Any break in the skin will heal by the formation of a scar tissue. Even cosmetic surgery wounds heal by scarring, and the trick is to hide the scars. But we can’t trick nature, and healing is not predictable – everyone heals differently.
The healing process has 2 stages: closure of the wound followed by strengthening of the wound. The wound closes over in several days, and that is good, but the slightest bump and it may reopen. This is where wound strengthening comes in, and it continues for months. During strengthening, scar tissue below the skin is constantly remodelling, changing the appearance of the wound. Hopefully this works in our favour.
If you could imagine the door frame in your house: you order a door but before fitting, the door frame has changed. This is exactly what can happen during the strengthening phase of wound healing. When it adversely affects the desired result, wound revision surgery is needed.
The aim of wound revision is to make the wound look as close to invisible as possible with the naked eye, and to restore any impairment of function. Wound revision simply means “redoing the wound” – sometimes part of it, sometimes all of it, sometimes the surface, and sometimes the deep layers. It is very individual and depends on your wound healing.
Options include surgical revision of different layers of the wound with stitches, debridement, dermabrasion and radiofrequency ablation. The procedures are carried out in the office under local anaesthesia and a dressing is applied. Topical creams are applied and in the ensuring weeks, wound management initiated to control the wound healing response.