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Monday Myths: Getting an Incision Wet

August 9th, 2010

Monday Myths: Getting a surgical wound wet is bad

Washing an incision after surgery is not bad.  It is important that only clean running water (showers only) and soap are used.   Baths must be avoided, as sitting in the water can contaminate it and lead to bacterial contamination.  The same is true for washing dishes when there is an incision on the hand, as there can be considerable oral bacteria contamination on eating utensils.

I believe that gently washing incisions in the shower within 24 hours after surgery does two things.  First, it reduces the normal bacterial growth on the skin around the incision.  Secondly, the normal debris and blood that can contaminate the surrounding skin following surgery are very easily washed away in the shower, significantly eliminating risk of infection.  Bacteria love to live in this stuff, especially the bacteria which most commonly cause infections (Staph and Strep).  Once the incision is washed, it is important to allow the wound to air-dry completely.  Bacteria hate dry environments.  Keeping the incision dry is also very important, so  avoid getting perspiration onto the incision.   This is particularly true when the incision is in the groin or armpit area.

I find that after my patients have a shower, it actually makes them better, too.   It is a great first step in getting back into your daily routine.  It is important to follow the after-care instructions regarding activity, but the sooner you resume your normal life, the sooner you will recover and interestingly, patients report that they have less pain.

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MONDAY MYTH #3: Cosmetic Surgery is easy to do

July 26th, 2010

Is it true that cosmetic surgery is easy to do?

I believe this is a mistaken belief that stems from two aspects of cosmetic surgery.     The plastic surgery community has largely looked down upon limiting a practice to elective cosmetic surgery, since its inception over 125 years ago.  Plastic surgeons doing cosmetic surgery exclusively used to be referred to as “nose crackers” or “hair dressers” by their reconstructive surgery colleagues.   It was considered a less noble specialty.   In fact, one of my earliest mentors as a medical student said, “Always do some reconstructive surgery, so your peers won’t call you a nose cracker!”

Secondly, the technical aspects of cosmetic surgery procedures are actually simple by design.   Incisions are small, there are few steps and the physiologic stresses to the patient are minor.   This all true.   But the difficult part of cosmetic surgery is the sculpture and all cosmetic surgery is sculpture.  Tissues are removed, implants are added or underlying structures are rearranged.  Poorly done, this sculpture will result in a very unnatural and aesthetically displeasing result.   Done well, the result will be natural and balanced, enhancing the patient’s own beauty and self-esteem.   A good result is often one that no one notices.

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