Looking after your wound begins immediately after surgery and continues for a period of at least 3 months.
Swelling must at all-times be kept to a minimum. This is especially important in the first two weeks. This can be done by means of regular ice pack application as well as elevation of the affected limb. If swelling persists, then the swollen skin edges will pull on the stitches which will constrict and prevent a good blood flow which limits oxygenation and healing.
Another factor which limits blood flow is smoking. Smoking is absolutely not allowed. There are many surgeons who refuse to operate on peripheral areas such as the feet because the wounds do not heal. Smoking also interferes with the healing of bone and may in fact cause fractures not to unite.
Blood flow and oxygenation is the secret to quick and uncomplicated wound healing. This is another reason why diabetic patients may have wound healing problems with increased rates of infection. This is because uncontrolled diabetes results in closure of the small capillary blood vessels responsible for carrying oxygenated blood to individual cells.
In order for wounds to unite the body as to produce a tremendous amount of new proteins which are used as building blocks to repair all damaged tissue. In order to produce these proteins we require extra energy and basic building materials. I recommend that all patients take Vit C and B-complex and increase their protein intake for the first month following surgery.
When stitching my wounds I do not use staples for external sutures except for very specific circumstances. In most cases the stitches are beneath the skin and absorbable. All my wounds will also have special skin tape (proxy strips) applied, which should help keep the tension off the actual wound and promote minimal scar formation. Dressings applied to the wound are all waterproof enough to allow showering only. Most wounds require dressings for up to two weeks. There after I recommend that one uses 24 mm wide Micropore or paper tape over the wound lengthwise, and this should be applied and changed every 2nd or 3rd day. One may bath or shower with the tape on. Just dry well afterward as per usual. A topical cream may be applied directly onto the tape and massaged onto the wound 3 x a day, and this will promote good healing and a less painful and swollen scar. We use Dermastine -A for this purpose for 1 month followed by removal of the tape and using a silicone gel ( Kelo-Cote) on the wound applied twice daily for 3 months.
While the wound is healing it is recommended that you minimize sun exposure to the wound which may cause permanent pigmentation.