Both accident, surgery and injuries, skin inflammation, burns and wounds caused by different causes bear scars and leave scars on the skin for a while in the healing process. This tissue, called a scar, can be a simple scar and can also be seen in the form of contractions and stiffening, that affect the patient's movement, even their situation.

Wound-related causes: These are seen in different forms depending on the severity, depth and inflammation of the wounds. Large and deep wounds leave much more and longer lasting scars. Dirty, strained and bleeding wounds cause a great deal of difficulty to the patient during the healing process.

Patient-related causes: Wounds that are directly related to the patient's attitude towards the wounds. Light-skinned and elderly people have fewer scars. Dark-skinned individuals may have rough scars. Despite all kinds of methods, the scars of puffy wounds in some people may be genetic.

Surgery - related causes: Thease are scars that occur in surgical interventions. Wounds, cuts and scars made in proportion to the body lines can be easily hidden in invisible areas. Stitches should not reduce wound strength, should not increase tightness. Early removal of stitches as soon as possible will prevent the formation of scars.

Systemic factors: Wound healing may be delayed due to Vitamin A and Vitamin C deficiencies, so there is a possibility of scarring. The use of steroids and immunosuppressive medicine also delays the healing of wounds.

Diabetes, collagen synthesis disorder, radiation, are factors taht make wounds difficult to heal. In addition, smoking, alcohol use, iron, zinc, copper and protein deficiency also prevents the healing of wounds.

The Healing Process Of Wounds

Consists of three stages.

1-inflammatory (inflammation) phase: it is the first response process given by the body to protect against trauma. Then it takes 3 to 10 days afterwards. The process of inflammation occurs due to the collection of blood flakes to the injured area, the contraction of the veins and the subsequent cessation of bleeding as a result of the expansion of the veins to the injured area. If the wound is not stitched immediately, but left open, the injured area will heal itself and the first phase will continue until new epithelization occurs and it is covered with the layer of skin.

2-Proliferative (proliferation) Phase: It will take 3 – 4 weeks and it starts on the second day. An increase occurs in cells called fibroblasts under the skin. In this process, the wound lips contract and try to shrink the wound by increasing the formation of new veins. Then the formation of red tissue begins. In the wound, the tension strength increases and epithelization begins.

3-Remodeling phase: It is a a process that starts from 3 weeks, extending to 2 years. Despite the wounds tension and strength increases, the wound tension force can never reach its original, natural strength. The process of scar formation begins in an organized manner.

What is Hypertrophic Scar, are there any differences with keloid?

Although the body reacts similarly to every scar, unfortunately, some wounds prefer to grow rather than shrink. Even if they grow up, they don't cross the scar boundaries. Wound types called keloids can also be seen after burns.

About Keloid

It comes from the Greek word “Cheloide” which means crab claw and is pronounced Keloid. Keloid is a form of wound healing. It is the form of healing stages of the wounds that occur after a taruma,  surgical incision, accident, burn, and become self-inflammatory. The feature of Keloid tissue is, irregular, limited, pink or even darker color, bright, puffy skin appearance. Itching, discomfort and a feeling of sensitivity when touched are unbearable. These wounds tend to grow, they have the appearance of a cauliflower, and it is not known when they will stop growing.

What is inside The Keloid tissue?

Compared to a normal skin structure, there are excessive type 1 collagen cells called fibroblasts and clogged microvessels. Although there are many claims and hypotheses, the real reason for its formation is unknown.

Who can Have Keloid?

It's only seen in humans. Most people with this scar are between 10 and 30 years old and are white – skinned women. It is less common in older people. However, it can be seen in every age group with every skin colour. In some people it is based on genetic formation.

What parts of the body does Keloid occur?

The back and shoulders, earlobe and chest area are suitable for keloid formation. It is rare in the facial region. However, it has been determined that it may occur in the neck and jaw lines.

Keloid Treatment:

If the exact treatment method is to be investigated, a negative response may be given. But the method of prevention is more in the foreground. People with this problem should not undergo elective surgery, different treatment methods should be applied.  Here are some:

In-lesion corticosteroid injection, silicone-containing cream and suppressing covers, laser treatment, cryotherapy (freezing treatment with liquid nitrogen), retinoic acid creams, radiotherapy application, Mesotherapy application, surgical intervention.

Prevention of scarring and wound care?

It is much easier and more important to prevent the formation of these scars than to correct, shrink and destroy the scars.

1-Dirty, infected wounds should first be cleaned well, washed with plenty of water and even infection treatment should be applied with antibiotic treatment.

2-Stone, soil, glass and especially foreign objects such as hair inside the wound should be cleaned thoroughly and skin and wound should be free. Dead tissue should be removed, hydration should be provided.

3-Non-reacting and less stitching should be used, and care should be taken not to keep the wound too tight in this process.

4-The finest and gentle stitches should be used.

5-During surgery, scars should be made parallel to the body lines and concealed.

6-Other solid tissues should not be damaged during stitching and also feeding of the tissues of the veins should not be prevented.

7-Stitches should be removed as early as possible.

8-Movements that may cause excessive tension should be avoided.

9-The wound should be kept clean at all times and the doctor's advice should be taken into consideration without any interruption of the dressings.

10-After 48 hours with the advice of the doctor, the wound should be washed and cleaned, any dirt or  similar factors that cause inflammation should be removed from the tissue..

11-Moisturizing and healing cream can be applied to clean wounds during dressing.

12-Trace remover can be used within the knowledge of the doctor.

13-It should be kept away from sunlight, the wound ahould be protected by hats and clothes for 1 year, at least 30 SPF features of sunscreen cream or lotion that does not contain allergic factors should be used.

14-Healer should be used for bodies whose wounds have late healing properties and should not undergo surgical intervention unless it is urgent.

15-Absolutely balanced and regular diet, plenty of vitamin C and protein should be taken.

Will there be scars on all the wounds?

More or less every wound is scarred. There is no surgical method or medication that leaves absolutely no trace.

Do Plastic Surgeons do Laser Stitches?

The interest in the beauty and aesthetic subject and the continuous laser stitching terms are commonly used and it originates from this unknown subject. Laser treatment is mostly used for similar purposes such as destroying and  peeling the skin layer . Therefore, it does not have a feature such as stitching and joining. The purpose of the laser stitching is the type of stitching that is discarded under the skin and not seen, it is not taken out as it can melt.  Since there is no scar formation in this intervension, there is no possibility of leaving a scar.

Human race, skin colour, nutrition and other diseases and disorders along with age can positively or negatively affect the healing of wounds. Some people may experience blistering or reddening during the wound healing process.

Will There Be Any Scars After Plastic Surgery?

Scarring is an unwanted condition after plastic surgery, But there is no such thing as never leaving a mark. Gentle stitching requires special ability such as concealment of stitches and proportionate equalization of body lines. After these procedures, it can be considered as aesthetic surgery without leaving a mark. If the examples are listed, there will be no scars on the skin since nose surgery is performed on the inside. In the case of prominent-ear surgery, since this is a behind the ear operation, no scar can be seen.In  Breast aesthetics, there is a stitching process in the folds between the nipple and the surrounding area, the remaining traces can be hidden and collected in certain points and areas to be made invisible.

Can existing scars be eliminated?

It is impossible for an existing scar to be completely erased. The goal is to shrink and hide the scar as much as possible.

For more information on the application of Scar Treatment and other enquiries please contact us at UCEP in Fethiye.