The incision, whether it is in the neck, hip or lower back is closed typically with sutures that are placed under the skin and won’t been seen. This is called a subcuticular closure. These sutures will dissolve by themselves in about 6 weeks and the skin incision will be healed long before then. You will find steri-strips over the incision. These are just sticky band-aids that hold the incision together better to make the incision more cosmetic over the long run.
The dressing over the incision that is on before you go home is called the op-site. It is essentially sticky saran wrap with gauze in the center that prevents the incision from getting wet. You may shower whenever you need to as long as the op-site is on. No soaking the surgical site for 2 weeks. That is a bath tub, Jacuzzi, pool or ocean.
Every 3 days, change the op-site and look at the incision. Make sure it is not significantly hot, red or swollen. If you notice any of the above, please call the office to discuss this with one on the nurses. When you reapply the op-site to the incision, try not to get the sticky part on the steri-strips as the next time you remove the dressing, you may also remove the steri-strips. This is not the end of the world but try to leave the steri-strips on until they fall off by themselves.
Bruising around the skin of the incision (purple or greenish-yellow discolored skin) is not abnormal. If a graft was taken from the pelvis, the bruising can appear all the way down to the inner thigh. If from the lumbar spine, bruising can go all the way down the buttocks. If the cervical spine, the bruising can go down to the collar bones.
Many back incisions can develop a seroma- a small collection of fluid under the skin. It is not dangerous. If you have significant headaches with this seroma however, call the office. There are rare occasions that a dural leak can occur and this needs to be treated.
Occasionally, an incision can drain on its own if the seroma builds up. Even without a seroma, the incision can heal slowly and drain small amounts of fluid. The sutures absorb through a process of inflammation. Rarely, these can work up to the skin and develop a granuloma. Call us if this is the case and we may put you on antibiotics to prevent any secondary infections.
Do not let the healed incision get sunburned for 6 months. If you do get a sunburn in this period of time, the incision can turn dark from pigmentation. Cover it with a band-aid or SPF 45 when outside in the sun to prevent this.
There are some products you can put on a healing incision to theoretically reduce scar formation. There is not much data yet on these treatments but some dermatologists recommend them. One is called Biafine cream. Some patients will put on Vitamin E oil and others will use a silicone sheet to reduce scarring. Please check with your dermatologist before you use these substances and no matter what, do not use anything in the first 2 weeks!