There is redness around the postoperative suture. The suture itches after surgery, the scar: why the old scar turns red, what to do Rash around the suture after surgery causes

Skin scars are an inevitable consequence of any open wound or injury. In most cases surgical intervention leaves behind postoperative stitches. The healing of these scars is facilitated by prevention after surgery: the surgeon should give recommendations that will make the postoperative scar almost invisible.

Any surgical intervention leaves behind a scar. The more complex the operation, the deeper the scar remains and the slower the healing process. In addition, the physiological characteristics of the human body play a huge role, in particular the supply of the skin with the necessary amount of blood.

Correct scar care allows the wound to heal faster and more gently, leaving minimal damage. Caring for postoperative sutures is necessary so that they tighten well and do not give the person any unpleasant sensations. Postoperative scars are divided into several main types:

Treatment of scars at home

In order for postoperative scars to heal easily and quickly, without leaving behind painful complications, they must be properly cared for. You should know how to treat a postoperative suture for better healing. Basic care involves treatment with an antiseptic. The simplest means for processing:

• Zelenka, which is a disinfectant and antibacterial agent.
• Alcohol is able to remove any contaminants and kill all pathogenic bacteria.
• Thanks to iodine, healing can be accelerated.

You can use special products designed to speed up the healing of postoperative scars. These include:

The seal on the seam is normal reaction. When the scar has become hard, it is necessary to continue treating the sutures with the means described above until complete healing.

Sometimes postoperative sutures can be removed independently at home, but subject to the doctor's permission. You need to know that there are two main types of seams.

Immersion - applied with thread, made of natural materials. Its advantages are that the material is independently absorbed by the human body and is not rejected. The disadvantage is that it is less durable. Removable - removed only when the edges of the incision are fused and are able to show how well the healing is proceeding. It is applied using silk, nylon, nylon, wire thread, and also a staple.

When removing threads at home, it is also necessary to take into account the timing after the operation. The approximate timing of suture removal after surgery will be as follows:

• From 1 to 2 weeks - for head surgery.
• From 2 to 3 weeks - in case of amputation.
• About 2 weeks - when opening the abdominal wall. In this case, the period will depend on the depth of penetration.
• From 1.5 to 2 weeks - on the chest.
• 2.5 weeks - for stitches in an elderly person.
• From 5 days to 2 weeks - after childbirth.
• From 1 to 2 weeks - for caesarean section.

As mentioned earlier, stitches can be removed at home on your own. Some rules must be followed:

You need to have sterile bandages and tissues and a furatsilin solution with you - for the safety of the suture removal process, so that infection does not get inside.

Preparations for healing and resorption

At any pharmacy you can purchase a product to care for scars after surgery. Among them, ointments for resolving sutures are especially popular. The principle of their action is to relieve inflammation, smooth out the scar with the skin, eliminate healing defects, give the scar a light shade and nourish the skin, making it smooth and elastic.

Basically, such products and ointments are created on the basis of silicone, with which you can get rid of the itching that inevitably occurs. during wound healing. Regular care of the seam helps it shrink and become less noticeable. The substances are applied in a thin layer, but their application may be ineffective. In such situations, at least six months of active use of the ointment is required. The most effective ointments for these purposes are:

• Gel Contractubex - smoothes the skin, accelerates cell regeneration and improves blood circulation.
• Mederma gel - resolves scar tissue, improving it through blood supply and hydration.

You can also use other means that speed up the resorption of sutures. Such medicines often contain onion extract. It is this component that is able to penetrate deeply into tissues, providing an anti-inflammatory and soothing effect.

Other gels and creams

It is necessary to choose a gel or ointment for caring for a scar based on its depth and scale. The most popular ointments are antiseptic. Such means include:

• Vishnevsky ointment. This classic healing agent has powerful tightening properties and removes pus from wounds if the suture does not heal after surgery, and the patient does not know what to do.
• Vulnuzan is a healing ointment made from natural ingredients.
• Levosin is an ointment with powerful anti-inflammatory and antibacterial effects.
• Eplan - has healing and antibacterial effects.
• Actovegin - can improve healing, relieve inflammation and improve blood supply to tissues. It is recommended to use if the scar has festered and turned red.
• Naftaderm relieves pain well and improves the resorption of scars.

Special patch

In addition, there is another new generation product that effectively combats postoperative sutures: special patch, which must be applied to the suture site after surgery. The patch is a plate that fastens the incision site and nourishes the wounds with the necessary nutrients. The main beneficial properties of this patch:

• Made from a material that absorbs discharge from wounds.
• Does not allow pathogenic bacteria to penetrate wounds.
• Does not irritate the skin.
• Nourishes the wound with air.
• Allows the seam to be smooth and soft.
• Does not allow the resulting scar to grow.
• Together, the scar retains the necessary moisture.
• It is comfortable to use without injuring the wound.

The use of folk remedies

To improve the condition of the skin, smoothing seams and reducing scars, it is necessary to act on problem areas in a comprehensive manner, using medications and folk recipes. In this case, the following folk remedies can help:

• Essential oils. The oil or mixture of oils will help speed up the healing of the scar by nourishing the skin and removing the effects of healing.
• Seeds of melons - for example, pumpkin, melon, watermelon. They are rich in essential oils and antioxidants. You need to make a paste from fresh seeds of these plants, apply it as a compress to the affected areas of the body.
• Compress made of milk and pea flour. From these ingredients you need to make a dough, which is applied to the damaged areas and kept there for at least 1 hour. The resulting composition tightens the skin well.
• Cabbage leaf is considered an old but very effective remedy. If you apply a cabbage leaf to a wound, it has a healing and anti-inflammatory effect.
• Beeswax can nourish the skin well at the scar site, relieving inflammation, swelling, and smoothing the skin.
• Sesame or olive oil well moisturizes and nourishes the skin, brightens, smoothes and tightens scars.

What to do if the seam comes apart

Sutures may come apart after surgery for several reasons. Most often this happens due to the following reasons:

• The wound became infected.
• The man's blood pressure has risen.
• There is a disease in the body that makes the tissues soft.
• The stitches are too tight.
• The scar is injured.
• The person is over 60 years old.
• The patient has diabetes.
• There are kidney diseases.
• The person is overweight or has a poor diet.
• There are bad habits.

In this case, you must urgently consult a doctor who will prescribe treatment based on blood tests. The specialist can apply postoperative bandage, and the patient will be monitored more carefully.

Under no circumstances should you try to heal a wound on your own if the stitches have come apart. In case of incorrect actions, the patient risks getting more serious complications - for example, blood poisoning.

In most cases, postoperative scars are very itchy. Itching is normal reaction to fastening threads, as they irritate the skin. If dirt gets into the wound, this is how the body resists germs. The stitch may itch because the wound is healing, tightening and drying the skin. When healing a scar, you should not scratch the tissue, because this action will not bring any pleasant sensations or relief, and can only aggravate the situation.

Hello! Two weeks ago I had surgery to remove my gallbladder using laparoscopy. Everything was fine, I treated the seams with brilliant green, but then a rash appeared and irritation around the seams, especially around the navel, began to itch. Why could this be: irritation with brilliant green? The dermatologist said it was just irritation and prescribed zinc ointment and some antibiotic ointment. I’ve been applying it for the 3rd day now, but there is no relief yet. What should I do? And what is this?

Tsurikova Svetlana, Yelnya

ANSWERED: 11/11/2013

Dear Svetlana! What you are describing is allergic dermatitis, which developed, in this case, due to “green stuff”. In this case, any hormonal ointment will help you well: “Ftorcort”, “Oxycort”, “Lorinden”, etc. And in the future, if necessary, replace the brilliant green with solutions of Chlorhexidine, Miramistin or other semi-alcoholic solutions. Be healthy!

QUESTION FOR CLARIFICATION 21.10.2014 Zapaschikova Olga, With. Perelub Saratov region

Hello. 2 weeks ago I had surgery to remove my gallbladder. All stitches are healing normally. But one is very bad, red and itchy. At the clinic, the doctor told me to apply zinc ointment and treat it with vodka. Tell me something please.

ANSWERED: 10/21/2014 Prutyan Grigory Valerievich Saint Petersburg 0.0 Dermatovenerologist

You may have allergic contact dermatitis: http://www.dermatolog-gtn.ru/dermatit.html But paratraumatic eczema cannot be ruled out. Post a photo of the rash here or on the VK group page: http://vk.com/public59843996

Related questions:

Inflammation of sutures after surgery is a problem that makes people nervous. After all, problems with a healing scar often begin after discharge from the hospital, and it is not possible to see a doctor right away. Why can a seam become inflamed, when should you sound the alarm, and what to do in this case?

Possible causes of suture inflammation

When the surgeon brings the edges of the wound together and secures them with suture material, the healing process begins. Gradually, at the border, new connective tissue and fibroblasts are formed - special cells that accelerate regeneration. At this time, a protective epithelium is formed on the wound, which prevents germs and bacteria from penetrating inside. But if the wound gets infected, the seam begins to fester.

Inflammation of the postoperative suture may begin due to a violation of the sequence and completeness of this process. If the sterility of the wound is compromised at the stage of suturing the wound, pathogenic microorganisms will already develop in it and sooner or later provoke an inflammatory process.

Dehiscence of sutures due to insufficient tightening of knots or overexertion of the patient is also a common factor in problems with a postoperative wound. It opens up, begins to bleed, and germs get inside. The same can happen if the patient accidentally (or on purpose - there are such precedents) tears off the crust from the protective epithelium.

By the way! Sometimes sutures (scars) after surgery become inflamed even in the most conscientious and responsible patients for no apparent reason. For example, due to low immunity, old age, and the presence of chronic diseases. All these factors increase the risk of problems with postoperative wounds.

Symptoms of suture inflammation

Some impressionable patients get scared if the seam turns a little red, and immediately try to anoint it with something or bandage it. There is also a category of patients who, on the contrary, do not pay attention to any changes, believing that everything is normal. Therefore, every person who has undergone surgery should know the main symptoms of suture inflammation:

• skin redness;
• swelling of tissues;
• local pain (aching, bursting, aggravated by tension of the skin);
• bleeding that doesn't stop;
• suppuration of the postoperative suture: discharge of white or yellow foul-smelling plaque;
• fever, chills;
• increased heart rate;
• increase in pressure.

We can talk about inflammation only if 5 or more of the listed symptoms are detected. Fever without redness and suppuration is a sign of another disease. Likewise, slight bleeding and swelling without an increase in temperature may be just a temporary phenomenon caused by mechanical damage to the seam (the bandage was abruptly pulled off, clothing touched the wound, accidentally scratched, etc.).

What to do if a seam becomes inflamed

If all the symptoms are present, and this is truly an inflammatory process, you should immediately contact a surgeon. If you have a high temperature, you must call an ambulance. If there are no signs of intoxication yet, you can contact the doctor who performed the operation or a surgeon at your place of residence.

Before going to the clinic, you need to put a bandage on the seam to avoid even more inflammation. To do this, first wash the wound with hydrogen peroxide. But under no circumstances should you rub it: just pour it on the seam and remove the resulting foam with a sterile bandage using blotting movements. Then you need to apply a bandage with an anti-inflammatory agent. If the wound gets wet, it is advisable to use a gel (for example, Solcoseryl, Actovegin); if it dries out, use ointment (Levomekol, Baneocin).

Attention! Before going to the clinic, it is not recommended to use fucorcin and brilliant green, because these antiseptics stain the skin, and the doctor will not be able to visually assess the intensity of hyperemia or determine the color of discharge from the wound.

Prevention of suture inflammation after surgery

To ensure that the postoperative suture does not turn red, fester or become inflamed, you must strictly follow the rules for caring for it. The doctor talks about this; Nurses also give advice during dressing changes. There is nothing complicated about this, besides, after discharge from the hospital, the postoperative sutures already have a completely “human” appearance, and the patient can only maintain them in normal condition.

1. Use only those external products prescribed by your doctor. Because depending on the nature of the wound and its location, not all ointments and gels can be used.
2. The use of folk remedies should be discussed with a doctor.
3. Avoid overstraining the area of ​​the body where the sutures are placed.
4. Take care of the seam: do not rub it with a washcloth, do not comb it, do not rub it with clothes.
5. Carry out home dressings with clean hands using sterile materials.

If problems do appear, and there is no improvement within 1-2 days (the blood does not stop, pus continues to be released, weakness appears), you should immediately consult a doctor. This will help avoid infection and the development of complications in the form of unsightly scars, enlargement of the wound surface, necrosis, etc.

No matter how careful and experienced the surgeon is, no matter what modern suture materials he uses, a scar inevitably remains at the site of any surgical incision - a special structure made of connective (fibrous) tissue. The process of its formation is divided into 4 sequential stages, and significant internal changes after fusion of the wound edges continue for at least another year, and sometimes much longer - up to 5 years.

What happens at this time in our body? How to speed up healing, and what needs to be done at each stage to ensure that the scar remains as thin and invisible as possible?TecRussia.ru explains in detail and gives useful recommendations:

Stage 1: epithelization of the skin wound

It begins immediately as soon as the damage is received (in our case, a surgical incision) and continues for 7-10 days.

• Immediately after injury, inflammation and swelling occurs. Macrophages emerge from adjacent vessels into the tissue - “eaters”, which absorb damaged cells and clean the edges of the wound. A blood clot is formed - in the future it will become the basis for scarring.
• On day 2-3, fibroblasts are activated and begin to multiply - special cells that “grow” new collagen and elastin fibers, and also synthesize the intercellular matrix - a kind of gel that fills the intradermal cavities.

• At the same time, vascular cells begin to divide, forming numerous new capillaries in the damaged area. Our blood always contains protective proteins - antibodies, the main function of which is to fight foreign agents, so a developed vascular network becomes an additional barrier to possible infection.
• As a result of these changes, granulation tissue grows on the injured surface. It is not very strong and does not connect the edges of the wound tightly enough. With any, even slight force, they can separate - even though the top of the cut is already covered with epithelium.

At this stage, the work of the surgeon is very important - how smoothly the skin flaps are aligned when applying a suture, and whether there is excessive tension or “tucking” in them. Also, careful hemostasis (stopping bleeding) and, if necessary, drainage (removing excess fluid) are important for the formation of a proper scar.

• Excessive swelling, hematoma, and infection disrupt normal scarring and increase the risk of developing rough scars. Another threat during this period is an individual reaction to the suture material, which usually manifests itself in the form of local edema.
• All necessary treatment of the surgical wound at this stage is done by a doctor or nurse under his supervision. You can’t do anything on your own, and it doesn’t make sense to interfere with the natural healing process yet. The maximum that a specialist can recommend after removing the stitches is to fix the edges with a silicone patch.

Stage 2: “young” scar or active fibrillogenesis

Occurs between 10 and 30 days after surgery:

• Granulation tissue matures. At this time, fibroblasts are actively synthesizing collagen and elastin, the number of fibers is growing rapidly - hence the name of this phase (the Latin word “fibril” means “fiber”) - and they are located chaotically, due to which the scar looks quite voluminous.
• But there are fewer capillaries: as the wound heals, the need for an additional protective barrier disappears. But, despite the fact that the number of vessels in general decreases, there are still relatively many of them, so the developing scar will always be bright pink. It is easily stretchable and can be injured under excessive loads.

The main danger at this stage is that the already fused sutures may still come apart if the patient is overly active. Therefore, it is so important to carefully follow all postoperative recommendations, including those related to lifestyle, physical activity, and medication - many of them are aimed precisely at providing conditions for normal, uncomplicated scarring.

• As prescribed by your doctor, you can start using external creams or ointments to treat the developing seam. As a rule, these are agents that accelerate healing: Actovegin, Bepanten and the like.
• In addition, hardware and physical procedures aimed at reducing swelling and preventing hypertrophy of fibrous tissue give good results: Darsonval, electrophoresis, phonophoresis, magnetic therapy, lymphatic drainage, microcurrents, etc.

Stage 3: formation of a durable scar - “maturation”

During this period - 30 - 90 days after surgery - the appearance of the scar gradually returns to normal:

• If at earlier stages the collagen and elastin fibers were arranged randomly, then during the third phase they begin to rearrange, oriented in the direction of greatest stretching of the edges of the incision. There are fewer fibroblasts, and the number of blood vessels decreases. The scar thickens, decreases in size, reaches its maximum strength and turns pale.
• If at this time fresh connective tissue fibers are subjected to excessive pressure, tension or other mechanical stress, the process of restructuring collagen and removing its excess is disrupted. As a result, the scar may become rough, or even acquire the ability to constantly grow, turning into. In some cases, this is possible even without the influence of external factors - due to the individual characteristics of the body.

At this stage, there is no need to stimulate healing; it is enough for the patient to avoid excessive stress on the operated area.

• If a tendency towards excessive fibrosis becomes apparent, the doctor will prescribe injections to reduce scarring activity - usually corticosteroid-based drugs (hydrocortisone or similar). Collagenase also gives good results. In less complex cases, as well as for preventive purposes, non-steroidal external agents are used -, etc.
• It is important to understand that such therapy should be carried out exclusively under the supervision of a doctor - a dermatologist or surgeon. If you prescribe hormonal ointments or injections yourself, just because the appearance of the suture does not meet expectations or does not look like a photo from the Internet, you can significantly disrupt the process of tissue restoration, up to their partial atrophy.

Stage 4: final restructuring and formation of a mature scar

Begins 3 months after surgery and continues for at least 1 year:

• The vessels that penetrated the ripening scar tissue at the previous stages almost completely disappear, and the collagen and elastin fibers gradually acquire their final structure, lining up in the direction of the main forces acting on the wound.
• Only at this stage (at least 6-12 months after surgery) can the condition and appearance of the scar be assessed, as well as plan any corrective measures, if necessary.

Here, the patient is no longer required to take such serious precautions as in the previous ones. In addition, it is possible to carry out a wide range of additional corrective procedures:

• Surgical threads are usually removed much earlier than the surface of the scar is completely formed - otherwise the scarring process may be disrupted due to excessive compression of the skin. Therefore, immediately after removing the sutures, the edges of the wound are usually fixed with special adhesives. The surgeon decides how long to wear them, but most often the fixation period coincides with the “average” period of scar formation. With this care, the mark from the surgical incision will be the thinnest and most invisible.
• Another, less known, method that is used mainly on the face is. “Switching off” the adjacent facial muscles allows you to avoid tension on the developing scar without the use of a patch.
• Aesthetic defects of mature scars do not respond well to conservative treatment. If hormonal injections and external ointments used earlier did not give the desired result, then at the 4th stage and upon its completion, techniques based on mechanical removal of fibrous excess are used: dermabrasion, peelings and even surgical excision.

Briefly about the most important things:

In addition to the local factors mentioned above, the healing processes of surgical incisions largely depend on the following circumstances:

• Age. The older a person is, the slower the damaged tissues heal - but the more accurate the final result will be. Statistically, rough hypertrophic and keloid scars occur more often in patients under 30 years of age.
• Heredity. The predisposition to forming large, uncontrollably growing scars often runs in families. In addition, people with dark and dark skin are more prone to excessive division of connective tissue cells.

Also, the following can disrupt the normal wound healing processes and worsen the final condition of the scar:

• obesity or, conversely, underweight;
• diseases of the endocrine system (hypo- and hyperthyroidism, diabetes mellitus);
• systemic collagenoses (systemic lupus erythematosus, systemic scleroderma, etc.);
• use of medications (corticosteroids, cytostatics, anti-inflammatory drugs).

Many injuries and operations cannot be completed without sutures, and as a result, scars appear. There are cases of scar formation after minor tissue damage. If there is no proper treatment or recovery period, then during healing there is a high risk of infection. Therefore, it is important to properly care for the wound and not ignore any symptoms, even if the scar or stitch after surgery is just itchy. It is not uncommon to feel discomfort from scars that have long since healed.

Causes of itching of fresh stitches

When a wound appears on the body, the body begins the process of self-healing. It rejects damaged cells and actively works to create new ones. The process is accompanied by the release of inflammatory blockers, including histamine. Its increased concentration causes itching.

The suture is very itchy after surgery or serious injury with damage to the deep layers of the skin. The body reacts to a slight scratch of the epidermis with a barely noticeable tingling sensation, or the damage heals without noticeable discomfort.

Another cause of itching can be constant external irritation of the developing scar:

• rough fabric;
• uncomfortable cut of clothes;
• use of allergenic care cosmetics;
• vigorously rubbing the scar after surgery with a towel;
• the use of creams and gels for resorption of scars.

Subject to proper rehabilitation conditions, the itching goes away over time. You should definitely consult a doctor if swelling, redness, ichor appears around a suture or healed wound, pus appears when pressed, or the area becomes hot. These are signs of an inflammatory process, the appearance of which requires mandatory medical intervention.

Why do old scars itch?

Many factors contribute to the appearance of itching in long-healed wounds. Some do not pose any threat to health, others are dangerous and require immediate medical attention, including surgery.

• Dry skin. An old surgical scar itches when using shower gel or soap with aggressive ingredients in its composition.
• Weather. The approach of rain and snow is accompanied by a jump in atmospheric pressure, which can affect the human body. The intensity of blood flow increases, providing an active rush to the vessels located directly next to the scar.
• Pharmaceuticals. To make the scar less noticeable, it is recommended to use creams and resorption gels. One of the side effects of the drugs is itching.
• Components of suture material. When using self-absorbable threads, their particles come into contact with adjacent tissues, causing irritation. The response is itching.
• Consequences of deletion. The postoperative period usually passes without complications, and the wound heals completely within 2-3 weeks. But if the old seam itches and the skin around it turns red, this may be inflammation or the growth of an incompletely removed formation.
  
• Formation of ligature fistula. The pathology is rare, but the risk of its occurrence still exists.
  During the operation, the tissues are stitched together in layers, and if the surgeon used non-self-absorbing material, the body may subsequently reject it. This happens immediately after surgery or months and years later. Redness appears, the seam itches, and the local temperature rises. In this case, you should consult a doctor. He may advise you to wait until the fistula matures.

• . As a result of stress, anxiety, constant lack of sleep, and apathy, itching occurs, the skin around the scar peels off, and small pimples may appear.
• Formation of a keloid scar. At the site of a healed wound, after a few months, the suture may become convex, rough, and acquire a reddish, burgundy or bluish tint. When a keloid scar forms, it itches, hurts, and looks unsightly. It is easier to avoid this by carrying out procedures to eliminate it.

What to do, how to get rid of itchy scars

Correctly identifying the cause of discomfort and following the doctor’s recommendations will help improve the condition or completely solve the problem associated with tissue scarring.

If you cannot determine on your own why the scar itches, a doctor will do this. Perhaps antihistamines and hormonal drugs will relieve the itching, but you cannot prescribe them yourself. This is fraught with side effects, as well as a deterioration in overall health.