Time correlation of stretching of the strip scar

[mmhce]

I have a few questions concerning stretching of the scar (from strip surgery)

 

1. When (at what period following surgery: days, weeks, months) does maximum stretching (widening or accumulation mass) of the scar tissue occur ?

 

2. How effective does keeping the security devices (stitches or staples) in, for longer periods of time, following the surgery, is, in reducing the width of the scar?

 

3. Is there published or consensual information circulating among us, with respect to point #2 above, concerning such added value of delayed removal of stitches or staples?

 

4. If so, what may be the conclusions? Is there a correlation (graphically or tabularly represented) between the width of the scar and the length of time the staples or the stitches were kept in, after surgery?

 

Thank you all for your contributions (particularly Dr. Lindsey if he reads this thread)

[BigBill1234]

I left mine in for 12 days... Time will tell.

[EpilepticSceptic]

13 days here!

 

Skin was already beginning to grow over the staples, which made removal more painful.

 

Everyone's healing traits are different.

[Dr. William Lindsey]

Scar width is generally proportional to skin edge tension. Therefore whatever can be done to reduce this helps scars. At our office, we favor long, skinny strips, so that there isn't alot of scalp to pull together. Additionally, deep sutures can take the load off of the skin edges so that the wound doesn't pull apart or the scar stretch after the skin sutures are removed. In general skin stitches should come out between day 6 and 10. Frequently getting doctors to agree on anything is like herding cats, and you will find no concensus on this forum on when sutures ought to come out. Just follow your doctor's advice as he has a reason for the time frame.

 

We take sutures out on day 7 unless there is some issue that would prevent that. Leaving skin sutures in for an extended period will not likely keep a scar from widening if the deep layers are not holding the skin edges together, nor will they keep an incision together that is falling apart due to infection. Back when I used to do head and neck cancer surgery, we'd still take sutures out by day 10, even in necks that had huge surgeries and in tissues that had already received radiation treatments. Sutured properly, those scars were consistently a "B" and often an "A". But if there was an infection or breakdown deep to the skin, the wound would fall apart regardless of sutures being left in. That was a difficult concept for me as a medical student and junior resident...taking sutures out of big surgeries on day 8 and seeing the scars do fine.

 

You can search this site til your fingers fall off and you won't likely have the perfect answer. During your evaluation process and visiting doctors, ask them their reasons and ask to see some representative scars. At our consultations we show a great scar, one that is our average scar, and often times I'll show the worst scar we've had in the past few years.

 

That is why preop communication and education with sites like this is so beneficial.

 

Dr. Lindsey McLean VA

[Michael5577]

Dr Rahal removes them after 14 days which seems too long.

[RCWest]

Dr Rahal removes them after 14 days which seems too long.

 

 

And at what length of time will you start getting "train tracks" from leaving them in too long?

[scar5]

Even though I am very smart, I can't answer your questions, #2,#3,#4.

So I will answer your #1 question from my own fantastic experiences.

At six weeks, my strip scars always look brilliant, and I am full of love and respect for my surgeon, who probably told me something that I hadn't heard before. Something that makes me believe. At about 8 - 16 weeks I am in denial. I see the widening gap, but also a few hopeful (misangled) buds, that I know are the mark of the wonder technique known as 'Tricophitic Closure'. Sounds good, doesn't it? ( I have always wondered why people don't discuss 'the hype' about this new and wonderful closure technique.) By six months, I can say that in all my surgeries, it doesn't get any worse. But keep in mind, your hair in the donor will change over the years, and that will effect the appearance.

[Michael5577]

No idea what the person above just said. Anyone else?

[scar5]

No idea what the person above just said. Anyone else?

 

Sorry, key words.

 

Question One can answer only (see top of thread)

6 weeks, scar excellent

8-16 weeks, scar stretches

6 months+, no change in width

Hair weaker in donor years later

 

in my experience

only

[Michael5577]

I spoke to Dr. Rahal a few days ago about taking out the stitches earlier than 2 weeks. He says that 2 weeks is the optimal timeframe if one wants to have minimum scarring. He has tried 7 days and 10 days in the past and his experience dictates 14 days for best results. So there you have it.