Appendectomy (Appendix Removal) Scar Care and Treatment

2023-02-15 18:16:44 By : Ms. Sona H

After the incision heals, you can begin to address scar tissue

Aubrey Bailey, PT, DPT, CHT  is a physical therapist with over 20 years of experience in a variety of healthcare settings. Silicone Container

Appendectomy (Appendix Removal) Scar Care and Treatment

Michael Menna, DO, is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York.

An appendectomy is performed laparoscopically by inserting tools through several small incisions or as an open procedure, resulting in a larger incision. Both methods cause scar tissue to form as the incisions heal. Typically, these scars fade over time with proper care. Scar care treatment can include topical creams or gels, such as cocoa butter, vitamin E, silicone gel, and more.

This article discusses scar care after appendectomy—the usual location of the scar(s), routine scar healing, signs of infection, what scar tissue feels like, and how to treat scar tissue as it forms.

Appendectomy scars vary based on the procedure used to remove this organ. A laparoscopic appendectomy is a less invasive surgery than an open appendectomy. One 2016 study found that people with a laparoscopic appendectomy experienced shorter hospital stays, required less pain medication, and had a faster return to regular activities.

Healthcare providers make multiple incisions during laparoscopic appendectomy surgery. The location of these incisions varies by the surgeon. Typically they make one small incision near the belly button, inflating your belly with gas to make room for surgical maneuvers. They make two others incisions in the lower abdomen, where they insert a tiny camera and other tools to remove the appendix.

During an open appendectomy, your surgeon makes an incision in the lower right abdomen (the appendix location). Once they remove your appendix, your surgeon closes the incision with stitches or staples. During the healing process, scar tissue forms in each incision.

Laparoscopic incisions are very small—usually less than one-half of an inch. Open appendectomy incisions are typically between 2 and 4 inches.

After surgery, your incisions go through the healing process. Initially, they will be swollen and tender to the touch and appear darker than your natural skin color. Small amounts of fluid will drain from the incision. This fluid should be clear or have a small amount of blood.

Once the wound closes, the scarred area will remain darker than your natural skin and shiny for several weeks as new tissue grows. It is normal for the scar to itch during this time. Eventually, your scar will fade, which can take up to two years.

After an appendectomy, monitoring your incision(s) for signs of infection is essential. Surgical site infections are relatively rare, occurring around 1% to 3% of the time. However, the effects of surgical site infection can be severe, especially if the infection spreads deeper than the skin. Signs of surgical site infection can include the following:

An infection can also cause pain in the general area of your surgery. However, this might not be immediately obvious because pain is expected during the first couple weeks after appendectomy.

Sometimes, excess scar tissue can develop after appendectomy. Abnormal scars can be hypertrophic or keloid .

Excess scar tissue is treatable, but there's no guarantee it will go away. Treatments can include:

On rare occasions, hypertrophic or keloid scars are surgically removed. However, they frequently grow back—and often end up more prominent than the original scar.

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the uterus. In one study, 37% of people with endometriosis had endometrial lesion growth affecting the gastrointestinal system. However, of that 37%, only 3% had lesions affecting the appendix. Endometriosis can also impact scar tissue after appendectomy or other pelvic procedures, but it is rare.

Pain is a normal part of the body's reaction to injury, trauma, or other causes, known as the inflammatory response. While it is uncomfortable, pain inside the scar is a normal part of the healing process. However, pain lasting longer than three months that does not improve is considered chronic and signals that you should follow up with your healthcare provider.

Similar to pain, itching is expected during the healing process. It can last up to six months and typically signals that you are experiencing the remodeling phase of wound healing when your body builds scar tissue and a new outer layer of skin.

Keeping your scar moisturized can aid in the healing process and impact the appearance of your scar. One 2020 review of medical literature on topical scar treatments found that silicone gel sheets and silicone gels were the most effective in reducing the appearance of scars. Silicon gel works by hydrating the outer layer of the skin, acting as a barrier against bacteria, and reducing pain and itch.

Once the incision has closed, you can begin scar massage. Using cocoa butter, vitamin E, or a similar product, massage your scar for 10 minutes twice daily. Use firm pressure—but not so much that it causes pain.

Scar tissue forms long after your incision has healed, so keep up the scar massage. Scar tissue will become softer and lighten in color around two to three months after surgery.

Taking proper care of your incision after appendectomy can help minimize complications with scar tissue. Follow your surgeon's specific instructions after surgery.

Scar tissue formation is a normal part of healing after appendectomy. Over time, scars typically become flatter and lighten in color. In some cases, excess scar tissue forms, leading to hypertrophic or keloid scars. Scar management begins with proper wound care while your incision is healing, followed by scar massage for several months.

Biondi A, Di Stefano C, Ferrara F, Bellia A, Vacante M, Piazza L. Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness. World J Emerg Surg. 2016;11(1):44. doi:10.1186/s13017-016-0102-5

American College of Surgeons. Appendectomy.

National Library of Medicine. How wounds heal.

Johns Hopkins Medicine. Surgical site infections.

Centers for Disease Control and Prevention. Frequently asked questions about surgical site infections.

Amini M, Moghbeli M. Appendectomy scar endometriosis: a case report. Middle East J Dig Dis. 2018;10(2):114-116. doi:10.15171/mejdd.2018.100

Farrukh O, Goutos I. Scar symptoms: pruritus and pain. In: Téot L, Mustoe TA, Middelkoop E, Gauglitz GG, eds. Textbook on Scar Management: State of the Art Management and Emerging Technologies. Springer International Publishing;2020:87-101.

Tran B, Wu JJ, Ratner D, Han G. Topical scar treatment products for wounds: a systematic review. Dermatologic Surgery. 2020;46(12):1564. doi:10.1097/DSS.0000000000002712

Puri N, Talwar A. The efficacy of silicone gel for the treatment of hypertrophic scars and keloids. J Cutan Aesthet Surg. 2009;2(2):104-106. doi:10.4103/0974-2077.58527

Frasson DN, Valange M, Almeras I, Izquierdo M, Ster G. Treatment of immature scars: manual massages. In: Téot L, Mustoe TA, Middelkoop E, Gauglitz GG, eds. Textbook on Scar Management: State of the Art Management and Emerging Technologies. Springer International Publishing; 2020:215-218.

American Society for Surgery of the Hand. Scar treatment.

By Aubrey Bailey, PT, DPT, CHT Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living. 

Thank you, {{}}, for signing up.

Appendectomy (Appendix Removal) Scar Care and Treatment

Silicone Container There was an error. Please try again.