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.