Sensitive Incision Scars

[SusieSW]

I had Bilateral TKR October 23rd, and found this forum shortly after that. It has been so helpful - and reassuring that what i have experienced is very similar to what others have gone through. I have two questions. First, my scars have become very large and sensitive. The doctor said they are more "reactive" than some and advised me to rub Vit E into the scars. I have found that I have to first deal with the pain of the skin stretching over the knees before I can go on to the pain of the exercises themselves. Clothing hurts. Have others had this? Any suggestions?

Second question - I have been postponing returning to work because my stamina seems so limited. When I am more active, I get cramps in my calves, more stiff and sore, and exhausted. I am in PT twice a week and diligent about exercise at home. Suggestions?

Thank you for this wonderful forum!

 

[Josephine]

Hi Susie - glad you have found this forum helpful.

As for your questions, it is not uncommon for scars to get sensitive or be abnormal. Does your scar look anything like this? I'm not talking of the bulging, just the reddy-brown colour and the texture.



This is what is known as a keloid-type scar. I have seen a few people whose TKR incision sites look like this. Some are ok but some are very sensitive.

Massage with creams is the only thing that will produce any change. Could take a while, though.

Other than that, I suggest that you get some rolls of hypoallergenic clinical tape and put a couple of strips along the scar when you want to go out wearing trousers or tights. It might work, it might not! but my hope is that it will stop the material rubbing on the scar.

As for returning to work - you do realise that you are only 10 weeks post-op? That is awful soon to be going back to work IMO. Another 2-4 weeks will make all the difference. You have had a very major op and that takes a lot of time to recover from.

It intrigues me how people think that so long as the scar is healed that must mean everything else is pretty much healed as well! Wrong! The healing of soft tissues like muscle and ligament are getting there but the deep healing of the bone takes many weeks. A fracture, for example, takes around 14-18 weeks to be well united. And all that healing draws from your general body strength and stamina. Little wonder then, that people feel drained for some weeks after major surgery.

I would postpone your return to work a couple of weeks and give your body time to catch up.

 

[Bev55]

Although my wound looks quite healed, some days it feels more sensitive than others. On the sensitive days it feels irritated by clothes brushing over it. I never thought to query it till this issue was raised. Is this a common reaction - even weeks along the line?

 

[Josephine]

Common enough, I'd say. But not inevitable. It is, after all, a deep, deep scar and took a lot of punishment during the op. I would expect it to complain for some while after, with or without the keloiding.

 

[SusieSW]

Josephine - Thank you for your quick response. Yes! What you picture is very similar to what my scars have turned into. Mine aren't quite as severe as in the picture, but the color and texture and even to a lesser extent the bulging are all similar. I'm 55 and I've never had keloids develop in response to injury or any medical procedure - is this so different that it would trigger this response for the first time?

My surgeon's nurse suggested massaging with Vitamin E cream. My doctor suggested Capsaicin. What I've read about both is not encouraging. The Vitamin E may not be all that effective according to some studies. Capsaicin is derived from red pepper, causes a burning sensation, shouldn't be applied to broken skin, and should be put on with latex gloves. I don't see how that will be tolerable on already sensitive, sometimes painful, scars. Any comment on either of these options? Is it really the massaging and softening effects that are supposed to help somewhat over time?

 

[grace]

I am 10 weeks post rt. knee replacement. I am 56 yrs. old. My incision scar is so painful. I wonder if maybe there may be scar tissue on the inside of the incision?
Also, I thought I would just have no problem at all with the surgery. It was a nightmare (the pain, slow improvement, depression). This was the most difficult time of my life. The knee works fantastic, but the pain is much worse than before surgery and I have such a difficult time sleeping. I wish I had waited. All I heard prior to surgery was how wonderful I would feel after the new knee.Also when I do manage to sleep I wake up with night sweats/chills. The surgeon could offer no explanation and was rather nonchalant regarding the pain. I did not have the continuous motion machine at home nor was it offered. I think that would have helped. I did about 10 sessions of PT and exercised at home on my own. My range on day 1 of PT was 107 degrees. My pain was a 9.I also feel that 3 days in the hospital is not enough.I know I will slowly improve. I wish I had done more research on this highly invasive surgery. The best to all of you. My surgeon told me on my last visit that recovery takes about a year. That was the first I'd heard about that.....

 

[Josephine]

Josephine - Thank you for your quick response. Yes! What you picture is very similar to what my scars have turned into. Mine aren't quite as severe as in the picture, but the color and texture and even to a lesser extent the bulging are all similar. I'm 55 and I've never had keloids develop in response to injury or any medical procedure - is this so different that it would trigger this response for the first time?

That's the thing about keloids. NO-ONE knows why they happen. My sister had two knees done. One is perfectly fine but the other has turned keloid! Most odd. All we do know is that they are very common problem in the skin types of African people.

 

[Josephine]

I am 10 weeks post rt. knee replacement. I am 56 yrs. old. My incision scar is so painful. I wonder if maybe there may be scar tissue on the inside of the incision?

Scar tissue isn't an abnormality, Grace. It's the very normal consequence of cutting tissue. Where it joins back together there will be a cellular structure that is quite different to the normal tissues in that area. Therefore, where ever you have an incision, or a laceration, you will get a line of scar tissue form. At first it will be thick but as time passes, it will get less and less until only a thin wall of it remains. But it will always be there - all the way through where the surgeon's knife went. Only bone does not produce scar tissue in response to injury or surgery.

And sometimes, like in your case, the scar can be very sensitive.

Also, I thought I would just have no problem at all with the surgery. It was a nightmare (the pain, slow improvement, depression). This was the most difficult time of my life. The knee works fantastic, but the pain is much worse than before surgery and I have such a difficult time sleeping. I wish I had waited. All I heard prior to surgery was how wonderful I would feel after the new knee. Also when I do manage to sleep I wake up with night sweats/chills. The surgeon could offer no explanation and was rather nonchalant regarding the pain. I did not have the continuous motion machine at home nor was it offered. I think that would have helped. I did about 10 sessions of PT and exercised at home on my own. My range on day 1 of PT was 107 degrees. My pain was a 9.I also feel that 3 days in the hospital is not enough.I know I will slowly improve. I wish

10 weeks is still VERY early, Grace. You are expecting too much. Sometimes rehab can seem to take forever but don't be discouraged. Sounds to me like you're doing just fine!

I had done more research on this highly invasive surgery. The best to all of you. My surgeon told me on my last visit that recovery takes about a year. That was the first I'd heard about that.....

I think someone should have shared that little gem of wisdom with you!




(Grace, sweetie - all surgery is, by definition, highly invasive!)