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EDITOR’S NOTE: Physicians, providers, and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in HEALTHWISE MAUI, which appears in The Maui News. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic, and Lana'i Community Hospital and accepts all patients. To submit a question, visit mauihealth.org/healthwise.
Q: Why do some wounds leave scars and others don't?
James R. Williams, MD, Infectious Disease, Maui Memorial Medical Center Outpatient Clinic: Any time your skin is cut or damaged, there is the chance of a scar. The size, depth, and location of the wound can play a role in whether a scar forms and how significant it is. However, there are things you can do to reduce the risk of scarring or to minimize the size and appearance.
Basic wound care is key for preventing scars from minor injuries:
• Keep the area clean with soap and water -- don't use hydrogen peroxide, which can irritate the wound.
• Use petroleum jelly or an antibiotic ointment to keep the wound moist, and cover the area with a bandage.
• Change bandages daily.
• Consider using hydrogel or silicone gel sheets for larger scrapes, burns, or sores.
• Use sun protection after the wound heals, either applying sunscreen or covering the area with clothing.
See a doctor for wounds that may require stitches, and follow the doctor's instructions for when to remove the stitches and how to care for the wound.
There are also things you can do to minimize scarring from surgical wounds:
• Massage. After the wound has fully closed, try gently massaging the scar every day to keep the skin soft and relieve discomfort.
• Scar tape. Taping the scar with paper bandage tape or silicone tape can reduce pulling and help prevent the scar from growing wider.
• Silicone sheets. Silicone coverings can help keep the wound area moist and clean.
• Avoiding tension. Avoid pulling or putting tension on the wound area.
In addition, nicotine can impair wound healing and increase the risk of scarring. Follow your doctor's instructions to stop nicotine use before and after surgery.
Even with proper care, some scars are unavoidable. If scar tissue is pulling your skin, restricting movement, or you don't like how it looks, treatment may make it smaller or less visible. Talk with your doctor about treatment options.
For non-healing wounds, Maui Health's Wound Clinic offers specialized care and advanced treatments to help wounds heal quickly and effectively. Explore our wound care services at mauihealth.org/woundcare or call (808) 986-4500 to schedule an appointment.
Q: When is knee pain more than just part of getting older?
Zachary P. Thielen, MD, FAAOS, Orthopedic Surgery, Maui Orthopedic Institute: If knee pain is quietly changing the way you live, it may be time to pay attention.
Maybe you have stopped taking longer walks. Stairs feel harder. You skip outings because you are not sure how much walking will be involved. These small adjustments can add up until your knee is deciding what you can and cannot do.
For many people, the cause is osteoarthritis, when the cartilage that cushions the knee gradually wears away. In advanced cases, the joint may become "bone on bone."
Knee replacement is not the first step for most patients. Medication, injections, physical therapy and bracing can help manage symptoms. But when those treatments are no longer providing enough relief and knee pain is affecting your mobility, sleep or everyday activities, it may be worth talking with an orthopedic specialist.
Age alone does not determine whether knee replacement is appropriate. A more important question is how much your knee is limiting your life.
If your specialist recommends surgery, know that today's knee replacement experience may differ from what you've known about it previously. Modern care emphasizes preparation and early mobility to help ensure optimal healing and outcomes. Advanced technology, including robotic-assisted knee replacement, is also available here on Maui.
Learn more about knee pain and what options are available to you at mauihealth.org/agingknee.