Treating the scars of heart surgery
September 8, 1999
Web posted at: 1:55 PM EDT (1755 GMT)
By Sharon Lim
When Gloria Thompson arrived at the hospital three years ago complaining of shortness of breath, the last thing on her mind was the scar that would result from her quadruple coronary-bypass surgery. A year later, however, the 10-inch scar down the center of her chest is still very evident and prevents her from buying dresses and shirts that allow the scar to peep through.
According to the American Heart Association, 759,000 open-heart surgeries are performed every year in the country. However, the scars left by the incision are not often discussed. Many people learn to deal with them over time, although some remain self-conscious and have trouble coping with these permanent reminders of their operations.
A heart-surgery incision is a 7-inch to 10-inch vertical cut down the middle of the chest, which extends along the length of the breastbone, says Dr. Niloo Edwards, director of heart transplants at the New York Presbyterian Hospital. This allows surgeons to open the ribcage and expose the heart.
Edwards added that pain from the incision is typically not severe, although patients may feel discomfort in the form of numbness, deep itchiness, tightness or burning. The long-term discomfort is minimal, although the area will be prone to numbness. Scars vary in size and appearance, depending on how the patient heals.
New body image
Because open-heart surgery is a lifesaving procedure, many patients are not immediately concerned with the scars. But when the immediate rehabilitation process has passed, patients tend to be more aware of the scars and may have trouble dealing with them. This was the case with Thompson.
"I get very depressed after I go shopping," Thompson says. "I no longer buy dresses that I normally would because the scar shows at the top of my chest. I haven't gone swimming since the operation three years ago, because I'm very self-conscious of being stared at."
In these situations, counseling or support groups may be appropriate, says Martha Russell, a clinical social worker who counsels persons undergoing heart or lung transplants at the Stanford University Medical Center. Counselors are available at most hospitals where heart surgeries are performed and may be seen before and after surgery.
Counseling can help
Support groups, such as the Dallas-based Mended Hearts, can assist in the recovery of post-heart-surgery patients. The groups provide those with heart disease and their families lectures and forums where their concerns can be discussed, says Darla Bonham, executive director of the national organization.
Treating the scar itself is another option, says Dr. Ken Gross, a dermatological surgeon at the University of California at San Diego Medical Center. Some doctors recommend a silicone-gel sheeting in the days after surgery to help the surgery wound heal faster. Scars that become thicker or develop bumps require more aggressive treatment, such as laser surgery or cryosurgery.
Some surgery patients use an over-the-counter cosmetic concealer, which can camouflage scars and the discoloration they cause.
The concealer Dermablend was specifically developed to cover up post-surgical discoloration and scars and will stay on the skin longer than conventional concealers, according to Pat Neglia, vice president of marketing for Crescent Products, Inc., the Richfield, New Jersey-based company that makes Dermablend.
Additionally, researchers at Tulane University Hospital and Clinic in New Orleans are developing surgical procedures that will cause less scarring. One of the procedures involves using incisions that are smaller than those conventionally used.
Badge of honor
Every patient's experience is unique, and emotional responses will vary, Russell says. Some wear their scars as badges of honor to display the second chance they've been given at life. Others grow to accept and feel comfortable with their scars, while some, particularly younger patients, find it difficult to get used to the changes to their bodies.
"I encourage patients to speak with others who are further along in their recoveries," says Russell. "It gives them an idea of how others deal with their experiences and ultimately makes them feel like they are not alone."
Copyright 1999 WebMD, Inc. All rights reserved.
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