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5 Realities of Your Suture Scar Line

Posted by Bryan Potok, CPO on

We all have a scar story to share. And this isn't any different from the realities of your post-amputation suture scar. Depending on the reason for your amputation, definitive closure of the wound may either take place immediately or delayed until much later.  With proper care and informed actions, we can avoid potential issues in order to reduce risks. The regeneration and appearance of new skin gives another chance for us to heal and move forward, but exactly how one can ensure a speedy recovery is entirely up to you. Here, we look at ways in managing suture scars and progress through it.

5 realities of your suture scar

How scar tissue is different than healthy skin

The human body reacts to injury in many ways, and adjusts its response accordingly. Scar tissue is formed following a wound or injury to some degree, and in your case, after a surgical procedure, and is the body's way to repair the compromised skin. Following a wound, the area bleeds and swells in response. This continues until a scab is formed, and while seemingly there isn't anything happening below the surface, your body is at work to form a more stable line of defense – a scar. A scar continues to form even until stitches are in place along the suture line. Some scars may appear raised, red, and huge. In such cases, a more thorough management is needed. On the other end of the spectrum, scars are considered "mature" once they resemble their final look – a flat, thin line on the skin. While these marks can never be totally erased, its appearance can be made less visible.

Improve your suture scar's outcome with massage

A great way to help reduce the appearance of scars is through massage. While there are only a few medical studies to promote this, the idea makes sense. Massage stimulates the skin, and this leads to stimulation of cell growth and  encourages movement that can breakdown skin adhesions underneath the suture line.  Collection of fluid at the residual limb due to swelling can also make the skin and tissue difficult to move. Thus, massage helps keep your limb movable and soft. Massage also prevents adherent scar tissue over a bone, which can delay prosthetic fitting.

You can perform your own massage daily and make it part of your routine - during bath time is a great place to start. To do this, place two fingers over the bony portion of the residual limb, and pressing firmly, move the fingers in a circular motion across the bony structure. Once the scar is healed, you may proceed with doing the same technique, but over the suture scar this time in order to loosen the scar tissue directly. You may also supplement it with products such as silipos gels that contain mineral oil gels that help condition and moisturize skin to prevent further damage from repeated abrasions and friction caused by dryness.

Suture lines don't always heal as expected in the beginning

When surgical scars heal properly, the sutures around surrounding tissues remain intact. But not all scar stories are the same, just like wound healing isn’t the same for everyone.  The care that you do for your wound will eventually make you more comfortable with less complications. With consistency, you too can make the transition period more streamlined. Self-care includes little things such as washing the wound daily, getting adequate nutrition, and adherence to medical advice. Include your family and friends in your care. This can mean teaching them to help determine signs of early infection such as redness, odor, warmth, and swelling.

Most amputees have found that when loved ones are involved in the process, they are more readily equipped to stop further complications. For Carmen Faris, a 50-year old resident from New York, she includes even her young children in the process in order to always be honest with them.

"When there's a problem, we all have to decide it together," Faris explains. "I didn't have an amputation; we had an amputation."

Preventing Skin Breakdown

One of the things you may need to deal with is to learn how to offload and redistribute the pressure that oftentimes build-up in the residual limb. This is something that is relatively common among recent amputees and only gets better over time.  So how do we deal with these issues?  Since high friction areas put fresh wounds at risk, wearing liner patches and socket enhancing gel pads can help dissipate shear stress. By avoiding direct contact on your healing suture scar, chances of wound rupture will be slim. And if you’re ready to use your first prosthetic, these products can also provide extra cushion for added comfort.

Sock Seams are your enemy

Likewise, a daily regimen of proper wound care and hygiene using prescribed creams can help moisturize the surrounding skin and prevent breakdown caused by drying out of skin tissues. You may be prescribed to wear socks in order to maintain a proper fit. However, seams are your enemies, especially when placed over your suture line.  If you do intend to use socks with seams, turn the seam to the back so that it's against your calve muscle for BK amputees, or move it to the inside if you're AK residual limb.

While living with surgical scars after an amputation is expected, dealing with the physical and emotional pressure they bring are not. Fortunately, there is a wide host of resources available for one's specifics needs. Just as scars tell our stories, scars remind us of where we've been - but it doesn't have to dictate where we are going.

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  • I,’m in my third year as a left below the knee I had so many blood clots that I made my decision in three day so we took the leg while I was in rehab six days after surgery I had an occupation person who let me fall pop out six staples it took ten weeks to heal I now have adhesions that hurt and are getting bigger I was hoping that someone could tell me how to get rid of these so that my leg will fit better

    patricia hoffman on

  • I am a double below knee amputee due to diabetes and I’m 37. First leg was the left. as removed June 4th, 2016. Then the right was removed August 9th, 2017. In total I had 13 amputations from march 2015 till December 2017. Stump/Nub care is very important. This article tells a lot of important things but not all. I know everyone is different but there is more to learn then these 5 steps. And side note My diabetes was under control and has been since 2013.

    Chad Blewett on

  • Great article. But I can also add that massage and gel pads, etc, can be invaluable in helping resolve issues of a scar from prior friction or sores, not only recent suture scars.

    philip tamoush on

  • I hope an effort is being made to get this kind of information to amputees immediately post “saw”. Or perhaps even preamputation. I know everybody’s circumstance might be slightly different; knowledge is power . . . .

    Darrel Smith on

  • I am 2 years into below knee amputation on right leg. 6 months after surgery I developed cysts in 2 places. On the suture line one was almost down to the bone on the very end. The other was to the far right on the suture line. Cysts were removed at The 6 month date. Now I have horrible adhesions. I’m in a 3rd prosthetic. Leg has atrophied almost smaller than real leg.
    But I am with bad adhesions. Both sides of bone. Still using wheel chair some. But walking too, not long distances because it starts to hurt. Now it’s moving my SI joint. 68 years old woman. I have been in good spirits ready to walk and drive again.
    But it’s not an easy job when hse wrk ,meals go on etc. I never sat down before this. I have a husband that’s precious. Been thru all this with me. But we have a business and he’s 76. He’s keeping that up. Amputee help is really helping along with rehab. But this seems to take forever. Is there anything else to move this along faster or smoother. Thank you Pamela

    Pamela DeLine on

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