Advice after your nerve block for surgery
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Scar healing and complications:
- Most scars will become flat and pale as they mature.
- Some people are more at risk of developing Hypertrophic or Keloid scars. Hypertrophic scars appear red and raised within the boundary of the wound. Keloid scars are caused by production of excess scar tissue and can increase in size out of the original boarders of the wound.
- Scar tissue can become contracted, usually caused by skin shrinking and tightening which can restrict movement and affect function.
Scar Treatments
Scar Massage:
Continuing firm pressure scar tissue massage using emollient cream is recommended while the scar continues to mature for up to 12-24 months.
Using emollient cream, such as E45, Aqueous cream or any non perfumed cream, to complete firm pressure circular and zig zag motions over the entire length of the scar. Continue for 5 minutes, 3-4 times per day.
Dycem Massage:
Apply the blue square to the top of your scar. You should not use any cream and make sure your hand is clean and dry before you start.
Hold the blue square in place, grip the skin and massage with lots of pressure to move the skin over the underlying structures and release the scar tissue.
Scar silicone:
Silicone products have been shown to assist with the management of scars and help to develop a soft, flat scar of normal colour. Used only once wounds are fully closed.
Mepiform
Mepiform is intended for the management of hypertrophic and keloid scars.
Application:
- Cut to appropriate size, ensuring that the dressing overlaps the scar by at least 1cm.
- Ensure the area for application is clean and dry.
- Remove protective film and apply Mepiform to the scar with the sticky side down against your skin.
Change and Removal:
- Ideally, Mepiform should be worn for 24 hours a day to achieve the best results.
- Remove the dressing once a day to inspect and wash the skin. The dressing can then be reapplied.
- Mepiform should be changed every 3-7 days or when the dressing no longer sticks to the skin.
- Mepiform is waterproof and can be worn whilst bathing and showering.
Cica-care Gel Sheets
Cica-Care silicone gel sheets are used to improve the appearance of red, dark, or raised scars by softening, flattening, and fading them.
Application:
- Cut to sheet to the size of the scar, allowing for a small overlap.
- Ensure the area for application is clean and dry.
- Peel off the backing and apply adhesive side to the scar, without stretching the gel sheet, and secure in place with compression bandage or tape for some compression through the tape.
- Clean in running water, pat dry to avoid tearing.
Change and Removal:
- Ideally, worn 24 hours a day with a minimum of 12 hours per day or overnight.
- Aim to start by wearing for less time (4 hours) and build up, if you experience any skin irritation, reduce the wear time or consult with a healthcare professional.
- Replace the Cica-Care sheet when it begins to wear out or if it becomes difficult to clean. This usually occurs every 14-28 days.
Otoform/Elastomer
Elastomer is a putty like impression silicone (silicone elastomer). It can be moulded and
applied to your scar. It is normally recommended for deep hollow scars that need an impression, or for curved areas like the hands. All Otoform moulds are individually made by your therapist specifically moulded to your scar.
Application:
- Ensure the area for application is clean and dry.
- Apply the Otoform mould over the scar and secure with compression bandage, tape, under your splint or pressure garment.
- Clean in running water or mild soapy solution, air or pat dry to avoid tearing.
Change and Removal:
- Ideally, worn 24 hours a day with a minimum of 12 hours per day or overnight.
Contact Details
If you have any concerns, or need to change your Hand Therapy appointment, please contact the Therapy Department on:
Frimley Park Hospital: 0300 613 3396
Heatherwood Hospital: 0300 614 0540 Option 3
Wexham Park Hospital: 0300 614 0540 Option 2
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Contact us
If you have any queries relating to this information, please contact the Hand therapy service.
About this information
Service:
Hand therapy
Reference:
UU/041
Approval date:
30 October 2026
Review date:
1 October 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.