Spine Deformity Surgical Wound Healing                            11-24-2020

 

Back in July (7-28-2020) I published two blog post on spine wounds, specifically the concepts and methods used to close the incisions used during spine surgery, mainly posterior spinal fusion incisions in pediatric and adolescent patients.

As I explained previously the goal in the end is a nice narrow (or thin) scar which blends into the individual’s normal skin tone.  What we want to avoid is a wide scar which has a different color and/or skin tone compared to the individual’s normal skin.  Simply put, we want the scar to be as unnoticeable as possible.  Spinal deformity surgery currently requires longer incisions, so we do whatever we can do to make the surgical scars more aesthetically pleasing and as “invisible” as possible

 

Preoperative

Typical appearance of the back of an adolescent with idiopathic scoliosis

 

 

Discharge from the hospital 3 days after surgery

Notice the thin strip of glue on the skin, this surgical glue seals the incision.  The glue typically falls off around 3-4 weeks after surgery. The small wound dressing, below picture on the right, is where the surgical drains were placed, and were now removed.  This dressing is removed after a couple of days and the small holes where the drains came out will be healed.

The back tissues are also swollen, which is normal after surgery.  This patient is only 3 days after surgery.  The purple markings are from the skin marker we use during surgery, which has not yet worn off.

 

 

 

2 years postoperatively (same patient which was 3 days postoperatively)

The surgical scar has completely remodeled.  It is narrow and similar to the patient’s normal skin tone.

The normal contours of the back are now present as the postoperative swelling which was present in the previous picture has long been resolved.  The incision is in the hollow of the back.

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Here is another adolescent patient

She is only 3 days after surgery.

 

Here she is now only 6 weeks after surgery

Notice the glue is all off the incision….

The back is a little swollen and the skin at the scar is slightly pink and raised.  Over the next 6-12 months the scar will fade to the patient’s normal skin tone, the pinkness will resolve and the swelling will return to baseline.