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pre-surgical and post-surgical rules for preventing your chances of developing scar tissue, fibrosis, adhesions, and chronic pain

Having a Surgery? Go into it as Uninflamed as Possible

Preventing Surgical Scar Tissue

On occasion I take a “can-you-help-me-with-this-particular-problem” email, and turn it into a CASE STUDY so that everyone can benefit. This latest edition comes to you from Josh B in response to a popular post I wrote called POST-SURGICAL ADHESIONS: ABDOMINAL WALL -VS- ABDOMINAL CAVITY.  Be aware that the information provided in this post is not meant to diagnose, treat, or cure any disease or health-related issue, and is provided only as general recommendations that could prove helpful for almost anyone who is thinking about having a surgery.

Hi….I was in a automobile accident in 1998. I was ejected from the vehicle and spent some time in the hospital since I had internal injuries, serious, near fatal injuries. The doctors needed to do emergency surgery right away on my abdominal wall. They cut me from the middle of my chest all the way down to the happy trail…or just below my waistline. I have no belly button and the scar is very significant.  Every now and again I’ve had abscesses form and rupture from the scar tissue, which are now on the verge of never healing. This requires daily dressing and salve to keep it flexible and able to adapt with my age and size.

What would you recommend as all the things you’ve explained have already been told to me by every doctor or plastic surgeon I’ve seen. It will tear every now and again and I’m used to the pain and discomfort. I just want to kind of shrink it or make it more pliable for me. Any suggestions or comments will greatly be taken in to consideration. Thank you.

The first thing I want people to grasp is that just because this problem is now two decades old does not mean that it is impossible that it could ever be improved for a post-surgical condition (or for that matter, any condition). The second thing I want to state before I begin is that this is not much information to go on (I don’t even know basics like Josh’s age or weight). 

If these are actually abscesses, it indicates that Josh has probably been on boatloads of ANTIBIOTICS.  And because the majority of the immune system is made up of bacteria (HERE), a great number of which are continually being killed off by said antibiotics, it is leaving those in similar situations susceptible to whole host of common problems (see links). 

Furthermore, a bit of research on abscesses shows that they are rarely solved (at least for the long term) with antibiotics alone.  The abscess must be opened up and debrided — problematic if it is happening over and over again in the same area as this will itself create scar tissue and fibrosis.  Here is the cherry-picked version of what WebMD says about abscesses.

When our normal skin barrier is broken, even from minor trauma, or small tears, or inflammation, bacteria can enter the skin. An abscess can form as your body’s defenses try to kill these germs with your inflammatory response (white blood cells = pus). Obstruction… can also trigger an abscess. The middle of the abscess liquefies and contains dead cells, bacteria, and other debris. This area begins to grow, creating tension under the skin and further inflammation of the surrounding tissues. Pressure and inflammation cause the pain.  People with weakened immune systems get certain abscesses more often because the body has a decreased ability to ward off infections.

One of the risk factors listed for developing abscesses is TRAUMA.  Another is DIABETES.  I have no idea whether or not Josh is diabetic or OVERWEIGHT (both of which are considered to be inflammatory problems — HERE), but the fact that he said something about his size would lead me to believe that it is a possibility.  Bottom line; although there are supplements that might be of benefit (proteolytic enzymes such as serrapeptase comes immediately to mind), MONOTHERAPIES are rarely the answer to anything, whether natural or PHARMACEUTICAL

The first steps anyone in a similar situation must take are to get to a normal weight, and make sure you are not feeding this infection / inflammation (just remember that sugar feeds both of these beasts — HERE and HERE — with infection being an extremely scary and common sequelae of surgical procedures).

What’s key here is to realize that FIBROSIS (another name for SCAR TISSUE), for whatever reason it forms, has a known cause — INFLAMMATION.  Although this is normal physiology; when the system goes haywire, it can cause severe problems (HERE, HERE, HERE, and HERE).  This means that without addressing underlying inflammation that may be present (SYSTEMIC INFLAMMATION much more so than local inflammation), it will be next to impossible to successfully deal with this problem. 

And how do I suggest people go about addressing systemic inflammation?  Although there are any number of methods, it all depends on what’s going on and how severe the problem is (inflammation has an almost unlimited number of potential drivers).   And it can’t be accomplished with medication(s).

Bottom line; when it comes to surgery, you want to go into it as uninflamed as is humanly possible — a lesson that is constantly driven home to me by the incredible numbers of emails I get from people struggling with POST-SURGICAL ISSUES (and yes; many are the result of COSMETIC SURGERIES gone awry (and yes, I realize that Josh’s surgical situation was not “elective”). 

How would I go about getting my body out of an inflamed state?  Although there are an almost infinite number of things that could easily be added to THIS POST, because it’s based largely on foundational principles such as eating an ANTI-INFLAMMATORY DIET, it’s a pretty good place to start — especially if you are contemplating an elective surgery.  Just remember; chronic pain — especially in the form of CENTRAL SENSITIZATION — is a bummer.

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