What will the wound look like?
Following a cleft lip repair your child will have dissolvable stitches (sutures) in place and an external layer of medical glue over the wound closure site. There will not be a dressing in place as it would not stay in place. Medical glue will be used as it acts as a protective layer to the wound.
Due to the nature of the surgery the wound will often appear quite swollen and red in the first few days after surgery. his is normal and will improve.
It is important to give your child regular pain medication such as paracetamol or ibuprofen, to help with any discomfort or swelling from the wound.
What if the wound gets dirty or infected?
For the first week following repair you should:
- keep the wound clean and dry
- if it becomes dirty, use only a soft, clean cloth with water to wipe over the site
If you have concerns about a wound infection, we advise you to contact your cleft nurse without delay or seek medical attention.
Common signs of infection include:
- Discharge from wound
- Rash
- Surrounding area red and hot to touch
- Temperatures (have a fever- above 38C)
What if the wound forms a scab?
Sometimes a thick scab can form over the wound site, this is completely normal and part of the healing process of the wound. It can sometimes cause the wound to become dry and itchy; it is advised it this instance from around four to five days after surgery you can apply of white or yellow petroleum jelly such as Vaseline to the lip to soften the scab and help to lift. Do not be tempted to pick off or rub the scab as this will cause the scab to come off before it is ready to.
What post-operative support will I receive?
You should receive regular input and support from a cleft nurse specialist. Your cleft nurse should contact you after surgery to check-in and answer any questions or concerns you have.
Your cleft nurse will arrange to visit you at home about one week after surgery and a further appointment at around four to six weeks following surgery. At these appointments they will ask about how your child has been following surgery and ensure they are recovering as expected, they will also assist with wound management care.
If you have any questions or concerns regarding your child’s care between appointments, your cleft nurse should be contactable within working hours by telephone.
When should I start to apply gel?
From 7 to 10 days after surgery or when the wound is healed and dry and the scab has come off, you can start applying Kelo cote gel.
Kelo cote gel is a silicone gel used to treat surgical scars, it is used to help flatten, soften, and smooth scars, while reducing redness and itching. It is clinically proven and is safe for use on children and those with sensitive skin. You should be given this on discharge from the hospital after surgery and it should be recorded as a discharge medication on your discharge letter. It is important to confirm you have this before leaving the hospital with your ward nurse.
You should apply a very thin layer of Kelo cote gel directly to the scar (do not rub in) three to four times per day for a period of 6 to 12 months to optimise the outcome of the scar. If you run out of gel your GP should prescribe you more. If you experience any issues, please contact your cleft nurse for support.
When should I start wound massage?
Wound massage involves rubbing and applying pressure to a wound to help prevent the scar from becoming hard and raised. Massage should start around four to six weeks following surgery, your cleft nurse should be able to advise and demonstrate the appropriate technique at a post-operative appointment.
It is important to wait until at least four weeks after surgery to commence massage as it takes this long for all the nerve endings and muscles underneath the skin to knit back together following surgery. If you commence massage too soon it can disrupt the healing process and impact on scar outcome/ function of lip. You may notice evidence of scar contraction over the initial few weeks following the surgery, meaning the wound site may become tight and the lip may lift slightly. This is normal and through scar massage following the four-week point can be improved.
What should I do if I am unhappy with the scar appearance?
It can take up to two years for a scar to fully mature. In the initial time frame, the wound would be monitored and reviewed by the cleft surgeon who would be able to plan ongoing treatment. Treatment options can include; steroid injections, laser therapy or a surgical revision of scar.
Further information
PALS (Patient Advice and Liaison Service)
PALS (Patient Advice and Liaison Service) for help, advice and information about NHS services. You can contact them on freephone 0800 032 02 02, email [email protected].
Useful websites
If you would like further information about health conditions and treatment options, you may wish to have a look at the NHS website.
If you would like to find accessibility information for our hospitals, please visit AccessAble website.
