Care of the incision

For paediatric patients, incisions usually heal very nicely into thin white lines over time. Everyone heals differently and over time, scars can stretch. Professor Winlaw makes the smallest incision to allow safe access for surgery.

You will receive instructions whilst in hospital about how to look after the incision.

For children with sternotomy incisions:

The sternum (or ‘breastbone’) is closed with thin stainless steel wire. This keeps the edges of the sternum together until it has healed completely, which is usually around six weeks. During this time, it is best not to pick children up under the arms, instead ‘scoop’ them up under the bottom to avoid putting stress on the healing sternum.

The skin is closed with an absorbable suture and the incision is usually covered until the day of discharge to prevent contamination. At this point the skin will be nicely healed over, the nursing staff will wipe away small bits of dried blood and the incision can be left open.

The principles after that time are keeping the healing incision dry, and avoiding tension on the incision.
Briefly wetting the incision to keep clean should be done but it is not good to soak the incision as it can get macerated. It should be kept mostly dry for two weeks after discharge at which point Professor Winlaw will review the incision.

Healing of the incision goes through a few phases, where the line of incision can be quite dark, before fading. After it has started fading, it is good to use some moisturizer applied in the line of the wound to avoid stretching it. Sorbolene with Vitamin E is sufficient. Other products are available and applied sparingly twice a day for two weeks is suggested.

Avoiding direct strong sunlight to avoid sunburn is advised for 3 months after the operation.

Activity:

Between discharge and the post operative appointment with Professor Winlaw, children should avoid strenuous activity and being ‘bumped’. Between 2 and 6 weeks after Hospital discharge, light activities including walking are fine but trampolining and contact sports should be avoided. Normal activities can resume from 6 weeks after Hospital discharge. If you have any questions, please contact the office.

What to look out for:

The main concern is the possibility of infection. This is uncommon but may become serious so it is important to seek medical advice if you observe redness, swelling or pus. An increase in pain associated with the incision, temperatures or being generally unwell are also important signs. If your child has any of these, please take them to either your local doctor or return to the Hospital to be assessed.

Please also let Professor Winlaw know if there is a problem as certain patients are at higher risk of problems, and a discussion with local carers and/or return to Rooms or Hospital for review may be necessary.

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