From the Guidelines
Proper surgical scar care involves keeping the wound clean and protected during the initial healing phase, with the surgical wound dressing removed for a minimum of 48 hours after surgery unless leakage occurs, as recommended by the WHO Global Guidelines for the Prevention of SSIs 1. The goal of surgical scar care is to promote optimal wound healing, minimize the risk of surgical site infections (SSIs), and improve the appearance of the scar.
- Key principles of surgical scar care include:
- Keeping the wound clean and dry, with gentle washing with mild soap and water once approved by the surgeon
- Applying petroleum jelly or a similar moisturizer to keep the wound moist and prevent scab formation
- Covering the wound with a non-stick bandage if needed
- Avoiding activities that stretch the wound during initial healing
- Using silicone-based products, such as silicone sheets or gel, to improve the appearance of the scar
- The use of advanced dressings on primarily closed surgical wounds does not significantly reduce SSI rates compared to standard wound dressings, according to the WHO Global Guidelines for the Prevention of SSIs 1.
- Postoperative care bundles recommend keeping surgical dressings undisturbed for a minimum of 48 hours after surgery unless leakage occurs, as stated in the study published in the World Journal of Emergency Surgery 1.
- Sun protection is also crucial, with SPF 30+ sunscreen applied to the scar for at least a year to prevent darkening and thickening of the scar.
- Gentle massage of the scar, using circular motions with a moisturizer or silicone-based product, can be started after about two weeks, as part of a comprehensive approach to managing surgical scar care, as suggested by the systematic meta-review of Cochrane reviews published in the International Journal of Nursing Studies 1.
From the Research
Best Practices for Managing Surgical Scar Care
- The management of surgical scars involves various non-invasive and invasive options, including the use of silicone-based products, compression therapy, taping, and moisturizers 2.
- Silicone-based products, such as sheets and gels, are recommended as the gold standard, first-line, non-invasive option for both the prevention and treatment of scars 2, 3.
- Topical silicone gel has been shown to be effective in reducing pigmentation, height, and pliability scores postoperatively compared with placebos or no treatment 4.
- Silicone gel sheeting is a commonly used treatment for hypertrophic scars, but the current evidence is limited and of low certainty 5.
- Other treatments, such as corticosteroid cream, may also be effective in preventing hypertrophic scar and keloid formation following surgical incisions 6.
Non-Invasive Treatment Options
- Silicone dressings: considered first-line treatments for hypertrophic scars and keloids 3.
- Silicone gels: similar to silicone sheets, silicone gels have also proved to help treating and preventing hypertrophic scars and keloids 3.
- Topical onion extract: may be less effective than silicone gel sheeting in reducing severity of scarring 5.
- Polyurethane: may be comparable to silicone gel sheeting in terms of reducing severity of scarring, but the evidence is limited 5.
Invasive Treatment Options
- Intralesional injections of corticosteroids and/or 5-fluorouracil: may be used to treat hypertrophic scars and keloids 2.
- Cryotherapy: may be used to treat hypertrophic scars and keloids, but the evidence is limited 2.
- Radiotherapy: may be used to treat hypertrophic scars and keloids, but the evidence is limited 2.
- Laser therapy: may be used to treat hypertrophic scars and keloids, but the evidence is limited 2.
- Surgical excision: may be used to treat hypertrophic scars and keloids, but the evidence is limited 2.