Scarred for life

The patient or parent's biggest concern is usually "will this leave a scar doctor?"

Some areas are better (necklace, thyroid, scalp, perineum) for not scarring, and some are worse, (sternum, eyebrows, backs) and more likely to scar.

What causes scarring?

There are generally two main factors:

• Infection
• Skin necrosis

Excess suture tension is a common contributor. Only apply just as much tension to just bring the skin edges together. Sometimes this can be hard to get right. 

See sidebar on tips on how to ease the tension.

The image of a classic movie scar that looks like a railway track - this should never been now with modern techniques. The cross hatches were where excess tension was applied to those sutures. 

Keeping low grade infections away also helps to minimise scarring. Have the patient apply Polysporin Ointment 2-4x/day.

Even just keeping the scar slightly moist after it has healed, for the first 3 months has been shown to signficantly reduce scarring. Use silicone ointment or even Vaseline several times per day in a light layer on scars that you want to disappear as much as possible.