Saturday, September 13, 2014

How to reduce the appearance of spinal fusion scar

Notes :- I had Posterior Spinal Fusion for Scoliosis on 17/2/2014. This series of posting on Scoliosis is my personal experience.  I hope my sharing on scoliosis and me will serve as an encouragement to those who have spinal deformities like me. There is hope/help for you in today modern medical technology.

For Spinal fusion surgery the procedure required the surgeons to cut through multiple layers of skin until the spinal disc vertebrate are expose. Only up to this stage then the surgeons is able to install the necessary spinal implants.   As the cut is right through all layer of skin, more care are requires for spinal fusion wounds compare to the accidental knife injuries in the kitchen during food preparation.

Immediately after the operations the wound are then seal up either with staples, stitches or tissue glue. A large long strip of Opsite post-op bandage strips are then use to paste on top of the incision. 
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Many people asked me did I sleep with my frontal body lying flat where my back is facing upward. (prone position) after the surgery?  NO.. NO immediately after the surgery I sleep on my back lying flat (supine position).  We can do bed turn as well. In fact bed turn every  1 hour is a must on day one to prevent blood clot and bed sores.

On the first day post- ops the doctor will change the dressing and inspect the incision.  The doctor would then able to anticipate of any signs of infections or abnormalities. A new large long strip of Opsite post–ops bandage strip is then paste on top of the incisions. This bandage can sustain certain level of waterproof. 

It is the uttermost patient responsibilities to take care of the incision.  This will help to lower the risk of infection. No doubt this bandage is waterproof.   Patients are allowed to take bath however need to be aware that it could sustain certain level of waterproofing only.  While the long strip of Opsite post-op is still there, the patients are allowed to take shower /sponge bath  however suggest do it in great precaution. 

Surgical incision always leave a permanent scar however care need to take to reduce the scar appearance even though you have vow not to allow anyone to look at it.

Stage 1– when with the Opsite post –ops bandage
  • NO soaking in the bathtub
  • Make sure no excessive sweating cause this will promote infection
  • During shower use a quick gentle water spray on the back
  • Use towel to gently pad dry on the back.  No back scrub or rub the incisions.
  • Ensure that at all ends of the bandage are properly seal.  If torn, water can sip in.  If this situation occur run to the nearby clinic with the extra op-site bandage plaster. Need to be aware that this is a special op-site bandage the normal clinic, pharmacy do not stock them.  You would not be surprise that some hospital also do not have such op-site bandage plaster as they do not handle spinal fusion.
  • Ensure no abnormalities eg signs of bleeding or oozing out yellow fluid.  Quickly run back to the hospital where you are treated if it does happen.
Stage 2 - Immediately after bandage removal till 6 weeks post ops.
    This bandage will only be removed on the 1st clinical appointment post ops.  This usually happen in between of 10 - 14 days post ops.

    Soap can be use on the incision scar after the bandage removal. Do not hastily apply lotion/oil.scar cream on the incision scar. You need to allow natural healing to take place. Do not purposely pick the scabs. Let it drop off by itself.  The scar will undergo a lot of changes including colour and texture.

    My incision scar on 2nd month post ops
    For some their scars healing taken a bigger footprint and tend to enlarge and rise progressively from the original wound.  Unlike the usual scars keloid do not subsides. Keloid are not health hazardous  however the bulging lump will get irritation from friction rubbing from clothes, beside occurrence of severe itchiness, pain even though it is a long years past scars.  Discuss with the dermatologist how to treat this if you scars develop into keloid.

    Stage 3 - From 6 weeks - 6 months post ops or longer

    Once the scabs had drop off, that usually happen on the 6th week after ops.  Lotion and scars removal cream can be administered. During this stage of healing process the incision scar need to keep moisture to promote a better healing process. Care should be taken into consideration of external application as you may develop allergies reaction. I use Bio Oil massage in a circular motion on the scar, at least twice  daily after shower. 

    Beside external care, a proper balance diet during recovery period is also important.

    Avoid Sunburn
    While the incision heals, the new skin form is very sensitive and less resistance to UV rays. The new skin are more prone to sunburn.  Sunburn will lead to worse scarring.

    Does Incision Scar Fade

    Yes, in the initial stage after the bandage removal, the scar line is reddish and a slightly raised.  As the days past the reddish line turn to pinkish and no longer slightly raise.  The scar line will continue to fade in colour.

    This is my scar appearance during 4th month post ops. 

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