The Stitch Matters!

Last updated: October 2022

I have had five surgeries for BCCs, seven other surgeries, and several other injuries that required stitches. I also have a tendency to keloid scarring and serious allergies to most adhesives, especially serious over areas of thin skin. So, I have lots of experience (too much!) with how my surgical wounds heal.

Types of stitches that work well

There are a few conclusions I can make about what works well for me, and what doesn't. First of all, interrupted stitches tend to work better than continuous stitching at reducing the size and thickness of the scars. Micro-stitches are always better, as are very close stitch intervals. Whenever applicable, internal dissolving purse-string stitches work best to reduce the height and thickness of surface scarring. And cyanoacrylate glue works much better than Steri-Strips or other adhesive bandages.

My preferences for adhesives

When adhesives must be used, Tegaderm or equivalent is better than all others I have experienced (less inflammation and less irritation). But even Tegaderm (and Steri-strips) are only tolerable for a few days - at most - so tight surgical closure that doesn't require long adhesive bandage covering is a must (gauze or Telfa pads held in place by Coban or equivalent wrapping works well, whenever applicable). On broad areas, such as my chest, gauze/Telfa pads held lightly in place with small pieces of J&J paper tape, changed daily with rotating the location of the tape, keeps the allergic inflammation to a tolerable minimum. Oral diphenhydramine (Benadryl) antihistamine, @ 25mg, QID, also helps.

Takeaways for post-skin cancer surgery stitches

When keloiding does occur, micro-injections of steroids into the scar significantly shrink the height and thickness, and relieves itching. Several courses of the steroid injections may be necessary for good relief. Don't hesitate to ask your dermatologist for this help.

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