WHY WOUND CLEANING IS IMPORTANT?

It is common to see people suffer minor injuries on the road, playground and while doing their daily chores. These wounds usually get contaminated with dirt from the road surface and it is brushed off as a normal occurrence. 

Cleaning wounds is essential because:

1. To remove the dirt and debris impregnated within the layers of skin. Body heals by regenerating skin over its abraded surface and the dirt gets imprinted permanently as a tattoo which is difficult to remove after some time.

2. Cleaning brings forward the hidden cuts and lacerations which can be sutured and leave a better scar.

3. Leads to early healing, shorter hospital stay, lesser antibiotics, and Regular follow up ensures that the scars can be managed with the best possible results....

DR. ASHISH GUPTA

DIRECTOR DEPT. OF PLASTIC, MICROVASCULAR AND COSMETIC SURGERY,

DEEP HOSPITAL, LUDHIANA

Plastic Surgery Suturing Vs Suturing

 

Plastic Surgery Suturing Vs Suturing

What we use and why:

FINE SUTURES:                            To prevent train track scars

MULTILAYERED CLOSURE:       To prevent stretching of scar as it takes the tension                                                                                     off the skin sutures

EARLY REMOVAL:    To prevent suture marks to become permanent.

                                                        Normal duration in which we take off the stitches is 5-7 days.

ZERO TENSION CLOSURE:        Leads to early healing

                                                                                 "As they say, Stress is Bad"

AFTER CARE:                                 Massage, avoiding sun exposure, Regular Follow up

ORIENTATION OF SCARS IN SKIN LINES:    To camouflage in plain sight

QUALITY OF SCAR:              All this leads to a  better quality scar which is nay visible J

DR. ASHISH GUPTA

SENIOR PLASTIC SURGEON, LUDHIANA

WHY NOT STITCH (SUTURE) A CUT?

 WHY NOT STITCH (SUTURE) A CUT?

We witness and experience numerous injuries during our lifetime 

but the ones that leave us in a dilemma are the ones that our little 

angles get during their endless sessions of mischief. 

Then the Dharm-Sankat starts, whether to get the CUT stitched or 

NOT.

1.      NOT ALL CUTS NEED STITCHES (SUTURES)

Wounds that are not long, not gaping; not bleeding; not near joints; not on scalp, face, hands and feet can and shall heal without suturing. But the decision should be taken with the Plastic Surgeon’s opinion.

2.      DISSOLVING STITCHES (SUTURES) ALSO LEAVE SCARS

It’s the injury that leaves a scar. When the cuts are in the skin creases and are sutured by an expert the resulting scar is almost invisible. Use of Fine Sutures and their early removal hold more importance than Dissolving vs Removable Sutures.

3.      SCARS IN CHILDREN STRETCH WITH TIME

With the growth of the child the cells in the skin multiply but the scar stretches. It makes it more important to suture the wound so that there is minimal stretching over the years till child is 16 -18 years of age.

4.      STITCHED (SUTURED) CUTS SCAR BETTER THAN GLUE

An invisible scar depends on the accurate approximation of the cut ends of the skin which can best be achieved by Suturing. In selective cases where skin is not gaping; the wound is small and superficial; skin glues too give good results.

5.      AFTER CARE IS MOST IMPORTANT

Treatment does not end with removal of bandages, it Starts from there. Avoiding sun exposure, religiously massaging of the scar and regular follow up with your Plastic Surgeon gets you the best possible results.

Coming up next : THE GOOD, THE BAD, THE UGLY ABOUT SCARS

DR. ASHISH GUPTA

SENIOR CONSULTANT PLASTIC SURGEON

LUDHIANA

+91-977977-1111

DOCASHISH2001@GMAIL.COM

DOG BITE & THE PLASTIC SURGEON

 DOG BITE DEFORMITY AND THE PLASTIC SURGEON

Newspapers and our Neighborhood gossip are usually ripe with the incidents of mauling of kids by stray or pet dogs. The penetrating and crushing nature of these bites can lead to lifelong deformities. What to do in such an event and how we as Plastic Surgeons can help are often lost in the mayhem that follows.

Q. How are Dog Bites Different?

A. Dogs tend to shake their heads around during an attack. It causes tearing of skin, loss of soft tissue, and crushing damage to the surrounding skin.

 

                        At time of Injury     3 Months after repair

Q. How are Dog Bites more dangerous than normal cuts?

A. The Dog’s mouth is full of bacteria which enter deep in the wound with the teeth and cause damage to vital structures like nerves, tendons, blood vessels leading to deformity as well as BAD SCARRING.

 

Q. What are the common areas of Dog Bite?

A. Most common areas involved are face, lips, ears, nose, neck, hands and legs.

 

Q. What to do Immediately in case of Dog Bite?

1.       Wash the wounds with soap and water for 15 minutes by watch.

2.       Cover the wounds with a clean cloth or Gauze piece.

3.       Apply direct pressure over actively bleeding wounds.

4.       Elevate the part where Dog Bite has happened

5.       Report to the nearest hospital.

 

Q. Should the Dog Bite wounds be left open or Sutured?

A. To prevent infection and for regular monitoring daily dressings have to be done. In case the wounds involve vital areas like Face, Hands or Injury to blood vessels, nerves the wounds have to be surgically cleaned and then repaired.

 

Q. What to do for Scars of Dog Bite?

A. A lot can be done to reduce the scarring:

         Early and proper suturing of the wounds gives Best Results

        Medical Management by silicon gels, coconut oil massage with avoidance of sun exposure

        Microneedling, Microdermabrasion, CO2 Laser Ablation

        Scar Revision Surgery

    Loss of half lip                1 Year after Repair

        domestic Dog bite 

Q. What the complications of Dog Bite?

A. The common complications of Dog Bite are;

a)      Infection

b)      Damage to important structures

c)       Deformity: Functional and Cosmetic

Q. Why go to A Plastic Surgeon?

A. A plastic surgeon is specialty trained to take care of wounds, which means being able to properly debride a wound free of dead tissue and foreign bodies, which would inhibit healing and cause infection. Although an important goal is to reduce deformity from the injury, the primary goal in treating dog bites is to prevent infection and promote good healing functionally and cosmetically.

DR ASHISH GUPTA

Senior Consultant Plastic Surgeon

Ludhiana

9779771111

docashish2001@gmail.com

Insta: docashish2001

SCARS NEED A SUPERSPECIALIST’S TOUCH

SCARS NEED A 

SUPERSPECIALIST’S TOUCH

WHAT IS A SCAR?

A scar is the fibrous tissue (thick, firm, red) laid down by the body as a natural process of biological healing at any site that sustains injury.

IS SCAR FORMATION PREVENTABLE?

The following factors determine scar formation: Size and depth of the wound; Location of the injury on the body; Blood supply to the area; Age of the person; Thickness, type and colour of the person's skin; Direction of the scar & Duration of the wound. Some of these factors can be modified to reduce scar formation.

CAN SCARS BE COMPLETELY REMOVED?

“Once A Scar, Always A Scar. We Can Improve The Quality Of The Scar.” A skilled PLASTIC SURGEON can definitely improve the appearance of the scar by disguising it, relocating it, or minimizing its prominence, by surgical and non-surgical means.

ARE THERE ANY TYPES OF SCARS?

Scars can be good scars or bad scars but scientifically they are classified into various type: Keloids, Hypertrophic scar, Hypo or Hyper-pigmented scar, Pitted/ depressed acne scars, Stretch marks (striae).

HOW DO I ENSURE THAT I GET A GOOD SCAR?

Follow the instructions given by your PLASTIC SURGEON properly and for the entire duration as directed. Regular follow up visits are necessary to assess the response of the body towards the treatment and if any change is required can be instituted at the earliest.

WHAT ARE THE NON- SURGICAL OPTIONS FOR IMPROVING MY SCAR?

Pressure garments and silicone gel/sheet (medical grade as advised by the PLASTIC SURGEON) has been the mainstay in the treatment of scars. Other options are: Chemical peels (by the Skin Specialist); Fractional Lasers or Nd:YAG laser therapy  (by the Plastic Surgeon); Intra-lesional injection of Steroids (by the Plastic Surgeon); Fillers

WHAT ARE THE SURGICAL OPTIONS?

The type of surgery may range from a simple dermabrasion (surgical peeling of outer layer of skin); micro-dermabrasion (does not require anaesthesia); Z- Plasty; scar excision; serial excision; scar revision; skin grafting or tissue expansion (in large scars).

IS SCAR SURGERY A MAJOR SURGERY?

Usually Scar revision surgeries for small scars can be done under local anaesthesia which do not require admission. Some larger scars or scars in sensitive areas like near the eyes, nose etc may require general anaesthesia and a day care admission in which the patient is sent home in the evening. Complex scars may constitute a major surgery and require admission for more than a day.

WILL INSURANCE COVER MY EXPENCES FOR SCAR SURGERY?

If the scars are causing functional problems like contractures, limiting ones daily activity, or hindering ones social interactions; such scar revisions are likely to be covered under the Insurance act. But a prior approval from the company is helpful. Cosmetic surgery is not covered under the gamut of health insurance.

HOW LONG AFTER THE SURGERY WILL MY SCAR LOOK BETTER?

The biological process of healing in a scar usually subsides by 6-9 months. It is by that time the final results can be commented upon.

DO HOME REMEDIES HELP?

People have tried lemon juice, shea butter, cocoa butter, honey, sun exposure for scar reduction but with inconsistent results. But application of Vit E, Aloe Vera creams, massage and avoiding sun exposure do facilitate better scarring.

DR. ASHISH GUPTA

ASSOCIATE CONSULTANT

S.P.S. APOLLO HOSPITALS, LUDHIANA