There has been a steady increase in the number of facial soft tissue injuries seen in the past year. Perhaps it is due to us being stuck in Singapore trying to avoid crowding around each other. Outdoor activities such as jogging and cycling have increased. Many of us are doing these activities for the first time.
Shallow scrapes and little bumps can be left alone to resolve on their own. In general, keeping the wound clean and allowing nature to heal these wounds is sufficient. Here are some of the questions that I am asked by patients when I attend to them.
Q: When can we use tissue glue or tapes to close a wound ?
A: Tissue glue and tapes are best used over relatively immobile non hair bearing areas of the face. The wounds should not be gaping too much. I have used these in younger children who cannot tolerate injections and where the preference is to avoid sedation and general anesthesia. The eyebrow and areas around the mouth are usually difficult to treat with tissue glue and tapes.
Q: When should a Plastic Surgeon be called in to treat the wound?
A: It is a common fallacy that the emergency room doctor doesn’t do stitching of wounds. There are well trained and experienced ER doctors who suture wounds beautifully. It would be reasonable to refer to a Plastic Surgeon when:
-the injury is in a complex region like the nose, lips, eyebrow and eyelids. In these areas, repairs need to be done in multiple layers and matching of junctions is very important.
-there is possibility of damage to an underlying structure like a nerve, blood vessel or duct
-the wound is jagged or curved in nature and needs trimming. An example of this would be an animal bite.
Q: Should I go for follow up after I am stitched up ?
A: The initial treatment of the wound is only the start of the healing process. If suturing is done well, primary healing occurs in the wound and the recovery of the wound is as rapid and scar free as possible. Even so, it still takes 3 months for a wound to achieve full mechanical strength. In contrast, poor stitching and poor matching causes secondary healing with more scar formation. The Plastic Surgeon will follow up and advise scar therapies to minimize this. So please allow us to follow you up.