As surgical techniques continue to advance, surgeons have been able to maximize scar healing and minimize the effects of extensive scar formation. Despite this, scarring is still a possible side effect of undergoing surgery.
Whether you are undergoing abdominal, gynaecological surgery or a c-section, we have got you covered!
Before we discuss scar healing and treatment, let’s clear up what happens to your body and what recovery will look like.
Scar healing
Scars are a normal aspect of the body’s healing process and may occur when the body builds tissue designed to close gaps and repair damaged skin from an injury.
As a result of the natural wound healing process, the skin previously damaged during the incision is replaced by connective tissue. During healing, both anabolic processes (breakdown of excessive collagen) and catabolic processes (formation o collagen fibres) take place.
This process can take up to 2 years after surgery, and the rate of tissue healing is different for everybody. It depends on many factors, including individual predisposition, how the scar is handling and the lifestyle of the person, including both diet and the amount and type of physical activity.
Scar formation
There are 3 stages of scar formation:
- Inflammatory phase lasting from 2 to 7 days after surgery
- The phase of hyperplasia and angiogenesis (the process of formation of blood vessels from already existing ones) lasts up to 6 – 8 weeks after surgery
- The remodelling (rebuild) phase can last from 6 months to up to 2 years after surgery
It is important to respect tissue healing phases when trying to work with the scar. After a week of correct wound healing, the strength at the site of scar formation is 3% healthy skin, after 3 weeks 20%, and after 3 months after incision 80%. This is the maximum strength a scar can achieve.
Scar healing phases
In the first phase of healing the scar should not be mobilised manually. Starting scar mobilisation techniques during this time can result in the wound spilling out and delayed healing. This is the time when you should take it easy. During this time, the most important thing is to rest, be careful when getting out of bed or chair, take care of the dressing and airing the wound (it is good that it is dry, and if it gets wet during the bath it should be changed to a new one). Wearing underwear that does not irritate the incision area is important too. During coughing or sneezing, try to protect the scar by bring the edges of the wound closer together.
The second phase of scar formation is the most important from the physiotherapy point of view. It is recommended to start working with a physiotherapist 6 weeks after surgery if the wound is completely healed. After the examination, the physiotherapist will be able to instruct you on how to work with the scar on their own. In a situation where it is not possible to consult a physiotherapist, it is necessary to abstain from autotherapy until full strength through the scar, that is, up to 12 weeks after surgery.
It is normal to feel stinging, pulling, itching or gentle discomfort during scar mobilisation, but is should not exacerbate during or after it.
During the third phase of scar formation, you can still start or continue working with the scar if required. At this stage, you can use more pressure during mobilization as the scar has already reached full strength at this point.
How to heal the scar?
There are many different ways to assist with scar healing.
Here are my top recommendations:
❎️Gentle compression – This will help to reduce swelling and pain. You can use your hand to gently compress the scar or lie on your tummy with a pillow underneath for few minutes a day.
❎️Scar massage – It can help to improve the overall appearance of the scar and the function of the tissue. It’s important to be consistent. It is recommended to start working with a physiotherapist at 6 weeks after surgery. After the examination, the physiotherapist will be able to instruct you on how to work with the scar on your own. In a situation where it is not possible for you to consult a physio, it is necessary to abstain from self-treatment until up to 12 weeks after surgery
❎️Silicon strips or a gel – It works best on hypertrophic/raised scars and keloid scars. Start using as soon as scar is healed, usually after 6 weeks, and wear daily for up to 6 months. This is the one I recommend to my patients
❎️Cupping – It is most effective on atrophic and very restricted scars. Your scar needs to be fully healed- start not sooner than 12 weeks and after physio consultation
❎️Low level laser – It works great for scars than show delayed healing and are painful
❎️Kinesiotaping – It helps reduce swelling around scar
❎️Manual therapy – special tissue mobilisation that physio will do to help reduce restrictions and pain
We have got you!
If you have undergone a surgery and you are not sure where to start you scar healing journey, make sure to contact women`s health physiotherapist for an assessment and treatment. You can book your appointment here in one of our two locations.
