Wound Healing and Scar Management

4 days ago

3 min read

After we have surgery or sustain an injury, our body's natural way of healing itself is to close the wound and form scar tissue.

Wound management following surgery or injury is very important to ensure your wound or scar heals well and to prevent infection.

Gloved hand therapist redresses a patient's wrist wound at Riverina Hand Therapy

While your wound is healing, it will go through four different stages: the haemostasis phase, the inflammatory phase, the proliferation phase, and the maturation phase.

1. Haemostasis

During this phase, your body stops any bleeding by activating its clotting system, forming blood clots at the opening of the wound. This stage can last up to two days, depending on how deep or severe your wound is.

2. Inflammatory phase

During this phase, your body activates its defence mechanism. This phase kills any bacteria and removes debris to ensure your wound is clean and ready for your body to start growing new, healthy tissue. This phase is usually the most painful and is often when your wound becomes red and hot, as blood rushes to the area to clean it. This phase usually takes up to six days. Excessive pain, redness or heat could indicate an infection, in which case it is important to contact your doctor to manage it appropriately.

3. Proliferation phase

Once your body has cleaned the wound on the inside, the proliferation phase begins. During this phase, your body starts to fill the wound with new, healthy tissue and blood vessels, and will also start to contract the edges of the wound, which can feel like tightening towards the centre. Your body then starts covering the wound with cells that create a protective barrier between the inside and outside of your body; these cells multiply to completely close the wound. This phase can last from four days to up to a month, depending on the severity and size of your wound.

4. Maturation phase

During this phase, the new healthy tissue (scar) that your body has made starts to strengthen and become more flexible. This is the longest phase of all and can take up to two years to fully mature.

Factors that can impact wound healing

• Diabetes

• Smoking

• Alcohol

• Increased BMI or bodyweight

• Poor nutrition

• Anti-inflammatory medications (NSAIDs)

• Radiation and chemotherapy

It is really important to manage your scar after an injury or surgery to ensure it heals well and can move freely. If your scar is not managed properly, or is left untreated, it can cause problems such as increased pain and hypersensitivity, and can restrict your movement, as scar tissue can become stuck to tissues under the skin, including nerves and tendons.

A number of factors can contribute to the way your body develops scar tissue, including the type of injury or surgery, the severity of your injury, and genetic factors.

After your wound has healed and formed a scar, it will go through a number of healing stages, changing in appearance from an "active scar" to a "mature scar." During the active phase, your scar may appear red, pink, or purple and may be raised and thick, itchy, or more sensitive. It is normal for your scar to be more reddened and enlarged for the first 4-6 weeks. Over the next 2-3 months, your scar will mature, becoming pale in colour, flat and soft, and should no longer be itchy.

How will hand therapy help my scar?

There are a number of treatment options your hand therapist can offer to help manage your scar. These include:

• Scar massage, which can help reduce sensitivity and loosen any areas that may be stuck

• Range of motion exercises, to ensure your scar heals mobile and keeps structures under the skin moving smoothly

• Silicone gel, to help your scar heal flat and smooth

• Desensitisation, to help improve the sensitivity of your scar

Close-up of a hand with a silicon gel on the wrist scar at Riverina Hand Therapy

If you have recently had surgery and have a scar, or have a scar that might be a little more sensitive than it should be, or that restricts your movement, contact your hand therapist to book in so they can provide you with the right tools to manage and improve your scar.

Have questions about your hand or wrist injury? Our experienced hand therapists at Riverina Hand Therapy are here to help. Call us on 02 6925 0157 or visit riverinahandtherapy.com.au to book an appointment.

This information is general in nature and is intended to support, not replace, individual advice from your treating health professional. Everyone's injury and recovery are different, so please contact your GP, specialist, or your hand therapist at Riverina Hand Therapy if you have concerns about your condition.