Scar adhesion treatment: What Are They, Symptoms, Treatment
What Are They, Symptoms, Treatment
What are abdominal adhesions?
Abdominal adhesions are bands of scar tissue that form between abdominal organs, mainly the small intestine. Adhesions occur after abdominal surgery and can cause your tissues to stick together, when normally they would just move around freely.
What is the abdominal cavity?
The abdominal cavity is the inside of the body, from the chest to the hips. It contains the:
- Digestive system, including your stomach and intestines.
- Female reproductive organs.
- Kidneys and adrenal glands.
Symptoms and Causes
What causes abdominal adhesions?
Adhesions occur after abdominal surgery, particularly between loops of small bowel.
What are the symptoms?
Most adhesions cause no symptoms at all. Sometimes, though, abdominal adhesions can cause the intestines to twist, similar to how a garden hose can become kinked. This condition can occur shortly after, or even years after surgery and can lead to complete or partial intestinal obstruction, also called small bowel obstruction.
With obstruction, food, liquid, air and waste cannot pass through the body. You may notice signs such as:
- Severe abdominal pain.
- Nausea and vomiting.
Diagnosis and Tests
How are abdominal adhesions diagnosed?
Imaging technology (such as X-rays, ultrasounds and CT scans) cannot detect abdominal adhesions. However, those studies can detect intestinal blockages related to adhesions
Management and Treatment
Do I need treatment for abdominal adhesions?
Most adhesions cause no symptoms and don’t require any therapy at all.
Additional surgeries will only cause more adhesions. For that reason, your healthcare provider likely will try to avoid surgery, unless blockages keep causing symptoms.
For adhesions causing obstructions, either acute (complete blockage) or chronic (repeated attacks that go away on their own), surgical removal of the scar tissue may be the only option.
Can you prevent abdominal adhesions?
A surgeon cannot avoid creating abdominal adhesions. However, adhesions are usually less common with laparoscopic surgery because of the smaller cuts. During a laparoscopic procedure, your surgeon inserts a tiny camera and instruments through small incisions.
Open surgery requires larger incisions, which can cause more adhesions. Again, the good news is that most of these adhesions don’t cause any problems
Outlook / Prognosis
What is the outlook for people with abdominal adhesions?
A person may have severe abdominal adhesions and never have any symptoms at all. However, if you experience sudden complete blockage of your bowels or repeated bowel obstruction after surgery, an operation may need to be considered by your surgeon.
When should I seek medical care?
A complete obstruction is life-threatening. If you experience any of the following symptoms, seek medical attention immediately:
- Severe abdominal pains or cramps.
- Significant abdominal (belly) swelling or bloating.
- Nausea or vomiting.
A note from Cleveland Clinic
Abdominal adhesions are very common after any operation in the abdominal cavity. Most patients never have any problems. However, if you have any signs of possible bowel obstruction, even years after surgery, tell your healthcare provider or get immediate medical attention.
How to Break Up Scar Tissue – Pain and Treatment
It’s a natural human response for the body to respond to physical injury by creating scar tissue. Whether it’s internal scarring from a physical injury, cuts, burns, sores like acne, or the remnants of scar tissue after surgery, the body naturally attempts to heal the wound by growing this type of tissue.
Unfortunately, scarred tissue is less flexible than healthy skin or tissue, and it can inhibit movement, while also causing pain. In addition, scarred tissue that forms on the outer surface of the skin sometimes looks unattractive.
So it’s no surprise that many people want to know how to get rid of scar tissue.
There are several different approaches for treating scar tissue pain and the scarring itself. First, though, it’s important to understand more about exactly what is scar tissue.
What is Scar Tissue?
The body’s natural response to an injury sometimes results in repairing the injury or damaged area by creating scar tissue.
Healthy skin has collagen proteins that form in multidirectional fibers, which allows our skin to be flexible and elastic as we move. Scarred tissue is not like regular, healthy skin because the collagen proteins form in just one direction making the tissue less elastic.
When a scar forms, it usually results in a tough, fibrous collection of cells or tissues that cover normal, healthy tissues at the site of an injury.
It’s important to note that not all scarring is external. It can develop in the joints from overuse injuries such as Golfers Elbow in professional and amateur athletes, as well as in people whose occupations require repetitive movements.
When tendons and ligaments are repeatedly stressed or injured, a build up of scar tissue can lead to less mobility, pain, and chronic inflammation.
Causes and Symptoms of Scar Tissue Pain
As scarred tissue develops, it may not be immediately noticeable, especially for internal injuries. With a burn, cut, or external sores such as acne, damage to the skin is usually what leads to pain and inflammation.
However, as the healing process continues and fibrous tissue grows, the area over the original wound may become raised, thick, and firm, causing less flexibility and mild to severe pain.
Long-term pain issues can occur with the buildup of fibrous tissue under the skin where tendons and ligaments are likely to be damaged, as well as the nerves. Fibrosis is the growth of excessive tissue that can cause loss of function in soft tissue and joints.
Symptoms of scar tissue pain can include some of the following:
- Itching and burning sensation near the scar
- Tenderness and sensitivity in the region around the scar
- Inflammation or swelling near the injury
- Warm feeling in the affected area
- Lack of mobility in the injured joint
Treating scar tissue pain, along with understanding how to get rid of fibrous tissue under the skin, is important for people seeking medical intervention for pain, discomfort, and mobility issues.
Treatment to Break Up Scar Tissue
For minor scars, people can take several at-home treatment approaches to get rid of scar tissue. Regularly applying moisturizer to an external scar and massaging it in the direction of the tissue can keep the scar softer and more flexible and it may decrease tissue sensitivity.
There are also silicone gel patches that adhere to the skin and can help promote tissue healing. Wrapping or taping the injury might also decrease tension and inflammation.
Scar tissue pain treatment for people with more serious issues can involve some of the following approaches:
1. Physical Therapy
Physical Therapy can be useful for breaking up scar tissue around a joint. Learning joint exercises and stretches can help reduce stiffness and may alleviate some of the pain cause by scarring.
This is also a useful way to learn and practice proper techniques for specialized movements, as a way to avoid future injury and the development of additional fibrous tissue.
2. Laser Therapy
Laser Therapy involves treatment that penetrates the skin and promotes the growth of healthy collagen. This treatment method is unlikely to get rid of scarred tissue completely, but it can be an effective way to help reduce minor itching, decrease pain, and improve some mobility.
3. Corticosteroid Injections
Corticosteroid Injections have shown to be effective for improving pain symptoms due to tissue scarring. Steroids are a very powerful anti-inflammatory, but the downside to these injections is that steroids can damage surrounding, healthy tissue, which may lead to further injury.
While some people respond right away to steroid injections, others require several shots over a period of a few weeks, which increases the danger of damaging healthy tissue.
4. Shockwave Therapy to Break Up Scar Tissue
Extracorporeal Shockwave Therapy, also called ESWT, sends impulse pressure waves deep into injured and scarred tissue to break up damaged tissue on a cellular level.
Pressure waves created by a Shockwave Therapy machine increase blood flow and the growth of new blood vessels to the affected area to improve healing more quickly than other methods.
Unlike surgery or injections, Shockwave Therapy is a non-invasive treatment approach, so there is no risk of infection or recovery downtime.
It can be used for chronic or acute soft tissue injuries, as well as post-operative surgery scarring and pain.
5. Surgery to Get Rid of Scar Tissue
Surgery is typically a last resort for treating scar tissue pain on injuries or problems where the scarred area is deep and excessive. Here, physicians try to remove damaged tissue or may even perform skin grafts by transplanting healthy skin from another part of the body.
There are always associated risks with surgery, as well as significant recovery downtime. Because of this, every outcome should be thoroughly discussed with your physician.
While scar tissue may appear to simply be an unattractive skin condition to some people, others have internal scarring damage that causes pain or impedes movement and overall athletic performance.
If left untreated, damaged tissue that becomes scarred can cause more severe problems in the future.
Whatever the case may be, the treatment methods outlined here should provide some good options for people who are wondering how to break up or get rid of scar tissue.
Image courtesy of Sander van der Molen.
Surgical Scar Tissue: a Less Talked-about Side Effect
When the short-term effects of surgery – such as oozing wounds and incision pain – have long faded, an unseen complication, surgical scar tissue, may be lurking beneath the skin.
Excess scar tissue, layers deep, can significantly reduce function and movement months after surgery. And on the skin’s surface, visible, lingering scars might be noticeable enough to really bother patients. Before you undergo surgery, here’s what to know about reducing scarring as you heal.
The job of a scar is to close the wound in your skin as quickly as possible, even if the wound is from a planned surgery. When experiencing a surgical wound, the body will quickly form scar tissue. Scar tissue is not made from the same great material you were born with. Scar tissue is contracting and tightening for 6 months to a year and can be dry and irritated. Learning how to care for scar tissue can improve your surgical outcome.
LAYERS OF SCARRING
Bend and straighten your elbow. The folds that form in your skin, known as Langer’s lines, represent the direction and orientation of the collagen fibers, similar to the grain of wood, says Dr. Robert Klapper, director of the Joint Replacement Program in Orthopaedic Surgery at Cedars-Sinai Medical Center in Los Angeles. During surgery, it’s not always possible for surgeons to cut parallel to the grain with their scalpels.
If you are not able, because of heart surgery for example, to get down to the sternum, we as surgeons have to violate the Langer’s line,” Klapper says. “This can often lead to keloids and bumps and poor healing, and extra scar tissue can take place.
Performing joint surgery, Klapper says, involves cutting into multiple layers of anatomy: the epidermis or skin surface; subcutaneous fat; fascia or connective tissue; muscles, tendons and ligaments; and the lining around the bone called the ostium. “It’s kind of like a seven-layer cake, if you will,” he says. “As a surgeon, you must respect in your repair of the surgery all layers of the seven-layer cake. All should get closed properly.”
The initial length of an incision after surgery could be deceptive. “You can’t tell a book by its cover – you can’t tell a surgeon by the skin incision,” Klapper says. “Oftentimes, if the surgeon can extend the length of the incision a little bit more, then your retractors are traumatizing the tissues less and you may end up with more of a disappearing scar than someone with a tiny incision.”
While surgery of the knees, wrists or ankles is meant to improve movement and function, excessive scar tissue around the joints can do just the opposite. Frozen shoulder, which sometimes follows surgery, involves a buildup of scar tissue around the shoulder joint, caused by irritation and inflammation. The result is pain and reduced range of motion. For unknown reasons, Klapper says, people with diabetes are much more prone to postoperative frozen shoulder.
Surgery anywhere in the body can lead to scarring. If your appendix is removed, for example, the small surgical scar on your belly is usually no big deal. But if you develop adhesions during abdominal surgery, that’s different. Adhesions are bands of tissue that form between organs and abdominal tissues, sometimes making them stick together. That can lead to bowel obstruction or chronic pain in the abdomen.
Pelvic adhesions that form after gynecological surgery lead to pain and infertility in some women. Surgical techniques, including using certain types of suture or creating adhesion barriers, can reduce pelvic adhesions. It’s worthwhile to ask surgeons how they plan to minimize adhesion risk.
Surgery is a form of trauma. “Any type of trauma ends up causing inflammation – swelling – of the tissues,” says Dr. Janet Yueh, who specializes in hand surgery with Cohen/Winters Aesthetic and Reconstructive Surgeons, based in Maywood, New Jersey. “Over time, that inflammation ends up being converted into scar. That scar can demonstrate itself in many different ways.” Healthy young people tend to form more surgical scar tissue than older patients, she says, because they have a bigger scar response to surgery.
At the skin level, a thickened, whitened, elevated scar, called a hypertrophic scar, can develop. Keloids occur when collagen buildup creates a larger, puffy-looking scar that grows beyond the boundaries of the surgical wound. Gels, silicone scar sheets and related products might be enough to even out skin color and improve the texture of a superficial surgical scar.
Injections, such as steroid compounds, can change the appearance, texture and size of elevated scar tissues. Other injectable treatments fill in caved-in scars. Surface treatments such as dermabrasion, laser or light therapy or chemical peels may also improve the appearance of scars. A dermatologist can guide you through cosmetic scar-revision choices.
With deeper scar tissue, Yueh says, patients complain about a sense of tightness rather than sharp pain. “That tightness can translate to soreness, to pain and to difficulty making a tight fist,” she says. If there’s no improvement after several months, surgical removal might be the next step. Although that comes with a risk of more scar tissue, it’s relatively small.
“I always counsel patients that with revision surgery, in the majority of cases it gets better,” Yueh says. “The numbers I usually quote are 70 percent that get better, 20 percent stay the same and about 10 percent get worse. It really depends on the surgeon and what the issue is.”
MOVING BEATS SCARRING
Before surgery, ask your doctor about how much scarring to expect and what preventive treatment you’ll receive. Also, ask whether minimally invasive surgery is an option. According to Cleveland Clinic’s Health Essentials webpage, minimally invasive surgery is the No. 1 method for reducing the risk of abdominal adhesions. And whether it’s knee surgery or cataract removal, Klapper says, the concept of minimally invasive surgery is so successful because it minimizes the scar.
Moving your joints the right way after surgery not only improves function, it helps prevent excess scar tissue from forming. “The earlier you get the patient moving – and I don’t care what the surgery is – the better the outcome,” Klapper says.
After surgery, Yueh recommends that her patients work with hand therapists – occupational or physical therapists with specialized training in conditions occurring anywhere from the shoulder to the fingertips. Targeted exercises and spring-loaded splints help stretch the skin and guide joints back into proper position. Massage and ultrasound therapy help soften scars. “With the combination of different therapies, over time the scar will soften and the patient is able regain motion of their fingers,” she says.
Contact BoulderCentre (303) 449-2730 for your hand therapy appointment with one of our specialists Sally Brown, Bridget Myers or Charla Stilling.
See all of BoulderCentre’s Physical Therapists.
At home, dedication to treatment plays a big role. By sticking with therapy and doing prescribed exercises at home, patients can do a lot to manage and minimize scarring.
The main thing is working with a doctor who can diagnose why they’re having the scarring and at what levels they’re having the scarring to figure out a good plan for them afterwards,” Yueh says. “Because often what’s going on underneath is much more than they see on the skin.”
BoulderCentre for Orthopedics & Spine can help. Call us (303) 449-2730 and ask to see one of our surgical specialists.
Article courtesy of U.S New Word Report.
Scar/Adhesions Release Therapy – Alternative Health Specialties
How Scar/Adhesion Release Therapy works
Often, scars result in a tightening of the surrounding tissue that can restrict movement or function in the body. These restrictions not only affect the joint, limb or surrounding area, but they can affect the underlying organs, too. This is because scar tissue has the potential to spread in any direction, including internally, throughout the body. Fortunately, releasing the scar can yield powerful results, which can improve mobility, diminish complications and decrease pain often associated with deep scars.
Since the body’s fascial system is interconnected, a restriction or adhesion in one area will often affect other areas and result in compensation patterns and pain. When a scar has been released there is no longer a restriction in the flow of energy, blood circulation and lymph drainage. The body can then complete the healing process.
A scar can be a mark left on the skin or on an internal organ by the healing of a wound, sore, surgery or injury due to the body replacing the connective tissue of the injured area. Scars are the result from wounds that have healed, accidents or surgical operations. The slightest restriction in the elaborate matrix of fascia can have major repercussions from one end of the body to the other. Scar Release Therapy is generally overlooked by health professionals because the extent of physiological effects scars can have on the body have never really been acknowledged.
A simple scar from a childhood accident to major surgery can have a lifelong effect both physically, emotionally and mentally. Scar tissue has the potential to spread in any direction including internally throughout the body.
It can also restrict movement or function anywhere in the body from a joint to an organ. Fortunately, releasing scars yields powerful results that can prevent a lifetime of compensation, complications and pain.
Scars will still respond to releasing treatment decades after they have been inflicted! Scars due to cesarean section which are twenty or thirty years old can be treated with great success. Cosmetic surgery as well as internal abdominal adhesions, when treated can relieve symptoms several years after they first appeared.
Whether from injury or surgery, scar tissue can been significantly improved and softened and circulation and function can be greatly improved with SMRT Scar/Adhesion Release Therapy.
Benefits of Scar Release
- Reduces muscle spasm
- Helps to prevent adhesion formation from surgery.
- Helps to maintain good posture
- Helps to increase athletic performance
- Reduces the risk of muscle strain and tearing Improves oxygen and nutrient delivery to cells.
- Helps to regain and maintain the full range of motion of a joint.
- Helps stimulate lymph circulation and elimination of cellular waste
Scar Tissue Treatment – Laser Therapy Colorado Springs
The effects of scar tissue on your activity level, and nonsurgical treatments that can help.
How do chiropractic care, acupuncture, and ESWT help with scar tissue?
Scar tissue forms when your body’s cells and tissue heals from an injury (trauma) or inflammation. Internal scar tissue forms to help the body heal after surgery, an accident, fall, infection, radiation therapy, and endometriosis. In some cases, scar tissues link to form an adhesion, which is a band of scar tissue. These adhesions can sometimes affect the proper functioning of our internal organs, joints, and nerves, requiring further surgery or other nonsurgical treatments to help break down, dissolve, and remove the obstructive scar tissue. In many cases, one would be hesitant to undergo another surgery if the scar tissue was caused by an initial surgery. There are options available to help reduce the negative effects of scar tissue that do not require surgery. In fact Springs Chiropractic offers several non-surgical options to treat scar tissue including therapeutic massage, acupuncture, and chiropractic care that is specifically performed to treat the limitations and pain caused by scar tissue.
It is important to know that most adhesions do not show up on x-rays, MRIs, or ultrasound tests. Some people are more prone to developing scar tissue than others. Some do not experience any trouble from internal adhesions, but others suffer when their internal scar tissue causes pain, hinders movement, and affects not only their quality of life but also their activity level. Whether you are a professional athlete or simply enjoy playing recreational sports for fun, exercise, and pleasure, this could have a huge impact on your enjoyment of life. Symptoms can also manifest in other parts of the body, causing confusion as to the true source of the pain. Adhesions are often the root cause of chronic pain in many individuals.
There are several effective, nonsurgical treatments for scar tissue, such as regular chiropractic care, steroid injections, laser therapy, and cryotherapy. Massage therapy and regular chiropractic care can also be effective in helping to break down scar tissue, enhance range of motion, and increase the flow of blood to affected areas.
If you are experiencing pain or other symptoms as a result of scar tissue or adhesions, check with your health care provider. If you are looking for sports injury doctors who offer various techniques to treat sports-related injuries, call the experts at Springs Chiropractic. We have muscle stimulation, ultrasound therapy, dry needling, laser therapy, kinesio tape, acupuncture, massage, and manipulation available. Your pain management treatment will be customized to fit your unique condition and situation, and we will do our best to help you avoid surgery whenever possible.
Abdominal and pelvic adhesions | Health Information
Treatment of adhesions
Most people who have adhesions don’t need any treatment for them as they don’t usually cause problems. But if your doctor thinks that you have a bowel obstruction or severe pain because of an adhesion, you might need to go into hospital for treatment.
Non-surgical treatment for an obstructed bowel
If you’re having severe symptoms due to an obstructed bowel, your doctor may suggest going into hospital so they can keep an eye on you until it clears. They’ll usually suggest not eating or drinking anything for a day or two. This will give your bowel a rest, helping to prevent it from becoming completely obstructed. In the meantime, you’ll be put on a drip to make sure you get enough fluids and salts. They’ll also put a tube into your nose, which will release gas and fluid from your stomach.
You’ll be offered pain relief with a stronger painkiller (for example, morphine) while you’re in hospital. Gradually, you’ll be able to reintroduce sips of drinks, followed by soft food and then more solid food.
These measures will usually be enough to clear a partial obstruction. But if there’s no improvement after a few days, your doctor may advise you to have surgery.
Surgery for adhesions involves a procedure called adhesiolysis to cut through and separate the adhesions. Your doctor may advise this surgery in the following circumstances.
- You have signs of a complete bowel obstruction. In this case, surgery may be done as an emergency procedure to clear the obstruction.
- You’ve been receiving treatment for partial obstruction for a couple of days, with no improvement.
- You’re having ongoing tummy or pelvic pain, thought to be due to adhesions.
It’s important to be aware that all surgery carries a risk of creating further adhesions. Your surgeon will talk through the risks, benefits and possible alternatives. They will only advise you to have an operation if they think it will help you.
Your surgeon may be able to do the operation using keyhole surgery. This means inserting surgical tools and instruments through small cuts into your tummy to see inside and to cut the scar tissue. There is thought to be less risk of new adhesions forming after keyhole surgery than after open surgery. Open surgery is when a single large cut is made into your abdomen. But if you have certain complications or a lot of your bowel is affected, your surgeon may have to carry out the procedure through open surgery.
Scar Massage and Tissue Release
Specialist massage techniques can effectively treat pain and immobility caused by scarring and adhesions, even from very old wounds.
Scar tissue and adhesions are part of the body’s healing process, formed in response to injury, illness, surgery and other medical treatments. However, sometimes too much tissue grows and interferes with the body’s functioning. Surgery to cut adhesions causes more adhesions and so patients can fall into an adhesion/surgery cycle.
Anything from a childhood fall to major surgery can have a lifelong effect on the body but this can be significantly lessened with scar tissue release– a systemic massage therapy which releases and re-aligns the body’s connective tissue. Although this is not a cosmetic treatment, scars can become less visible as a side effect.
What are adhesions and scar tissue?
Adhesions are fibrous bands, or thin sheets of tissue, that grow as a result of trauma to the body. They stick together other tissues and/or internal organs. Depending on their size or location, they have different names e.g. cross links, micro-adhesions.
Scar tissue is a concentration of thick, pale fibres formed on the skin or internal organs caused by healing after injury, disease or surgery. They have limited flexibility, circulation and sensation.
What effects can they have?
Scar tissue can spread to any part of the body, restricting movement and functioning. If it forms around a nerve it can cause pain and numbness.
Adhesions restrict motion as well. In a frozen shoulder they grow between the shoulder joint surfaces. You can also find them in the ovaries, uterus, testes and intestines.
Indirectly, both scar tissue and adhesions can affect the liver, heart, lungs and breathing.
What’s involved in scar massage treatment?
New scars and adhesions need to be left for at least 12 weeks before treatment – much longer for deep or abdominal/visceral scars. Consent from your surgeon or doctor needs to be obtained before scar massage treatment.
A minimum of six treatments are required to treat scarring, unless it is superficial. Adhesions should be treated twice a week over several months, depending on the depth and width of the adhesions and of how long they been there.
The first task is to discover how far the scarring and adhesions have spread. Much is not visible, so this is done by feeling the affected area. A number of techniques are used to treat the scarring and adhesions:
- Cross fibre friction to soften the hardened tissue and help break it up, one branch or layer at the time.
- Warming the tissues so to lengthen them and re-align them.
- Myofascial release
- Stretching exercises
Between treatments, there are a number of things you can do:
- Warm up the area with hot water bottle – heat helps to loosen the fibres
- Wrap a compress soaked with caster oil and keep on the affected area for 60-90 minutes – this will help to break up scars and adhesions
- Some people find that the herbal supplement Fibrovan helps to break up scars and adhesions. NB This is not a product endorsement or guarantee.
The following are the areas I can treat:
- Caesarian section
- Back and hip surgery
I practice from my relaxed and comfortable consulting room in the leafy Hermitage area of Morningside, Edinburgh.
remedy for scars and scars Silplast
Remedy for scars and scars: how to get rid of hated marks
Feeling attractive is essential. The feeling of one’s own beauty keeps the quality of life at a high level. The confidence of a person who loves himself is instantly guessed by society through his movements, eyes, gait.
Scars and scars can be a barrier to achieving this inner state. They are unaesthetic and give the appearance unnecessary rudeness.Shyness, stiffness, constant frustration due to restrictions in the choice of clothes and the need to apply certain makeup in order to visually hide an unnecessary detail of the appearance – all this daily reminds of itself unpleasantly.
How to get rid of scars? We will answer in our article.
Scars and scars: what is the difference
The terms “scar” and “scar” in medicine mean a dense formation of connective tissue after surgery or mechanical damage.
A scar, or scar, acts as a kind of “lock” after tissue regeneration. It is composed mainly of collagen. And it has only one function – to hold the living tissue together. Therefore, hair does not grow in the place of scars, sweat glands do not work.
There are several types of scar:
a scar flush with the skin level is normotrophic. Such a scar does not change the topography of the skin;
the scar below the skin level is atrophic.Outwardly, it resembles a pit or a ditch, because it sinks in relation to the surrounding skin;
the scar above the skin level is hypertrophic. Often such a suture can be seen, for example, in the lower abdomen after a cesarean section.
The scar has an unpleasant tendency to grow and become larger than the actual size of the wound. This is called a keloid scar. It does not occur in all cases, and its appearance depends on the specific properties of the skin.
The external effects on the skin after the same operation or mechanical damage can be very different. Organisms are all different. And the tendency to scarring of the skin is also different.
Therefore, someone after appendicitis a year later has a pale scar in one level with the skin. And someone has a pink-red bumpy path that remains like this for several years.
And in the second case, it is good to combine special exercises on the scar with means that are designed to eliminate its external signs.
Methods of getting rid of scars and scars
For many, it is of paramount importance to make the scar invisible on the skin. In addition, you need to understand that a scar, especially after an abdominal operation, is a deeper formation. And it is necessary to deal with it entirely: taking care of the appearance and developing it “inside”.
Why is not only the visual part of the scar important? After all, the operation has already passed, the state of the body has returned to normal, and you can relax.The point is adhesions – fibrous joints that form in places of tissue damage. They can be compared to strong threads or ropes. The consequences of the formation of adhesions differ from the resources of a particular organism and can be both harmless and threaten, for example, by curvature of the spine.
At the site of the scar, blood flow is limited, the tissues begin to experience oxygen deprivation, and this leads to the formation of adhesions. Here, a daily simple massage is very important – along the seam “draw” crosses with the pads of your fingers: horizontal and vertical lines.It is good to combine massage with medical treatment in the form of special ointments, which will be recommended by the attending physician.
When it comes to eliminating the visual signs of a scar, the best scar remedy varies from situation to situation. Here it is important to approach the solution of the problem on an individual basis and, together with a specialist, choose an effective and safe way to eliminate the scar.
drug treatment – the use of ointments, gels and drug therapy with the introduction of the necessary drugs;
mesotherapy can make the scar invisible, this is the introduction into the surface of the scar of injections with nutrients that soften the rough tissue and prevent it from “thickening” and growing;
laser resurfacing – scar correction occurs by heating the skin to high temperatures and turning it into steam;
surgery, or scar excision, is usually used when the previous methods are unable to cope with the task.
Scar correction can be supplemented. A specially formulated silicone patch for scars and scars will help you achieve the desired effect.
Silplast: how it works
An important advantage of the plate is that it prevents the aggravation of the unaesthetic appearance of the scar. Silplast prevents connective tissue from overgrowing, because it prevents the deposition of collagen, which forms scar tissue.
And at the same time, it can be used effectively also with old scars. Why? Silplast is a plate made from the thinnest layer of silicone with compressive properties. Optimum moisture absorption in the scar is created in the connective tissues.
Silplast should be worn for several months. At the same time, the plaster practically does not affect the usual way of life – due to its subtlety, it does not hinder movements, and the hypoallergenic special glue does not allow it to come off.You can even go to the pool and gym with it.
1. “I have a slightly non-standard reason for using the Silplast patch. I use it after removing the tattoo. I am very glad that there is such an invention. Really convenient: you can take a shower in it, sweat in the gym. Does not pinch, does not itch. The main thing is to change it in a timely manner and process the scar ”
2. “I started using Silplast with a long-standing scar.The fact is that my suture after the cesarean section was more than a year old, and it still remained convex, reddish-pink and with a clot of skin at one end. I was warned that this patch would need to be worn for several months. The most amazing thing is that I have only worn it for three weeks now and have already noticed the first improvements! The scar has turned pale! Looking forward to the final result now ”
3. “I was advised by the doctor to use Silplast as soon as the suture heals after surgery. He explained this by the fact that this special plaster will not allow the scar to become huge and red.I was worried about sensitivity at first. The seam was unpleasant to touch. But he exceeded all my expectations. Invisible both in sensations and visually. Very thin, very. And at the same time it sits firmly on the skin, does not peel off, even if it rubs against clothes. And you can wash in it. And the main thing is the effect – the shovel is thin, even and pale! ”
Doctor about Silplast
“The effectiveness of the Silplast patch depends on the correct approach to its use. Silplast must be applied daily for six months, depending on the specific situation.Remember that one patch is enough for five, maximum seven, days. Then it ceases to adhere tightly to the skin and needs to be replaced. When replacing the patch, the skin must be processed and dried.
I also recommend that you consult with your doctor and, if required, apply specially formulated gels and ointments under the patch. Don’t be afraid to peel the patch away from your skin. Silplast can be peeled off and glued several times a day. The main thing is to wait for the preparation to dry on the skin before re-sticking the patch. ”
90,000 Dissection of adhesions (laparoscopy) in Moscow – gynecological clinic Gineko
The adhesion process is a protective property of tissues to react to damage through the process of fencing off healthy tissues from pathological effects.Due to inflammation, infection or tissue damage during surgery, the body has the peculiarity of forming additional tissue (adhesions) that plays a protective barrier function. In some people, this process is more pronounced in others, less actively. Therefore, adhesion is not found in everyone.
As a result of excessive formation of adhesions, infertility can develop. At the same time, the function of such important organs of the female reproductive system as the fallopian tubes (their obstruction develops) or the ovaries (on the surface of which dense films are formed that do not allow the egg to leave during ovulation are disrupted.This is manifested not only by pain in the lower abdomen, lower back or sacrum, but sometimes it becomes the cause of intestinal obstruction. To get rid of the disease, it is necessary to dissect the adhesions. The operation to remove adhesions is called adhesiolysis.
Basically, the presence of an adhesive process can be suspected only by indirect signs. It is possible to assume adhesions of some organs during gynecological examination and palpation on the basis of data on the presence of their displacement from the anatomically correct location or pain on palpation.Reliable diagnosis is possible only during laparoscopic surgery.
Reasons for the formation of adhesions
As a result of the inflammatory process, damaged tissues acquire pathological properties, often thicken and stick together with nearby organs. This leads to the formation of adhesions not only in the organ directly affected by the inflammation, but also in adjacent tissues.
After any operation during the healing period, reference tissue can form at the site of the injury.
- Internal bleeding
In case of damage to internal organs, blood or other fluids are released, which can subsequently be transformed into adhesive films. Any internal bleeding must be treated by a specialist.
- Women’s diseases
Adhesions on the female pelvic organs can form as a result of not fully cured sexually transmitted infections.
Another female cause of adhesions is considered to be frequent abortions and improper use of intrauterine contraceptives.
The symptomatology of the adhesions differs depending on the organ involved in the process. Treatment is prescribed depending on the prevalence of the disease. Surgical dissection of adhesions can be performed using several methods. We recommend adhesiolysis.
Adhesiolysis is a surgical laparoscopic treatment of adhesive disease.Adhesions are removed with special laparoscopic equipment in the operating room. Laparoscopy for dissection of adhesions is needed to restore the function of the female genital organs. This is the most effective treatment.
Before a planned operation, a woman should be examined by a gynecologist and pass all the necessary tests. This is a standard list of examinations to identify contraindications for surgical treatment or to carry out the necessary correction before surgery.Typically this is:
- General blood test and blood test for coagulation and hormones
- general urinalysis
- Ultrasound of the abdominal cavity organs (if necessary)
- Ultrasound of the small pelvis
- tests for syphilis, hepatitis B and C, HIV and others as prescribed by a doctor.
On the eve of the operation, it is necessary to follow a diet and carry out a bowel cleansing procedure.
Contraindications to surgery
- Acute course or exacerbation of chronic diseases of the cardiovascular, respiratory, urinary, digestive and other systems.
- Uncorrected hemostasis disorders;
Laparoscopy is performed under general endotracheal anesthesia.
- For laparoscopy, 3 small incisions are made on the skin of the anterior abdominal wall: in the navel and 2 in the bikini area.A camera and manipulators are introduced through them.
- Gas is injected into the abdominal cavity to raise the abdominal wall. This provides a comfortable workspace.
- The surgeon grasps the adhesions with the instruments, dissects them and removes them.
- Damaged vessels are cauterized with a coagulator.
The total time of the operation is determined by the severity of the adhesive process.
In the absence of complications, the patient is discharged from the hospital within a day. Painful sensations disappear within a few days. The complete recovery process takes several weeks. During this period, it is recommended to follow a diet, limiting physical activity.
Benefits of laparoscopy for adhesion dissection
The main advantages of laparoscopy are the minimal surgical impact on the body.
- Only a few small incisions are made instead of the wide traditional incision. Scars are practically invisible on the body.
- This treatment requires a short recovery period. Painful sensations go away after a few days. You can return to your usual vigorous activity after a few weeks.
- Laparoscopy is the safest surgical method for women. After such treatment, a woman has more chances (in comparison with a conventional operation) to become pregnant and give birth to a healthy child, since adhesiolysis practically does not cause trauma to the body and to a minimum extent is the cause of adhesion due to minimal tissue trauma.
Adhesive disease of the abdominal cavity: long course, difficult treatment
Photo is illustrative. From open sources
Nikolay Sivets, Head of the Surgical Department of the 6th City Clinical Hospital of Minsk, Doctor of Medical Sciences. Sci., Professor of the Department of Military Field Surgery, Belarusian State Medical University:
– Adhesive disease refers to pathological conditions associated with the formation of adhesions in the abdominal cavity in a number of diseases, with traumatic injuries of internal organs, incl.h. in case of an operating injury. It belongs to the number of still unresolved problems of abdominal surgery. In most cases, it is the inevitable marriage of the surgery, not the surgeon. A doctor, saving a patient from one fatal disease, is forced to contribute to the emergence of a new one.
A great contribution to the study of adhesive disease was made by N.I. Pirogov, who was the first in Russia to perform an operation under ether anesthesia for strangulated small bowel obstruction. In 1914, the German surgeon Erwin Pyr published 157 cases of abdominal adhesions after various interventions and for the first time raised the question of the need to prevent the development of adhesions.The research was continued by V. A. Oppel, Yu. M. Dederer, V. A. Blinov.
With the development of surgery, the range of operations became wider. More often, there were painful conditions, designated as adhesions, adhesive obstruction, adhesive disease. The study of the process of adhesion has shown that the painful conditions accompanying the formation of adhesions give significant variants of clinical manifestations, indicated by the symptom complex of adhesive disease. It was found that the adhesion process is based on abnormalities in the function of the peritoneum associated with hypoxia, which develops as a result of a prolonged inflammatory process, which leads to a violation of its fibrinolytic function (A.N. Dubyaga, 1987; R. A. Zhenchevsky, 1989; D. M. Scott-Combes 1995; J. N. Thompson 1995; S. A. Whawell, 1995).
The presence of adhesions leads to a decrease in the quality of life, chronic abdominal pain, infertility in women, threatens intestinal obstruction. According to a number of authors, 1% of those who underwent surgery on the abdominal organs are treated annually for adhesive disease. Intra-abdominal adhesions after manipulations of the surgeon on the abdominal organs occur in 80–90% of cases. The incidence of recurrence of acute adhesive intestinal obstruction is 30–69%, repeated operations aggravate the condition and lead to death in 13–55% of cases.
Leading moments in the formation of adhesions:
- diseases of the abdominal cavity organs in combination with surgical trauma;
- bruises and injuries of the abdomen;
- malformations of the abdominal organs.
The cause of the formation of adhesions in 98.8% of cases is surgery. After appendectomy, adhesion occurs in 22.8% of patients, which is primarily associated with the incidence of the above-mentioned disease.
There are many classifications of adhesive disease, but in practice, the classification according to D.P. Chukhrienko.
The scale of the adhesive process – from total to the formation of separate strands, fixed at two points. As a rule, the adhesive process is more pronounced in the area of operation. Often, bowel loops are soldered to the postoperative scar or fixed to the walls of the postoperative hernial sac.
Clinical manifestations – from minor abdominal pain to severe forms of acute intestinal obstruction. One of the main complaints is constant pain throughout the abdomen without clear localization.Nausea, often vomiting, bloating, rumbling in the intestines, difficulty in passing gas and stools, and gastrointestinal discomfort are also noted. There are functional disorders on the part of other organs involved in the adhesive process. In adhesions with a predominance of pain, characteristic changes in the parameters of peripheral blood, liver functions, and gastrointestinal tract organs are usually not observed.
To establish the diagnosis of adhesive disease, it is necessary to conduct an X-ray examination of the gastrointestinal tract, i.e.because the presence of laparotomies in the anamnesis does not mean the presence of adhesions in the abdominal cavity. X-ray diagnostics is based on the detection of deformities, unusual fixation, adhesions with the abdominal wall in a polypositional study.
Laparoscopy was contraindicated until recently due to the high risk of damage to internal organs. Now it is used for adhesions for both diagnostic and therapeutic purposes.
Fibrocolonoscopy is often effective in terms of diagnosis.
Laboratory data do not give anything pathognomonic.
The treatment is difficult: you can never be sure that a laparotomy performed with adhesive disease will eliminate the causes that caused the adhesive process.
Interventions are often performed on an emergency basis. Patients with chronic obstructive and recurrent adhesive obstruction are routinely operated on.
A surgeon finds himself in a difficult situation in the presence of a dense conglomerate of intestinal loops.It would be rational to impose an off bypass bypass; radical, optimal for the patient – resection of the entire conglomerate.
The most serious problem is recurrent adhesive intestinal obstruction, adhesive disease itself.
Operations are different – depending on the nature of adhesions and the type of intestinal obstruction. The most common is the separation of adhesions. Plane adhesions, causing bends, constrictions, formation of double-barreled, are dissected. The connective tissue cords are excised at the site of their attachment.Deserosed surfaces on the intestine are peritonized by imposing interrupted sutures on the intestinal wall. With cicatricial adhesions that deform the bowel loops without disturbing the nutrition of the wall, bypass anastomoses are usually applied between the loops of the small intestines, between the small and large intestine, and less often between the sections of the large intestine.
The choice of access is important. Many are operated on more than once – their anterior abdominal wall is scarred. Therefore, most surgeons consider the best approach to be a lower midline laparotomy, which, if necessary, can be extended upward.Access through the old surgical scar is fraught with opening the intestinal lumen.
Incisions of the anterior abdominal wall should be sufficient. The peritoneum should not be roughly grasped and pulled to the edges of the wound; napkins inserted into the abdominal cavity should not be fixed to the peritoneum. Avoid extensive eventration of intestinal loops and drying of the visceral peritoneum covering them. Cover the intestinal loops with wet wipes moistened with isotonic sodium chloride solution. During the operation, a thorough hemostasis is needed, and the spilled blood must be evacuated in a timely manner.It is important to prevent ingress of iodine solutions, alcohol, oils, small foreign bodies, dry antibiotics on the parietal and visceral peritoneum.
Case from practice
Patient K., 55 years old. Physician by profession. I went to the surgical department of the 6th City Clinical Hospital of Minsk in a planned manner for consultation with a referral diagnosis of “adhesions of the abdominal cavity with episodes of intestinal obstruction.” Complains of periodic bloating, bouts of pain for the last 3 months, nausea, delayed discharge of gases and stools.
In 1971 at the age of 10 he was operated on for acute destructive appendicitis with diffuse peritonitis. An appendectomy was performed, the abdominal cavity was drained. After 2 weeks, he was reoperated in connection with the development of early postoperative adhesive intestinal obstruction. A laparotomy was performed, the adhesions were separated.
After 10 years, he was operated on in one of the clinics in Minsk for acute adhesive intestinal obstruction: laparotomy, adhesions were dissected, intestinal obstruction was eliminated.A year later, in another clinic, he was again operated on for acute adhesive intestinal obstruction. There was a massive adhesive process in the abdominal cavity. It was possible to enter the cavity only by excision of the inner sheets of the sheaths of the rectus abdominis muscles in the mesogastrium.
During the revision of the abdominal cavity organs, a massive spread of adhesions along the loops of the small and large intestines with the involvement of the greater omentum, parietal and visceral peritoneum in the process was revealed. In the right half of the abdominal cavity, a conglomerate of loops of the small intestine, blind, ascending and right half of the transverse colon was found.An attempt to isolate the intestinal loops from the conglomerate is unsuccessful. The operation was completed by the imposition of a side-to-side ileotransverse anastomosis.
The patient was discharged after recovery. For about 20 years, there were no pronounced symptoms of impaired intestinal passage.
Slow deterioration started about 3 years ago, during the last 6 months it has been intense. Retention of stool and gas for 2-3 days has become a constant phenomenon. The patient gave up hard and rough food, began to eat little. 2 months before going to the 6th City Clinical Hospital of Minsk, I took only liquid food – often, in small portions.To ensure passage through the intestines, he changed the position of the body and massaged the anterior abdominal wall. Weight loss began, decreased performance. For the last 3 weeks, the diet has included liquid soups, baby gummies, and liquid chocolate.
At the initial examination – a patient with reduced nutrition, but without signs of exhaustion. The skin is of a normal color, dryish. Lungs, heart – no peculiarities. The stomach is not swollen. There are scars after appendectomy and upper mid-midline laparotomy. On palpation, the abdomen is soft, slightly painful in the mesogastrium.The infiltrate without clear boundaries is determined along the right lateral canal. Symptoms of peritoneal irritation are negative.
Clinical diagnosis on admission: “adhesive disease of the abdominal cavity with chronic disturbance of the passage through the intestine.”
General clinical analyzes of the patient without significant deviations.
On the roentgenogram the pulmonary fields without visible infiltrative changes. Strengthened, enriched pulmonary pattern in the basal regions, the roots are unstructured, somewhat expanded.The heart is not enlarged. The aorta is hardened and deployed.
Fibrocolonoscopy was performed, for which the patient prepared himself for 2 days to avoid acute adhesive intestinal obstruction (refusal to eat and drink; neither Fortrans nor cleansing enemas were used). There were no problems for examining the intestines during colonoscopy. The endoscope is inserted into the dome of the cecum. The intestinal lumen is normal. In it, up to the hepatic angle, there is an insignificant amount of wash water. The walls of the intestine are elastic. Peristalsis, folds are not changed.The mucous membrane is shiny, pink. The vascular pattern is normal. The Bauginia flap is well defined. The terminal ileum is intubated. The lumen is ordinary, on the mucous membrane there are flattened erosion under the fibrin. In the lumen of the ascending intestine, a large number of formed feces. In the transverse colon there is a wide mouth of the ileotransverse anastomosis. The endoscope was passed into the discharge gut to a depth of 40–50 cm. The lumen was normal. On the mucous membrane, multiple flat erosions on the verge of ulceration, under fibrin.Biopsy (3 fragments). The adductor intestine was intubated to a depth of 35 cm (no features).
Conclusion: the state after the imposition of an ileotransverse anastomosis (functioning). Diffuse erosive ileitis of the discharge intestine (Crohn’s disease?).
It was decided not to perform an X-ray examination of the intestines with passage of barium sulfate, so as not to provoke an acute adhesive intestinal obstruction. The clinical picture and colonoscopy data are sufficient to make an informed decision about performing the surgical intervention as planned.
The patient was operated on under endotracheal anesthesia. The old surgical scar was excised. Upper midline laparotomy with bypassing the navel on the left. There is no free abdominal cavity as such. Massive adhesive process after previous operations. The loops of the small intestine are “embedded” in the anterior abdominal wall along the entire length of the operating scar, since the peritoneum of the anterior abdominal wall was removed in the previous operation. The mobilization of the proximal small intestine was performed with technical difficulties.The intestine has a rigid wall, a diameter of about 6 cm. It was revealed that there is an ileotransverse anastomosis 150 cm from the tract ligament. Further mobilization made it possible to establish a conglomerate of loops of the small intestine in the area of the ileotransverse anastomosis. The conglomerate is divided, however, the loops of the small intestine from the side of the cecum are scarred and recognized as functionally incompetent. The stricture of the discharge segment of the ileotransverse anastomosis is palpated. The course of the small intestine from the tract ligament to the ileotransverse anastomosis was traced.The latter is imposed anti-peristaltic.
There is a conglomerate of loops of the small intestine along the right lateral canal, not divided in the previous operation. An attempt to separate it was unsuccessful. As a result of a thorough revision, it was found that the cause of the violation of the passage through the small intestine is its multiple adhesions and kinks, a conglomerate of intestinal loops along the right lateral canal, as well as the stricture of the ileotransverse anastomosis. The adhesions are as far apart as possible. The bowel loops are straightened along the left half of the abdominal cavity.On the right, it is unrealistic to separate the loops of the small intestine without damaging them. A right-sided hemicolectomy is shown. A single block mobilized a conglomerate of intestinal loops, including about 80 cm of scar-altered, with adhesions of the ileum, blind, ascending and right half of the transverse colon with ileotransverse anastomosis. Right-sided hemicolectomy was performed. Formed isoperistaltic ileotransverse anastomosis “end-to-end” double-row suture. We pass the anastomosis, applied without tension.Sutured “window” in the intestinal mesentery. The integrity of the peritoneum of the right lateral canal was partially restored. Drainage tube along the right lateral canal and into the small pelvis, as well as along the left lateral canal. The abdominal cavity is drained. The wound of the anterior abdominal wall was sutured in layers with the imposition of a mechanical skin suture. Bandage. The duration of the operation is 9 hours 15 minutes.
Macrodrug: scar-altered loops of the small intestine (about 80 cm of the ileum), blind, ascending and half of the transverse colon with ileotransverse anastomosis with a total length of about 140 cm.
Histological conclusion: fragments of the small and large intestine with desquamation of the epithelium in the lumen, hemorrhages, focal necrobiotic changes in the mucous layer of the colon, scant lymphocytic infiltration in the mucous and submucosal layers. From the side of serosa – proliferation of fibrous tissue with neoangiogenesis, leukocyte infiltration. At the edges of the resection, there are similar changes. The mesentery with congested vessels, lymph nodules with sinus histiocytosis, areas of fibrous tissue.
Final clinical diagnosis: chronic adhesions of the abdominal cavity with total adhesions and impaired intestinal passage. Cicatricial stricture of an ileotransverse anastomosis.
Operation: laparotomy, elimination of adhesions, right-sided hemicolectomy with resection of ileotransverse anastomosis and formation of a new ileotransverse anastomosis “end-to-end”.
The postoperative period was uneventful, the drains were removed on the 3rd-4th day, the wound healed by primary intention.The patient was discharged with recovery. Stool on the day of discharge and later – 3 times a day. There are no signs of intestinal passage disturbance in the immediate postoperative period.
1. Operations for long-term adhesions of the abdominal organs with chronic disturbance of intestinal passage are preferable to be carried out in a planned manner, in the daytime, prepared by the surgical team.
2. In order to avoid damage to the loops of the small intestine, the best access should be considered a lower midline laparotomy, which, if necessary, can be extended upward.
3. Rationally apply a bypass bypass; a radical, optimal option for the patient – resection of the entire conglomerate.
4. When operating on a patient with adhesive disease, it is necessary to observe a number of known measures to prevent the recurrence of adhesion formation.
Medical Bulletin , 18 July 2016
Treatment of skin scars
Skin scar treatment
Skin scars (cicatrix) – secondary morphological elements that occur after inflammation, surgery or injury.After destruction, the skin acquires a focal pathological change in the form of an overgrown connective tissue with an unbalanced distribution of functional elements, therefore, any scars should be interpreted as a pathology, and not as a physiological norm. A scar is a product of incomplete regeneration of the skin after its damage and inflammation, at the site of cuts, injuries, burns, ulcerations, deep pustules, tubercles, knots, cracks. Unstable scars – cicatricial formations in places of increased alternating (stretching, compression) mechanical loads after secondary healed wounds (open fractures, infected or contaminated wounds) or split skin grafts, in which recurrent manifestations with infection occur without violating the integrity of soft tissues.They are distinguished by etiology (postoperative, post-traumatic, burns) and the level of growth of fibrous tissue from the skin surface. Scar classes: keloid, hypertrophic, normotrophic (normal), normo-atrophic, atrophic. Depending on the class of the scar, the methodology of treatment changes dramatically, and variations in the treatment of scars within each class are possible. It is believed that scarring is a 3-stage process that requires increased cell activity. Stage 1 lasts 2-3 months and is characterized by an increase in the volume of the scar.Stage 2 lasts 3-4 months, during which the volume of the scar decreases rapidly. Stage 3 lasts from several months to a year, and ends with the formation of a flat scar. The width of the scar is directly proportional to the volume of the scar tissue formed during stage 1 of its development.
Keloid scar is a dense convex formation with a stretched smooth (at the beginning red, then paler) surface. Its edges are uneven with characteristic outgrowths in the form of crab pincers, sticking out in different directions from the axis of the scar.Excessive scar tissue is called a keloid (from Greek: ???? – tumor and ????? – kind). A true keloid is also determined, which occurs without skin damage. Keloids do not cause pain. There are 4 types of keloid scars: star-shaped, cords, fan-shaped, array. Treatment of keloids is specific.
Hypertrophic scars are divided into 2 types: extensive and limited in area. They are somewhat smaller than keloid scars and normalize after a few years. With specialized treatment, normalization is much faster.
Normotrophic scars are flat formations almost indistinguishable from the surrounding skin. It is considered an excellent result if it became possible to transfer scars of other classes into normotrophic ones.
Normo-atrophic scars differ from others in that the collagen-depleted atrophic part is surrounded by annular normal scar tissue, which is absent in other classes of scars. It is generally recognized that the treatment of normo-atrophic scars is the most difficult task in cosmetology.The complexity of their treatment is aggravated by the fact that deep knowledge is required in several sciences at once, therefore, according to the rating of inventive problem solving and the classification of the level of dermatocosmetology problems, they belong to the 5 (highest) level of complexity. The class of normo-atrophic scars is extensive. Post-acne scars differ from postoperative scars mainly in shape (round in post-acne scars and linearly elongated or elliptical in postoperative scars), and post-traumatic scars can have a complex zigzag shape without axes of symmetry.They can be healed, albeit difficult. The most effective method is circular dermabrasion, developed at the Central Clinical Hospital of the SOCVD.
Unfortunately, until now, atrophic scars are not amenable to radical treatment. Among them are linear atrophies (striae distensae – striae), spotty atrophic dermatitis (anetodermia, dermatitis atrophicans maculosa – anetoderma) and Pasini – Pierini atrophodermia (atrophodermia Pasini – Pierini), in which atrophy of the epidermis and dermis is observed with the disappearance of elastin.
Treatment of skin scars is a multi-stage process that lasts a long time. it is required to restore the collagen structure of the skin.
90,000 indications, operation progress, recovery – Clinic of the Central Clinical Hospital of the Russian Academy of Sciences in Moscow
Neurolysis – an operation during which the nerve is freed from the tissues that compress it. These can be adhesions, scars, calluses. Neurolysis surgery helps restore nerve conduction, which for one reason or another has been disrupted.The main reason for the formation of obstructing tissues is trauma, inflammation. In this case, the process affects the surrounding elements, damaging the nerves, blood vessels, soft tissues. As a result, the formation of rigid fibrous scars that compress the nerves and prevent impulses from passing through the tissues normally.
Neurolysis of a nerve is aimed at its release and restoration of the impaired function of the limb. There is external and internal neurolysis:
- External is used when the scar has not penetrated deep into the nerve trunk.
- Internal is required when scar tissue grows between the nerve fibers that need to be released.
There are many options, depending on which nerve you need to work with. Peripheral nerve neurolysis is required after trauma, domestic or industrial injuries:
- Ulnar nerve area – problems in this area are common and cause serious problems for the patient.
- The area of the median nerve under the knee – strongly affects the sensitivity.
- Radial nerve area – elimination of the dangling hand problem.
- Peroneal nerve area – to eliminate paralysis that prevents the extension of the foot.
- Also, operations are performed in the areas of the facial nerve, recurrent laryngeal nerve, etc.
Execution of transaction
The operation is carried out in several stages:
- Introduction of anesthesia.
- Opening of connective tissue with a scalpel along the entire length of the nerve.
- Detection of fiber bundles, excision of the scar between them.
- Access to the nerve is open, it is isolated from the surrounding tissues.
- The scarring area is determined by palpation. The scar is found and removed.
- Excision can only be performed over the nerve, bypassing the lateral sides, to avoid damage to blood vessels and other structures.
- Miniature stitching.
- Placement of a nerve in the resulting muscle space.
- After these manipulations, the constriction disappears, the previously lost sensitivity appears.
Rehabilitation after neurolysis
Recovery after the intervention begins with the restoration of sensitivity and the cessation of painful sensations. This happens by relieving pressure on the nerve. All other functions are restored somewhat more slowly. The earlier the operation is performed, the easier rehabilitation will be. After the operation, gradually:
- The functionality of the nerve is improved or completely improved.
- Soreness disappears.
- The ability to feel is restored.
- Sweating is returning to normal.
Where to do it?
Neurolysis requires extreme care, deep knowledge, high qualifications and experience from a surgeon. Neurolysis can be done at the clinic of the Central Clinical Hospital of the Russian Academy of Sciences in Moscow. Experienced specialists carry out operations with a quality guarantee. To make an appointment with a surgeon, get a preliminary consultation, learn more about prices and terms of service, call the phone numbers listed on the website.
»Removal of scars and scars with a laser, laser resurfacing of scars and scars
Scars or scars are formations that remain after the healing of wounds, operations or burns. Scar tissue is mainly composed of collagen, so hair and sweat glands are not restored on it, it is highly sensitive to the effects of sunlight. The following types of scars (scars) are scientifically distinguished:
Atrophic or hypotrophic scars – scars, the tissue of which lies below the level of the surrounding healthy skin i.e.That is, a small depression is formed on the surface of the skin. This type of scars most often occurs after acne, chickenpox, or other skin conditions.
Normotrophic scars – scars that are located at the level of the surrounding healthy skin. Such scars are most often distinguished by a heterogeneous surface or tissue color.
Hypertrophic scars – Scars that form within the wound, but lie above the surrounding skin. This type of scar is most often formed with an extensive and deep area of skin damage.
Keloid scars – scars, which are a type of hypertrophic scar. They have a characteristic bumpy, dense profile that rises sharply above the level of healthy skin, often colored pink or bluish in color. A keloid scar in the first months after its formation is often accompanied by painful sensations and itching. This scar can be wider than its base and hang over the edges of the surrounding skin. Keloids are more likely to form in the neck, occiput, collarbone, sternum, shoulder blades and shoulder, and tend to relapse (exacerbation) after treatment.
The main causes of a hypertrophic or keloid scar are:
- Inadequate wound healing when the scar was re-traumatized;
- the location of the wound on the delicate areas of the skin of the shoulder, sternum, etc.;
- metabolic disorders – diabetes, atherosclerosis, hypovitaminosis, hypoproteinemia;
- individual skin characteristics in dark-haired and red-haired people;
- external ultraviolet, x-ray irradiation of the wound or its reinfection.
Methods for the treatment of scars and scars are divided into two groups:
Medication and cosmetology : they include injections of special decontamination preparations into the scar tissue, treatment of the scar with various ointments and creams, for collagen resorption, hormonal preparations or ozone therapy. All of these methods work only with a very small scar. The treatment is always very long, the positive outcome of which is not guaranteed. It is almost impossible to completely remove a scar or scar using cosmetological methods.
Surgical : The scar is either surgically excised or laser resurfaced. The surgical method is now used extremely rarely because is painful enough and cannot be applied to all types of scars. Removal of scars and scars with a laser is the most advanced treatment technology. The laser vaporizes the scar tissue layer by layer without damaging healthy skin. Grinding is carried out under precise control of the working depth, quickly, almost bloodless.
The following advantages of laser treatment of scars and scars are highlighted:
- Laser surgery allows you to completely get rid of scars and scars.
- laser scar removal is a completely non-contact method because keloid tissue is evaporated by a beam of light.
- laser can be used to remove and polish scars of any size.
- Treatment of a scar or scar can be done in a few clinic visits.
- with a point effect on the treated area with a laser beam, the wound is disinfected, which eliminates the possibility of re-inflammation.
- there are no side effects when removing a scar with a laser.
Is it painful to remove scars and scars with a laser?
The operation can be performed under local or even general anesthesia when a very large surface is being treated. With small scars, painful sensations during the operation are practically absent, except for a slight burning sensation from the laser beam.
Treatment time and number of procedures for complete scar removal:
With relatively small scars, the scar can be completely removed in 2 – 3 procedures, between which about a month should pass.During this period, the laser-treated surface is completely healed, which allows the surgeon to accurately determine the depth of the required treatment during the next laser resurfacing of the scar. Thus, complete scar removal takes 3 to 4 months. However, for very large or deep lesions, up to 8 to 10 treatments may be required.
Where to remove a scar with a laser in Moscow?
For the treatment of scars and scars in Moscow, we suggest you use the services of our specialized center for laser medicine clinic “K-MED” for the following reasons:
- The latest equipment : In our laser surgery center of the K-MED clinic, we use only the latest surgical or cosmetic lasers.Operations are carried out in a modern operating room that fully meets all approved standards.
- Experienced Doctors : Our center has been in existence for over 15 years. Our surgeons have vast practical experience in scar treatment and thousands of successful surgeries.
- Removal of scars and scars without pain : the operation, if desired, is carried out under local anesthesia, which is selected individually for each case.
- Transparency of work : before removal, the attending physician will fully tell you how the operation will proceed and discuss the price with you.
- Time savings : we value your time very much, therefore we will coordinate the appointment with you in advance so that you do not have to wait. On average, one scar removal procedure takes 20 to 30 minutes.
Get free detailed consultation by phone (495) 434-34-44 or (495) 670-20-28 from 8 am to 8 pm daily.
Our addresses : Moscow, Metro Yugo-Zapadnaya or Belyaevo / Konkovo, st. 26 Baku commissars, 6; Moscow, metro station “Proletarskaya” st.Talalikhina, 2/1, bldg. 5.
I did resurfacing in the clinic of the scar on the cheek after injury. In the summer, the scar looked very unaesthetic and was very different in color from tanned skin. It took three resurfacing to leave almost no trace. Now I’m waiting for summer to see how the place under the scar will differ on tanned skin. The surgeon said he would hardly be seen. Great impression!
Sergei (Moscow region, Naro-Fominsk, 2014)
I went to the clinic to have a scar on her hand reworked after a car accident.Scar about 5 cm on the inner surface of the arm. I couldn’t wear short sleeves in the summer as it looked terrible. For a long time I did not dare to start removing, but a friend advised me to do a laser resurfacing. Now, after three procedures, the scar is practically invisible. She refused anesthesia during the operation herself. It was unpleasant, but not terrible. Then everything passed quickly. After three weeks, the wound healed. I recommend the surgeon Mitish E.V.
Valentina (Moscow, 2013)
Last year she burned her hand.I was very careful with the burn, while the wound healed, but still there was a scar. I went to the clinic for a scar resurfacing with a laser. Made three operations between each of which was a month. The third time, the scar was not visible at all. I was very afraid that it would not work out, but everything turned out great. Thank you very much to the surgeon Mitish. E.V. I am very glad that everything worked out.
Alexandra (Moscow, 2014)
About 10 years ago he burned his hand when he was fixing the car on the collector, and then knocked out the sore.So the scar on my hand remained for all these years, until I decided to completely remove it. I did a burn scar resurfacing with a laser in the “Lama” clinic with the surgeon Elena Valerievna. I was very pleased with both the result and the clinic. The atmosphere is cozy, there are no queues, everything is by appointment. Convenient and inexpensive.
Leonid (Moscow, August 2013)
“After a difficult case of peritonitis, from which all the hospital doctors saved, I had three huge scars all over my stomach, which I really wanted to get rid of.I was looking for a clinic for a long time and accidentally found out about “Lama”. After consulting Yevgeniy Nikolayevich Burkun, he promised to help me and fulfilled his promise. A year after the operation, I can wear a swimsuit without hesitation, because my scars are practically invisible. I would also like to thank the staff of the clinic, who take great care of the patients, and recommend Lama.
Alexandra (Moscow, 2015)
“Ten years ago, a terrible event happened: glass from a broken window left noticeable scars on my face.It was very scary to decide on an operation – what if it gets worse? So I suffered for so many years … Maybe I still pulled it, if my friend, in the literal sense, had not led me by the hand to the “Lama” to Nikeshin Akim Yosifovich. He is not just a wonderful person, but a great specialist, like everyone else in this clinic. This is how I received a “new face” and help, which I had never even dreamed of. Thank you all. ”
Alena (Balashikha, 2015)
I want to express my gratitude to Doctor Burkun Evgeny Nikolaevich! I turned to him about laser resurfacing a scar on my leg.The doctor told me everything about the procedure and warned me that in my case it would take several sessions to make the scar completely invisible. In total, I had to do the resurfacing in three sessions, but each time it was short-lived and without discomfort. Now I am completely satisfied with the result, normal smooth skin at the site of the large scar.
Svetlana (Moscow 2017)
I had an old burn on my leg the size of a 5 ruble coin. I decided to remove it before the summer season.I chose the method for a long time and decided to do laser resurfacing at the Lama clinic. Honestly, I’m very happy. The clinic is very good, everything is clean. Friendly staff. How many was according to the price list, and so it happened. After two procedures, there was practically no trace left of the scar. I did it under local anesthesia. It didn’t hurt at all, and then it didn’t hurt very much. I recommend everyone not to hesitate, but to do the operation with a laser.
Victoria (Moscow, 2013)
Resurfed the scar on my arm that remained after the accident when I underwent surgery.For two years I thought that he would resolve itself, but it did not happen. Has brightened, but did not become less. Vidocq was so-so. The surgeon removed it with a laser at one time. It was not even worth waiting so long, but it was necessary to do it right away.
Alexander (Aprelevka, December 2013)
In the office in the kitchen, she poured hot soup on her leg as she pulled it out of the microwave. The burn was 10 centimeters square. For a long time it did not overgrow, and then there was a scar on the leg. So she removed it in the clinic. I did laser resurfacing of the scar under local anesthesia.It didn’t hurt. The leg became even, without bumps. It can still be seen that the skin is of a different color, but I hope that by the summer everything will pass. I liked the clinic. The attitude of the staff and doctors is very good. You can feel the positive atmosphere in the clinic.
Christina (Moscow, April 2014)
A year ago, I had an operation that left a scar on my stomach. It was especially noticeable in the summer, when all the rest of the skin was tanned. Before the summer season, I did laser resurfacing of the scar.I am very pleased with the result. All traces were completely gone a month after grinding. Hopefully the skin will tan evenly now too. I recommend doing such procedures not in beauty salons, but in clinics. There are professionals of a completely different level, and not just beauticians. I am very pleased with the lama.
Olga (Moscow, March 2014)
Face resurfacing from scars
Beautiful, clean and healthy skin is the object of dreams not only of women, but also of representatives of the strong half of humanity.But what about those with blemishes such as scars, scars or acne spots? Modern cosmetology offers many options […]
Laser resurfacing of scars
Skin imperfections, especially if these imperfections are present on the face, cause a lot of inconvenience to a person. For many, scars and scars on the skin are a real tragedy. They can occur after acne, acne, other diseases or injuries to the skin of the face. However, there is […]
90,000 Operations for adhesive disease in Genesis Dnepr.Surgical treatment of adhesions for infertility in Ukraine.
Operations for adhesive disease
When does adhesive disease occur?
Films or bands of connective tissue, which seem to “glue” the organs of the abdominal cavity together, causing changes in the anatomical location, are called adhesions. They arise as a result of a special response of a special insulating tissue shell, which starts the process of growing new connective tissue. Often, their formation is preceded by surgery.Also, among the causes of adhesive disease, autoimmune factors, infectious and inflammatory processes, chemical or mechanical effects can be distinguished. For surgical intervention, mainly the laparoscopic method is used.
Symptoms and diagnosis of adhesive disease
Since the formation of adhesions is characterized by the adhesion of connective tissue, as a result, it is possible to compress organs and disrupt their activity due to constrictions or twists, as well as complete or partial obstruction (for example, fallopian tubes or intestines).The main symptoms include pain, digestive disorders, infertility. Asymptomatic forms that do not interfere with the patient do not always require surgical intervention, however, the disease is insidious and can manifest itself in the most serious way, requiring immediate surgical intervention. Diagnosis of adhesions includes taking anamnesis, ultrasound diagnostics of the abdominal cavity, Doppler sonography and other methods. The tactics of further actions is determined by the attending physician.
Operations for adhesions
Despite the fact that the cause of adhesions in most cases are previous operations, they also have to resort to surgical intervention to remove them.Each clinical case requires a unique approach to treatment and there are no universal methods, however, the most commonly used is laparoscopic adgeolysis. With its help, the dissection of adhesions occurs without opening the abdominal cavity, subsequently leaving invisible scars, and minimal trauma is achieved. Only small punctures are required for the specially designed endoscope and two (maximum three) accessory tubes. For dissection of neoplasms of connective tissue, it is possible to use laser, electrical and aquadissection methods.The operation is performed under general anesthesia. Contraindication to the operation is significant damage to the abdominal cavity, peritonitis, or the presence of intestinal fistulas.