Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Wound infection: If signs of infection begin, such as redness, increasing pain, swelling, and fever, contact
a doctor immediately.
Wound reopening: If sutures are removed too early, or if excessive force is applied to the wound area, the wound can reopen. The doctor may restitch the wound or allow the wound to close by itself naturally to lessen the chances of infection.
Excessive scarring: All wounds will form a scar, and it will take months for a scar to completely contract and remodel to its permanent form. However, scarring may be excessive when sutures are not removed promptly or left in place for a prolonged period of time. This may result in a scar with the appearance of a "railroad track."
Keloid formation: A keloid is a large, firm mass of scarlike tissue. This scarring extends beyond the original wound and tends to be darker than the normal skin. Keloids are common in wounds over the ears, waist, arms, elbows, shoulders, and especially the chest.
Keloids occur when the body overreacts when forming a scar. They are common in African Americans and in anyone with a history of producing keloids. People with a tendency to form keloids should be closely monitored by the doctor. Injection of anti-inflammatory agents may decrease keloid formation. Also, large keloids can be removed, and a graft can be used to close the wound.
Bulky scars can remain within the boundaries of the original wound. These
occur mostly around joints. Hypertrophic scars tend to develop a peak size and
then get smaller over months to years. Keloids, on the other hand, rarely go
away. For people with hypertrophic scars, a firm pressure dressing may aid in preventing them from forming.