need help with primary scar

[Karen w]

My daughter is a 10mo lbpi. She had primary surgery at TCH at 5mo. old. Her therapists are concerned about her scar and the possibility that it may be restricting some movement. The upper part of her scar on her neck looks great and has almost faded away. However, the lower part of the scar that extends onto her chest and shoulder is raised at several places and is still bright pink and bumpy. It is in an awkward place so they are unable to use gel bandages on it or a type of pressure bandage. I have massaged it 2-3 times daily with Mederma and sometimes cocoa butter. Just wondering what others' experiences were with this and if there are other things we can do to keep the scar from keloiding or getting worse.

[Julie-work]

Karen,

The same thing happened to my daughter; however the upper part of her scar is also thick. They said that her scar was hypertrophic. Her scar was also restricting her neck movement. Her PT did myofasical (sp?) release and we used silicon pads on it after we had tried various scar creams. Dr. Nath told us that it takes a year for the scar to mature. Our PT told us that you can affect the appearance of the scar for up to 2 years so we are still working on it at times. TCH told us that they had never seen a scar like our daughter's and that it looks like she had an alleric reaction to the sutures. Her mod quad scar does not look quite as bad but it is a little thick. She has soft tissue restrictions in the armpit that her PT is addressing now. Unfortunately much of the appearance of the scars is based on the individual's own healing processes, but it is wise to address the restricted movement right away.

[francine]

For those of you having major scar issues I would highly recommend finding an OT that works with burn patients - they are very well versed in scar management and can really help figure out a plan of action. There are many things that can be done.

But you can cream yourself to death and if the scar is meant to be a bad one then it will be. Scar healing is defined by the child's own auto-immune system. Sometimes children are allergic to the suturing material (this was Maia's problem as well). A "good scar" that heals perfectly is NOT because the surgeon did a good job and a bad scar because a surgeon did a bad job.

I am trained in scar massage techniques, used all the good stuff, used Mederma, used silicone patches, a $300 compression garment and even had a scar revision (surgery to correct it) and if you're going to keloid - you're going to keloid. One of her scars healed ok - hardly noticeable at all and the rest are pretty ugly.

I think it's very important to have a good attitude about whatever the scar looks like so that your child will have a good attitude about it too. Maia and I talk about how wonderful her scars are and that miracles happened underneath them. I kiss them and massage them all the time in gratitude for what is under them.

I'm betting on a cure for scars (or something close to it) by the time Maia has to go to her prom. I figure that they'll go to the doctors office that morning - get it lasered off and off they go. LOL Star Trek medicine right? Who knows - ya gotta dream.

-francine

[LeeAnne]

Michaelas scar from her mod quad is hypertrophic. We were told by our local doctor and then later by Dr. Nath that it looked like she had an allergic reaction to the sutures. Her neck scar from primary , her front shoulder scar and the top of the Mod Quad scar are smooth and barely visible but from the crease of the armpit down it looks bad. The color is fading but it is bumpy and odd shaped. For those of you who sew, it almost looks like someone tried to gather the skin to make a ruffle. So far, knock on wood, it hasn't restricted any movement and we were told it could be redone later on if we want. I'm like Francine, I'll just wait for McCoy to run that machine over it and it will be gone!LOL Wish the whole injury could be done that way!

[christy]

thin line, fish hooky look here for primary. It started out wonderful but started looking snagged after a few months.

[francine]

I guess there is more I wanted to add...

I do believe that scar massage is very important to break it down so that movement is not restricted. You can do this scar massage yourself and you can have a therapist who knows MFR do it (however MFR on the neck post primary is contraindicated because they want the grafts to heal without a hitch or anything interrupting it).

The other thing I wanted to add was that when Maia has a fever or has an eczema breakout - her scars keloid much worse - then they go back down afterwards. When her arm got too cold in the snow storm - her scars were highly raised and purple.

And the last thing I wanted to add was that we did get the most change from using a silicone type product called oleeva (you can just do a search for it and get it online)

Maia's scars looked beautiful each time until about 2 months post surgery when each time she became infected. I found out from our experiences that not only was she allergic to the suture material but she was allergic to the neosporin I had applied once she was infected. For her last surgery Dr. Nath did part of it sutured and part of it glued - I didn't use Neosporin only hydrogen peroxide and the results were much better for her.

[Karen Hillyer]

Hi There
I have very fair skin and any wound leaves me with terrible scars as they ALWAYS go keloid on me.
I mentioned this to my dental surgeon once in passing, as I was due to have surgery to remove a thyroid tumour and I was concerned about the scarring on my neck.
he has worked extensively with facial/oral cancer sufferers who have had to endure radical facial surgery and he said he always advises people to massage with pure vitamin E oil. You can get it from any health food store.
I did this with my thyroidectomy scar and it's the ONLY scar I have which has faded and is smooth and pale looking.
Well worth a go - but you need to massage EVERY day for about 6 months to see any change.
Good luck

[francine]

Just a note about the vitamin E that you should try it on another area of the body first to see if the child is allergic to it - most of the time Vitamin E is flotating in wheat germ oil and if your child is allergic to wheat this would cause a significant problem - make the scar worse. (been there done that)

[burdz]

Mederma has not been shown to work according to my plastic surgeon. It is massaging the area that helps the scar not what you put on it and yes, vitamin e can be irritating.

[burdz]

I just noticed someone talking about hydrogen peroxide... Our family doctor just told my husband that hydrogen peroxide impedes healing.

I just had canser removed from my face and had a skin graft done and it was recommended that I use neosporin while it was healing and massage the area with moisurizer as scar tissue and skin grafts are dryer than normal skin. The plastic sergeon said it is massaging the area that helps the scar not maderma or any of those other products. Also use sunblock as the sun will affect scar tissue differently than normal skin.