Huge numbers of people sustain cuts and lacerations that need stitches. When these injuries occur deep into the skin, they leave scars. From the moment the healthcare practitioner puts in the final stitches, the healing process begins. It’s never possible to fully predict how any single individual will form scars from stitches and injuries because of the extremely complex nature of the wound healing process. In this article, we’ll review how you can optimize the final appearance of your scars. From stitches to wound care to sun-protection, and more – it’s all covered here.
With Stitches, Scar Quality Depends On Good Wound Care:
Any complication that arises during the wound healing process such as infection or accidental opening of stitches can negatively impact final scar quality. As such, focusing on after-care and ensuring a smooth wound healing process is critical to maximizing your chances for excellent scar quality. Doctors and other healthcare practitioners often have slightly different wound care protocols for injuries that needed stitches. Scar quality depends on following them to a tee. Here are a few basic aftercare instructions that will help optimize your scarring:
Getting The Wound Wet
Most healthcare experts recommend at least 36-48 hours of keeping a wound dry. This is because the stitched cuts generally take about two days to become water-tight which prevents germs from water getting into the wound. Don’t soak the wound in a bathtub, pool, or hot tub for at least 2 weeks.
Dressings and Bandages
Many doctors apply supportive tapes called Steri-Strips over stitches. Scar quality can benefit from these because they help to prevent the wound from opening accidentally. More superficial wounds such as abrasions or burns usually are treated with topical ointments, such as Polysporin ointment or regular Vaseline and bandages. Healthcare practitioners have different protocols and regimens for wound care. There is no “one size fits all” set of instructions for how to manage dressings and bandages after a laceration is stitched. Inquire with your doctor as to what she or he recommends.
The timing of stitch removal depends on several factors including:
- body area
- the “tightness” of the skin closure
Facial area stitches are usually removed around 5 to 7 days after the injury. But, stitches on other areas, especially those where movements occur such as the knee or wrist may need 2 weeks or more of healing before stitches are removed.
Another factor that plays into stitch removal timing is the tightness of the stitches. A simple cut that is stitched closed differs from one in which a segment of skin was removed during the injury. The latter type of injury will be stitched under more tightness or tension because the skin edges need to be drawn in a greater distance to close the wound. This type of injury might call for delaying the stitch removal date so that the wound doesn’t open after removal of the stitches. Scar quality will likely deteriorate if that happens.
STITCH REMOVAL IS DONE AT DIFFERENT TIME FRAMES DEPENDING ON BODY AREA
With Stitches, Scar Quality Depends On Not Opening Them!
It’s tempting to return to work and exercise, or even everyday activities as soon as possible. But, anything that puts stitches at risk for opening will delay wound healing and increase the risk of poor scar outcomes. Speak to your doctor about timing to return to strenuous work, exercise, or everyday activities that could put a strain on your stitches. Different body areas and wounds call for variable times off.
After Removal Of Stitches, Scars Need Sun Protection:
Once stitches are removed, wounds are generally considered healed in that the skin has mended. But this is really only the very beginning of the healing process. For the first year at least, scars should be protected from direct sun exposure. This is because sun exposure in the first year of healing can cause permanent hyperpigmentation (darkening) of the scar which can make it more visible and conspicuous. Make sure to use at least a number 30 SPF sunscreen whenever the scar may get exposed to the sun in the first year of healing to avoid this. Keep in mind that UV rays from the sun can penetrate many clothing fabrics so using sunscreen is important even when clothing covers the healing wound.
AVOID SUN EXPOSURE ON HEALING AREAS FOR ONE YEAR TO AVOID DARKER SCARS
Other Measures To Optimise Your Scars:
Consider using silicone gels for scars or silicone tape products which have been shown to reduce the chances of forming heavy scars. Silicone products have the greatest amount of scientific data supporting their use to minimize scarring.
How Will Your Scar Turn Out?
If you suffered a wound that needed stitches, scar quality will usually fall into one of four categories:
|Type Of Scar||What They Look Like||Example|
|normal/mature||fine, flat and blend well “good scars”|
|hypertrophic||raised, red and thicker type of scar|
|keloid||considered the worst scars extensively raised, thick, discolored; grow far outside the area of the injury to the skin|
|widespread||flat, pale, wide, and stretched scars|
Predicting scar results is an extreme challenge because of the large number of factors that interact to determine final scar quality. These include the type of wound, location of the wound, and personal healing tendencies.
Scars From Stitches: Types Of Wounds
Clean lacerations such as a cut with a sharp knife are the best setup for good scar quality. This type of wound mimics, to a great extent, the type of incision a surgeon might make during a procedure. Conversely, wounds that tear the skin, or, even worse, remove segments of skin from the body completely are a more complex situation. Issues related to blood flow to the skin caused by these types of more “haphazard” skin injuries can impact scar quality negatively. Moreover, if the skin has been removed from the area completely, there will likely be increased tension and tightness on the stitches. Scars are well known to have an increased chance of becoming raised and thick hypertrophic or keloid scars when there is significant tension on the skin closure.
Scars From Stitches: Location Matters
Different body areas can heal very differently even on the same person. Factors such as repeated movement of the area such as for lacerations over the knee and wrist can lead to widespread type scarring. Some areas also have built-in propensities to put stress on the stitches. Scars in areas such as the shoulder, upper back, and middle chest over the breastbone are at the top of the list of body areas that can form very thick scars even in individuals who have healed other wounds very well.
DIFFERENT BODY AREAS CAN HEAL WITH DIFFERENT QUALITY SCARS EVEN ON THE SAME PERSON
Scars From Stitches: Personal Healing Tendencies
The list of factors that interact in complex and incompletely understood ways to determine an individual’s natural scarring qualities is long. These include skin tone, ethnicity, family history, medical conditions, and many more. The complexity of this “brew” is, in large part, what makes predicting scar quality for any one person so challenging whether from surgery or lacerations needing stitches. Scar prediction on an individual basis remains mostly an unmet challenge by medical science.
Sustaining a significant laceration is an anxiety-provoking experience. This is especially true if the injury occurred on the face and was deep enough to need stitches. Scars from stitches and injuries remain unpredictable on an individual basis. Taking all measures to avoid wound healing complications is key. Complications that can adversely affect scar quality include infection and opening of stitches. Scars from clean cuts and scars from stitches on body areas that place less tension and movements on the wound tend to heal better. The complexity of genetic and other factors that go into personal healing tendencies, however, make scar quality prediction a difficult challenge.