You know the old adage about things that arrive in threes? Well, here’s another: Two clients this week opted out of much-needed lumpectomy surgery due to the possibility of scarring. Meanwhile, a questioner on PetMD requested information on how to inhibit scar formation when stitches happen.
In case you’re wondering, this isn’t as common an issue in pets as you might think. Sure, we’ll sometimes concede to a cosmetic delay ‘till after a big show. And even reasonable people will pout over a post-op imperfection. But not often will the issue of scar formation arise as a stumbling block when it comes to a medically indicated procedure. Not when the alternative to a scar is either an unsightly lump or a potentially catastrophic cancer.
But then, everyone’s different, right?
Still, there’s one thing we can all agree on and it’s that a scar is not our friend, no matter the species. If at all possible, pretty and pristine is better, says most everyone in this culture. Though a scar can be a badge of honor, minimizing it only makes sense.
So what’s a veterinarian to do when faced with an owner intent on denying a needed procedure based on the inevitability of a scar?
For my part I offer the following advice:
1) Always use an e-collar and/or other methods of avoidance after surgery. Restrain and/or contain pets to limit incision-stretching, suture-popping movement. Self-trauma with its need for re-suturing and the eventuality of delayed healing is the number-one reason for large, ragged scars.
2) If a scar is an especially big deal for you, inform your veterinarian of this. There are some extra measures we can always take to reduce the size of a scar: Smaller gauge suture material, subcutaneous sutures, etc.
3) Keep close tabs on the suture line to ensure there’s no obvious evidence of infection as indicated by swelling, redness or any other discoloration. Infection will always increase the chances of more visible scarring.
4) Apply Vaseline or Aquaphor (my favorite petroleum-based product) to help keep the skin soft as it heals, to reduce scabbing and to make stitches come out cleaner. Bacitracin or neosporine can be OK, too, but I tend not to use the antibiotics unless I have to.
5) Some dogs are more likely to scar. These are sometimes the lighter-colored dogs who have a tendency to recruit pigment in the course of healing. Short- and spiky-haired breeds are also especially prone, if only because their scars will always be more exposed (Rhodesian ridgebacks, pit bulls, weimeraners, viszlas, boxers, etc.). Greater attention to the above points is recommended in these cases.
Scars may be unavoidable but that doesn't mean you can't preempt a more pronounced appearance. But even if you do get big lesions post-op, keep in mind that much though scars may seem unsightly to you, our pets will never care.