Monday, May 31, 2010

Ugly Caesarean Scar

Dear Dr. Jason,


我在去年十二月剖腹后至现在已差不多六个月了。外表伤口从起初密得蛮漂亮,但这两个月伤口处就凸出小小的小肉块。我听别人说这肉会随着时间越长越多。请问这消息是真的吗?我需要回去你哪儿再复诊吗? 您的回复我感激不尽。



One of the common problems faced by the patients with caesarean delivery is scar keloid formation.

Keloid is referred to the thickening of the surgical scar and formation of a layer of thick tissue on top of the scar.

Because of keloid, the surgical scar looks very prominent and ugly.

Thickened and ugly caesarean scar due to keloid

Not all the patients develop keloid after the surgery.

Your body genetic composition is the main factor in developing this problem. You are inherited with the gene that promote keloid formation.

Many patients mistakenly blame the doctors for poor surgical skills, but in fact the problem is primarily caused by your skin condition.

A better surgical scar with less keloid

A good skin healing without keloid

For my past 13 years of practice as a doctor in Malaysia, I noticed that the Indian patients generally recovered better with less keloid problem.
Malay and Chinese patients tend to face more keloid problem after the caesarean delivery.

Typically, the keloid will appear after 3 months of the surgery and it will progressively worsen until about 1 year after the surgery.

Luckily, many of them the keloid will slowly disappear and become less prominent after 2 to 3 years.

There are many preventive steps you can take to prevent this problem :

1) Avoid unneccessary ceasarean delivery if you know that keloid is a family inheritance problem within your family, or your past surgical experience which left a prominent keloid.

2) Apply tight compression to the surgical wound 1 month after the surgery. Wearing a tight body bandage or tight underwear to compress the scar may prevent the keloid.

3) DON"T scratch the scar eventhough you feel itchy. The more you scratch, the worse it becomes.

4) Applying silicone gel or steroid scream to top of the scar 1 month after the surgery may reduce the severity.

5) Steroid injection into the scar after 1 month of the surgery may prevent and treat this problem. Monthly steroid injection into the scar will make the keloid slowly disappear.

Steroid injection into the keloid scar

6) Laser treatment is also effective and useful in this situation.


Anonymous said...

Hi Dr Jason,

I understand from my friend that Bagan Specialist have 3D/4D scan. May I know when is the suitable time for a pregnant lady to do this test?

Dr Jason Ong said...

Around 6 to 7 months.