Care of the scar / wound after spine surgery

09.12.2022.

We hope that the spine surgery went well, you prepared the house for recovery, and most importantly, you have a positive attitude about recovery. Trust me, that's a very important part.

After you've been discharged from the hospital and come home, it's your turn to take care of your scar. Taking proper care of your scar can help you avoid pain and discomfort, and will certainly reduce the risk of problems such as infection and allow for the best possible healing.

Your surgical incision will be closed in multiple layers.

The surgeon will first sew up the muscle layer and then the skin layer using dissolvable sutures, staples and steri-strips. Steri-strips usually stay in place for two weeks and you should let them fall off on their own when they loosen. Dissolving stitches will disappear on their own and usually do not need medical attention.

You all know what a scar is, but what you may not know is that as the scar heals, adhesions form deep within the tissue.

Adhesion is a general name for something that grows on tissue, and in your case it is cells trying to close the resulting wound.

The result can be pain in a distant place, not just in the area of the scar. So it is not only the aesthetics and how the scar will look when it heals, but also the function of the tissue around the scar that is important.

A few days after surgery, you will probably feel itchy in the area of the surgical wound. Most people say this is a sign of healing, but it can also be a result of the steri-strips or staples used to close the incision.

If itching becomes a big problem, talk to your doctor or nurse. They may prescribe medication or a cream to relieve the itching to make it more bearable.

Occasionally, a suture knot will be visible next to the incision, which should not pose any danger. If you notice it, just in case, contact your doctor to examine it.

To reduce the risk of infection, ask your doctor how long you should keep the incision area dry.

Check the incision every day for signs of infection and change the dressing as recommended by the doctor.

Take a photo of the surgical scar every couple of days with a cell phone with a flash or under stronger light.

You can add photos to the MySpine application, which I created in cooperation with a team of doctors based on my personal experiences of recovery after spine surgery. You will find the item "Documents and history" in the menu. All the documents you have there, you can easily share with your doctor, so that he has a better insight into the course of recovery. I am honestly proud of that application, and the comments from doctors and users are more than excellent.

Showering and sun exposure after spine surgery

For the best healing of the wound from the operation, it is forbidden to scratch the wound and stitches, apply lotions or powders to the wound and expose it to sunlight for 3-9 months after the operation. The problem is that the skin that forms at the site of the scar is new, thin and therefore more sensitive to sunlight. If you happen to get a sunburn on the scar, it will almost certainly heal worse.

If you need to take a shower, and the doctor has forbidden you from urinating on the wound, cover it with a plastic bag so that it does not get wet.

Showering is possible 2-3 days after the operation, if you have not received different instructions from the doctor. Complete submersion of the wound under water is not allowed for 3-4 weeks after the operation until the wound is completely healed.

If the gauze becomes wet from showering or fluid (lymph) from the incision, replace it with clean, dry gauze and a new adhesive waterproof bandage.

If you have a back brace or a collar, remove it in order to properly wash the wound.

You may experience pain, numbness, tingling, and itching in the area around the incision. There may also be slight oozing and bruising, and a small lump may form. This is normal and you have nothing to worry about.

What you need to watch out for is infection

Symptoms that indicate a possible infection are:

a yellow or green discharge that increases over time
an unpleasant odor
unusual changes in the shape of the cut and its redness or hardening of the surrounding skin

Likewise, if the bandage is excessively bloody, the incision site is hot to the touch, you have a fever or a temperature higher than 38°C, you feel increased or different pain in the area around the incision, it is possible that it is an infection, so definitely contact your doctor.

Changing bandages

Changing bandages doesn't have to be a job for medical staff only. With appropriate instructions, you can do it yourself, but be sure to consult your doctor first.

If you are going to change the bandage yourself, before you start:

prepare sterile gauze of the appropriate size
medical gloves
a plaster
scissors
a garbage bag

How to replace a bandage (9 steps)

First, wash, disinfect and dry your hands. After that, put on medical gloves.
Cut the plaster into appropriate lengths and open the sterile gauze.
Carefully peel off the self-adhesive bandage from the wound and carefully remove the old gauze from the surgical incision.
Clean the incision only if instructed to do so by your doctor.
You can clean the surgical wound by washing it with a syringe filled with saline solution.
Inspect the incision for signs of infection.
Place clean, sterile gauze over the incision and tape it on all four sides.
Place all waste in a plastic bag and throw it in the trash.
Take off the gloves last and wash your hands.

Cleaning the incision from the surgery

So, now we will say something more about cleaning the cut.

If you have received instructions from the doctor that you can clean the incision yourself from the operation, follow these guidelines:

Gently rinse the incision with saline solution or water to remove the resulting scabs.
Do not rub, scratch the wound or soak it.
Do not use alcohol, hydrogen peroxide, or iodine to wipe the wound, as they can damage tissue and slow wound healing.
Air dry the wound or pat it gently with a clean, unused towel before applying a new bandage.

You will notice that stitches and staples cause redness and swelling around the incision along with mild irritation and itching. Moderate discharge and oozing from the wound is normal for the first few days after surgery.

If the discharge does not decrease a few days after surgery, becomes red and bloody, or you notice pus, be sure to contact your doctor.

After the wound from the surgery has healed and nothing is leaking from it anymore, you can use creams and plasters that help the scar to heal as well as possible.

For this purpose, I used the Contractubex night intensive patch, which regulates the scar formation process and prevents the excessive formation of scar tissue.

Scar massage (manual treatment)

Scar massage is a popular method for softening, smoothing and reducing the visibility of a scar. It has several important functions, it stimulates collagen remodeling, reduces itching, provides moisture and flexibility to the scar.

When and how to properly massage a scar

Once your stitches have been removed and all the scabs have fallen off, you can begin to gently massage the scar.

As a rule, the scar is ready for massage approximately 2 weeks after the operation.
It is recommended to massage the scar two or three times a day for about 10 minutes.
The scar should be massaged according to the instructions for at least 6 months.

Massage the scar itself and the surrounding tissue with soft fingertips.

Apply a small amount of baby oil, lotion or oil with vitamin E to the scar to soften, lubricate and prepare your skin for massage. Oils with vitamin E can be applied to the scar one month after surgery.

We recommend the following three methods of scar massage.

#1 Circular method

With two fingers, in the form of small circles, massage along the length of the scar and the skin around it.

#2 Vertical method

Massage the scar up and down with two fingers.

#3 Horizontal method

Massage the scar from one side to the other with two fingers.

When massaging the scar, adjust the pressure as much as you can handle. Start with light pressure, gradually progressing to deeper and firmer pressure.

When massaging, try to apply enough pressure to lighten or whiten the area around the scar.

If you experience any of the following symptoms, stop massaging and be sure to contact your doctor: