sutures.

In order to use phytotherapeutic agents, you need to consult a doctor. He will choose the most suitable option. These can be teas and decoctions for oral administration, which increase immunity and body tone, or decoctions for local treatment of sutures. Such drugs have an anti-inflammatory effect, anesthetize, improve the circulation of substances, have an antimicrobial effect, improve the formation of new tissue at the wound site.

Possible complications slowing down the healing of sutures

After suturing the different reasons there may be complications with its healing. As a rule, this is an infection, due to which suppuration of the suture develops, preventing its healing. There can be several reasons for infection:

• poorly processed materials during surgery;
• the appearance of a hematoma and the development of tissue necrosis;
• poor quality of materials used for suturing;
• weak immunity and general health.

These reasons significantly complicate the recovery of the patient. If the work of the surgeon was insufficiently qualified, and there were complications after the operation, then in this case left to deal with the consequences. But the cause of weakened immunity can be tried to eliminate in advance. It is enough just to eat right, take vitamins and exercise. Such active people the reserves of the body are much larger, and at critical moments they will cope with inflammation and disease. In addition, their internal reactions proceed faster, and these are the processes of recovery, metabolism, oxygen transport and the formation of new tissues. Therefore, people who lead an active lifestyle usually recover faster and tolerate various diseases more easily.

Correct stitching required

With respect to hygiene postoperative suture can be avoided unpleasant complications and speed up the healing process. Stitches after surgery must be carefully looked after. If a complication develops, then such sutures heal much longer. To avoid complications and reduce recovery time, the sutures must be properly processed. It is necessary to stock up in the pharmacy with hydrogen peroxide, brilliant green, cotton buds and discs, sterile bandages. Be sure to consult with your doctor about how often you need to treat the seam. Before handling, wash your hands with soap and dry them well. Seams should be processed after water procedures.

Initially, the area to be treated should be blotted with a towel. In no case do not rub, you need to get wet very carefully so as not to break the resulting crust. After that, give a little time for the skin to dry, and then treat with hydrogen peroxide. This can be done in two ways: blotting the seam with a bandage soaked or watering it with a thin stream. Allow to dry again after processing. Using a cotton swab, treat with brilliant green and, if necessary, apply a bandage from a bandage. Bandages are not usually required, but in some cases, the doctor may recommend bandaging to care for stitches. If you carry out such treatment at least once a day, you will soon see that the sutures heal faster.

Subject to all the recommendations of the doctor, the exception harmful factors, in the presence of which the sutures heal worse, you can significantly reduce the time of their healing and minimize complications. The main thing is not to forget about proper nutrition, hygiene procedures and reasonable physical activity.

Any operation is accompanied by trauma to the soft tissues of the patient. An open wound is formed directly at the site of the surgical intervention, and one of the main tasks of the surgeon is to prevent the penetration and development of infection in the wound, as well as to accelerate its healing and healing processes. postoperative recovery patient. Of course, the healing of the surgical wound depends on the general condition of the body and the health of the skin.

What are the results after Carpal Tunnel Syndrome Surgery? The success of the operation, as well as conservative therapy, is highly dependent on the severity of nerve compression. The fist formula could be: The longer the nerve pressure exists and the older the person, the worse will be the prospect of losing all symptoms of the disease. Unfavorable factors are also diabetes mellitus or polyneuropathy.

If surgical therapy is carried out at the right time, it should be expected that the agonizing night pain will disappear, as well as violations of the feeling of the skin. The treatment is different. Although a fistula can usually only be repaired with surgery, there are several options for performing post-surgery wound care as well.

Experts distinguish between two types of wound healing - primary and secondary intention.

Primary Tension characterized by the fact that the edges of the wound grow together without the formation of an intermediate tissue, in other words (in relation to postoperative wounds), the doctor tightens the edges of the incision, sews it tightly and applies aseptic bandage. After some time (usually 5-7 days), the stitches are removed, a scar remains at the site of the incision, which eventually becomes less noticeable, or disappears altogether. Usually, by primary intention, properly and timely treated shallow wounds and cuts heal. Of course, if the surgical suture is done as required.

If, for example, the collection of holes, which is thorough surgical method, is not a question of the respective patient, the coccygeal fistula is radically removed. For this purpose, a dye is injected into the fistula canal and all discolored tissue is excised. In order for the fistula to be completely removed, it is usually necessary to cut out the coccyx. The resulting wound is large and can either be sutured or swabs filled, otherwise left open. " open hole» in tissue exists for a long time.

The prospects for recovery are very good. In closed wound healing, the suture is often displaced from the infected middle of the buttocks in various ways. Although closed wound healing with a suture provides the advantage of faster healing, it often results in a recurrence in which the coccyx appears after surgery, requiring further surgery.

So secondary tension the situation is a little more complicated. Wound healing by secondary intention is characterized by the fact that the edges of the wound are not tightened, or partially tightened. In this case, the formation of the so-called granulation tissue begins in the "open" area - a network of small blood capillaries surrounded by cells connective tissue. This whole process is called granulation and is somewhat similar to the formation of a film on the surface of milk. Granulation develops from the center of the wound and in the process of growth moves to its edges. Healing by secondary intention is often preceded by inflammatory processes in the wound, accompanied by the formation of pus and exudate. In surgical practice, to ensure the release of pus from the wound (drainage), the surgical incision is usually not sutured to the end, small gaps are left at the edges for drainage tubes or other surgical devices.

Tension or complications of the skin can lead to rupture of the suture. The suture supports the healing process of deep wounds and injuries. The surgical suture closes the wound, the edges of the wound are tightly connected together. When a new and stable tissue is formed, the thread can be pulled out. Some factors contribute to the loosening of the sutures at certain points or the opening of the wound after suturing.

How can the seam be opened?

The wound does not heal quickly in all places. In certain areas, the skin takes longer to fully grow. If the suture threads are drawn too early, new enough skin is not formed. There is no support for the wound, the scar may open. If the skin tension at the wound site is very high, the sewing may rise again after the threads are drawn. The newly formed tissue does not have sufficient strength to hold the wound fields together.

There is another type of wound healing - healing under the scab, but this is not typical for a surgical suture, so we will not consider it in this article. One way or another, there are certain terms that set how long the suture heals after surgery for a given disease.

Complications of the surgical wound:

Different thread tension during sewing also plays a role when the wound suture is partially opened. Not every seam is sewn with the same tension. The result can be different skin tension and a scar that is not completely healed. The wound suture may rise again when a wound healing disorder occurs. The skin at an injury is insufficiently perfused, the edges of the wound die. The seam is not sufficiently held and may open. The damage to this healing disorder requires a lot of time and special medical supervision for a complete cure.

Spoil the patient's life after surgery can bleeding from a sutured wound, education hematomas(bruises) around and inside the suture - as a rule, this is a consequence of insufficiently reliable ligation of a vessel cut during the operation or damage to its wall by a purulent-necrotic process. Bleeding can also be caused poor clotting blood. Treatment or surgical (opening the seam, re-treatment of the wound - removal of dead tissue, dressing large vessels etc.), or conservative in case of acute hemophilia - taking coagulants. There are also cases when

If the wound suture has disappeared, it is important to reduce skin tension in the affected area. Too much tension prevents the wound from healing and the suture opens further. Pavement strips that are glued through the wound seam are well suited. The open suture site should be closed by normal wound healing. The wound suture must be clean and dry. Appropriate disinfectant or a suitable cream helps the healing process and protects against infections. Cover the area with a sterile dressing or dressing.

If there is a damaged stitch or bleeding in the exposed area, seek medical attention immediately. If necessary, for inflammation, it is necessary to conduct an open wound treatment. If the wound suture is located at points of the body with high skin tension, an open suture or injuries to the back or joints are often exposed to severe stress. After the threads are pulled out, the tape protects the scar. Adheres through tight skin tissue, reduces tension and supports healing.

Drug for the treatment of difficult-to-heal sutures
and postoperative wounds

Despite the achievements surgical technique, the use of modern sterile materials and the skill of surgeons, there are frequent cases of complications from the postoperative wound, when the healing time is noticeably lengthened.

Why is this happening?

Once the suture has opened, a new wound closure through the wound suture is not always possible. The risk of infection is great. In some cases, the doctor checks whether a new suture is required and whether it can be performed without problems. Rest and non-rest important rule it's good for a fresh scar to heal - especially when it's in a range that moves around a lot.

There are cultures where people only feel beautiful when their body is scarred. In addition, members of Striking Relationships are often wounded from their student days. Most people, however, feel that a scar caused by an accident or surgery is like a deformity, especially when it is clearly visible. However, patients can do a lot, so it doesn't get that far - fresh scars can often be treated so they're less of a concern later.

On the one hand, the cause of difficult healing postoperative wound directly depends on the degree microbial contamination. So, with "clean" wounds, the number of complications reaches 1.5-7.0%, with conditionally "clean" - 7.8-11.7%, with contaminated (wounds that come into contact with organs contaminated with microbes) - 12.9 -17%, with "dirty" (purulent) wounds - more than 20%.

I would never promise an invisible scar, says Sven von Saldern, President of the German Society for Aesthetic plastic surgery. "But a scar can heal so well that even a surgeon has to look for it." But this requires at least two things: an experienced surgeon who stitches the wound so that the skin is not under tension. And a patient who has patience until the scar is completely healed.

Also important, but not affected by the stakeholder, are higher life ages, at which scars often heal better than younger years, and genes that do not lead to large scale scarring. So it would be nice if a 14-year-old wants to get rid of a mole: "I'm very wary of this," says von Saldern.

On the other hand, it's connected with general condition human body who underwent surgery. To unfavorable factors include: age over 70 years; nutritional status (malnutrition, malabsorption syndrome, obesity); concomitant infectious diseases; violation of anti-infection protection systems, including immune status(oncological process, radiation therapy, treatment with corticosteroids and immunosuppressants, parenteral nutrition); related chronic diseases(diabetes, chronic inflammatory processes, circulatory failure, impaired renal and liver function).

It also depends on where the scar is. “Overlapping scars are more common on the shoulder, chest and earlobe than elsewhere,” says Gerd Gauglitz from the Clinic and Polyclinic for Dermatology and Allergology at the University of Munich. There, the skin is subjected to a lot of stress. "Of course, a long scar is under a lot of stress, but it doesn't automatically make it worse than a small one."

Hypertrophic scars often develop under stress. According to the guidelines for cortical therapy of the German Dermatological Society, they are limited to the area of ​​the original wound, but exceed the level of the skin and thicken thickly. They may be spontaneous, but often not completely. Even so-called keloids are possible: growing scars outside the original wound that rarely return. If keloids are simply cut out, according to Gauglycer, 50 to 100 percent of all cases new growths occur.

At the same time, the natural (physiological) mechanisms of healing are significantly reduced, reparative (restorative) processes are sharply inhibited, which is a manifestation difficult healing of the postoperative wound and sutures.

How to effectively help healing?

Of course, you can diligently engage in general strengthening and systemic therapy thus affecting the whole organism "as a whole". And wait for months, when normal physiology will be restored. But when it comes to chronically non-closing wounds, more effective means are needed.

Whether it is an ugly scar, you can appreciate it already in the first weeks after the operation. Second: "Don't exercise for three weeks, especially if the scar is in a range that moves a lot." Even if the threads have been drawn and the surface looks good on the surface, the scar still does not heal.

Even if the scar is covered with abrasive clothing, the sick flyer of the professional association of German dermatologists has a meaningful pavement coverage. In fact, various studies are increasingly showing their usefulness. However, there are still doubts about the effect of other scars and creams. And we are absolutely good at pressure, as we know from combustion medicine. There, people with serious disabilities are in compression suits to influence the scars. However, it is important that the scar does not irritate or set in motion.

Ointment Stellanin ®- a new generation drug for the treatment of wounds and sutures in patients undergoing surgery:

• Eliminates infection, swelling and pain, prevents the synthesis of inflammatory mediators - prostaglandins, biologically active substances, initiating and maintaining the inflammatory process. As a result, even extensive inflammation stop very quickly.


• Activates vascular growth factors vegf-A and vegf-B. Newly incoming cells are specialized in tissue, which leads to restoration of the structure the lowest, damaged during the operation of the basal (growth) layer of the skin.

The active ingredient in Stellanin-containing ointments is the substance Stellanin (1,3-diethylbenzimidazolium triiodide). Stellanin is a complex chemical compound - organic part of the molecule affects the activity of the gene apparatus of the cell, powerfully activating the regeneration processes in it. Simultaneously inorganic part of the molecule has a pronounced effect on the entire spectrum pathogenic microorganisms.

This may worsen the condition. “I would be a little more careful about scar tissue, the research situation is controversial,” Gauglitz says. A burn or surgery usually leaves a scar on the skin. That helps to make it as unobtrusive as possible. Delicate, plump and flawless - this is the skin of a child. But over the course of a long life, one or the other injury will not fail. A space wrapped around the forehead that needs to be stitched. First surgical procedure which leaves a larger scar. Ideally, a light line that is barely visible reminds us of this, but it can also be a widespread or beaded, reddish line.

In addition to regenerative properties, Stellanin has a powerful antibacterial effect. He eliminates in the woundbacteria, and mushrooms, viruses, protozoa.

It is especially important that all pathogens wound infection do not possess to Stellanin neither natural nor acquired resistance.

How surgeons can act on scars

Scars can hurt, itch, strain, or restrict movement. How the newly formed tissue develops, among other things, is a predisposition. However, patients and doctors can influence the appearance favorably. Some scars can be cleverly hidden. “In the case of groin surgery, for example, we can place an incision in the intimate area, where the scar is barely visible,” says Dietmar Lorenz, professor at the German Society for General and Visceral Surgery. If the surgeon cuts the incision along the stretch lines of the skin, this will also be less noticeable after healing.

In the presence of pus, thanks to the excipient (polyethylene glycol), which is part of the Stellanin-PEG ointment, the wound is quickly cleared of purulent content. At the same time, inflammation is blocked, pain and swelling are eliminated.

The high efficiency of the drug was confirmed by leading Russian scientists:

Choice suture materials and methods affects the same as the time of the drawing, the traces of which will be left behind. Only small incisions are needed for endoscopic procedures. The decisive advantage is that patients recover faster.

If the wound heals well and does not occur, the chances of an inconspicuous scar are especially high. “The decisive factor for this is, on the one hand, that we work without waterless or poor,” says Lorenz. "On the other hand, the wound must be sterile until it is sealed." This usually happens within 24 hours. If there are no problems, it heals the wound in a few weeks.

"Already in the first day treatment of wounds with Stellanin-PEG ointment, there is a positive trend in the healing process, inflammation decreases ... Young cells with a high level of metabolic processes". (From the Report approved by the Director of the Institute of Surgery. A.V. VishnevskyAcademician of the Russian Academy of Medical Sciences V.D. Fedorov).

The newly formed tissue remains active for a long time. It will take up to a year until the scars settle down. Smoking should be avoided for as long as possible, as nicotine reduces blood flow, makes wound healing more difficult, and thus increases the risk of disturbing scarring.

Light movement can be beneficial. But in sports, lifting and carrying, fresh tissue can become overstressed - and the scar can become wiser. Caution: inflammation associated with redness or swelling is always a reason to visit a doctor.

Surgical operations are quite common in our time. Most patients agree to them without the slightest fear and doubt, some even do "optional" operations at their own expense - we are talking, of course, about plastic surgery. And yet, many people are not even worried about how the intervention will go, but how noticeable the sutures will be after the operation. Do not forget that how quickly and how well the incisions heal depends largely on the care of them during the recovery period.

Basic rules for caring for sutures during the recovery period

Surely, you will be told how to care for the stitches after the operation when you are discharged, but if the medical staff forgot about it or you don’t remember, we remind you. The main rule is to always keep the seam clean and dry. If the incision has already healed well enough, and open wound no, you can wash it plain water With laundry soap. After each hygiene procedure be sure to apply an antiseptic. Zelenka, iodine or potassium permanganate solution will do. But the regular use of alcohol or cologne for washing should be abandoned - the thing is that these compounds dry the skin too much. If there is even the slightest suspicion that the sutures have become contaminated after the operation, they should be washed with hydrogen peroxide. The same procedure is necessary for festering sutures.

To wear a bandage or not?

The issue of dressings during the rehabilitation period after surgery should be decided by the doctor. It all depends on the depth and length of the incision, where it is located, how well it heals, and other factors. The patient must listen to own feelings. For example, if operations cling to clothing, a bandage should be applied at least during periods of physical activity. Another topical question: should the seams be processed special ointments, accelerating healing, or is it easier to let everything take its course? It is worth using folk remedies with caution, but among pharmacological products there are many compounds that have proven themselves positively. The most popular remedy is Levomekol ointment, you can also use any panthenol-based products. After removing the threads, you can treat the scars with special oils and various formulations, accelerating cell regeneration and moisturizing the skin.

Operation time: will the stitches heal soon?

The question of the duration of rehabilitation after surgery is more than individual. On average, the stitches are removed for 7-10 days. In some situations, this period can be extended to two weeks, more rarely, as the risk of ingrown threads into the skin increases. Remember: Your doctor or nurse should remove your stitches after surgery, unless you were told otherwise when you were discharged. After the threads are removed, scar care must be continued. Regardless of how the rehabilitation after the operation goes, the incision site is considered to be completely healed approximately one month after the intervention. Namely, when a clear scar is formed.