People often think that a surgeon’s scalpel is even sharper than a razor. And that it takes real effort for a surgeon making a skin incision to know how deep and where to cut.
But these are misbeliefs. A scalpel is usually no sharper than a good kitchen knife and making the incision is the easiest part of the surgery.
Human skin is a marvellous organ. It grows with you when you gain weight. Shrinks when you get skinnier (to a certain extent). Your skin changes color, regulates your body temperature, grows hair, oils and heals itself.
Well, most of the time your skin heals itself.
The importance of taking good care of your surgical wound and scar
Surgical scars turn red and are a bit raised for a while after which toning down and flattening occurs.
Sometimes however, wounds do not heal properly and scars may not evolve as we hope and expect them to do.
Which is why properly managing your wound and scar is essential to optimzing its final appearance. By treating your incision and scar optimally you are enhancing the healing process and increasing chances on a less prominent scar.
Thus, your role is much bigger than the role of the surgeon who only makes the cut and puts in some stitches afterwards. It’s guiding the healing process afterwards what really counts.
How your scar will turn out may not be the first thing on your mind during surgery recovery but it is of importance to many.
After all scars may cause itch and pain, feel tender, keep you from sleeping, make you feel self-conscious, or even anxious and depressed. Especially scars that grow big and lumpy. Which is common after surgery because the deeper a cut the more scar tissue generally is created. And thus the bigger the risk on excessive scar tissue.
Silicone gel the best surgery scar treatment
Because post-surgery scarring is virtually inevitable it’s nice there are silicone gel scar sheets. These thin self-adhesive dressings are clinically proven effective on hypertrophic scars.
Silicone sheeting is internationally the recommended regimen of treatment for hypertrophic scars.
Because it involves very few to no side effects it is preferred over more invasive first-line treatments such as cryotherapy, pressure application and steroid injections.
Since the early 1980s, silicone gel sheeting has been widely used in the treatment of hypertrophic scars and keloids. Several clinical studies and reviews have confirmed its efficacy. Source: PubMed.
Surgical scars are generally hypertrophic scars
Hypertrophic scars are common after surgical procedures as well as injuries such as abrasions, lacerations and other skin ailments.
These scars are thickened scars that generally develop within the boundary of the original wound site and get smaller in time. A specific, more problematic type of hypertrophic scars are keloids which extend beyond the wound boundary and tend to remain raised and lumpy and are hard to remove.
The benefits of silicone sheets for surgery scar treatment
Researchers don’t exactly know or agree how silicone gel works. The main thing is that they have shown to reduce excessive collagen production typical in surgery scars.
Using silicone on your incision (right after the wound has healed when there’s no scab anymore) has the following benefits.
- help prevent excessive scar tissue growth (prevent ugly scars from forming)
- flatten and soften the scar
- make it less red or purple and more skin colored
- help reduce scar size and appearance
- increase skin elasticity
- reduce itch and pain
- are a noninvasive treatment meaning there are nearly no side effects
Do silicone sheets work? Studies and my experience
Most studies have found silicone sheeting to be effective in both reducing scar size and improving scar appearance. Some studies are less positive, one study concludes that:
Trials evaluating silicone gel sheeting as a treatment for hypertrophic and keloid scarring showed improvements in scar thickness and scar colour but are of poor quality and highly susceptible to bias.
However, and I speak from experience since I have used silicone sheets for scars on my neck and face and on a big surgery scar on my chest, I was really content with the results. The sheets worked. They smoothened, reduced color, and flattened my scars.
I also liked that by attaching the sheets to the scars there was a buffer between the still delicate and sensitive scar tissue and clothes (especially zippers or buttons) and other things such as a safety belt.
Of course, what worked for me may not work for everybody but although some are relatively skeptical, most studies concur about their efficacy.
A meta-analysis (research comparing findings of a wide range of studies) concluded that silicone gel sheeting had marked benefit.
Two proven effective scar treatments combined, the benefits of silicone gel and tape
I mentioned how exactly silicone gel sheets improved my scars. The only thing they do not do is making a scar less wide.
Once a scar is of a certain width you can’t do anything about that except for maybe surgical excision. But, obviously, that comes with its own risks.
What does seem to help prevent your incision wound from turning in a wide scar is applying adhesive tape.
We all know Steristrips, the little cloth-like pieces of tape usually applied when you are still in the hospital. They keep the wound closed and reduce tension on the wound bed.
This method of action can also be used to your advantage when treating the scar. Since scars are also susceptible to tension you can benefit from using silicone tape (instead of dressings).
Application of adhesive tape is proven to improve scar appearance.
Silicone tape will reduce stretch and tear along the scar and by doing so the tape helps minimize the degree of scarring in terms of widening and thickening. Since this special tape also has a silicone padding it offers the best of both treatments.
Studies found scar taping to be safe, effective, well-tolerated, and able to significantly improve scar appearance.
Another advantage that silicone tape has over silicone sheets is that it doesn’t require effort to keep attached. Contrary to sheets which may stick less well especially on the face or joints. Downside is that adhesive tape doesn’t have the comfortable buffer function many thicker sheets have.
How does silicone gel work?
Although researchers think there are more aspects the following are the two main methods of action of silicone scar gel:
- While allowing the skin to breathe silicone gel hydrates the scar and surrounding tissue. This hydration is theorized to have a diminishing effect on fibroblasts which form the collagen in the scar.
- Silicone also normalizes the collagen synthesis in abnormal scars and increases the level of collagenases which breaks down the excess collagen.
Gel vs sheets
Besides silicone sheets there are also silicone ointments available. These are much easier to apply and keep attached. Shortly after application they dry up and form a thin film.
Some studies indicate the liquid silicone works just as well as sheets while a few others demonstrate sheets are more efficient. Opinions differ greatly on this matter. Even medical professionals seem to disagree.
But then again some even suggest steroid injections while these are known to have potential side effects. Why not first try a non-invasive method I would think. All in all, most data supports sheets.
Depending on the location of your scar I would recommend using either silicone sheets or silicone tape.
If your scar is on a location on which you will have a hard time keeping them attached or you don’t want to have it show in public I would opt for a silicone gel cream such as Kelo-cote.
Make sure to start using the product of your choice right after the wound has closed since this will yield the best results.
Be aware that you may need to wear the silicone sheets, tape, or gel for months in order to achieve a satisfying result. This may vary, I already saw improvement after a few days.
Here’s more info on surgery scar removal.