Wound scar from pacemaker

Hello fellow bionic peeps!
I had my pacemaker implanted the day before yesterday...feel good, but wound is a bit odd looking? For a start, it's almost horizontal (rather than more vertical like nurse told me it would be). It also has about a third of it looking a bit lumpy top and bottom, and another third the skin below is puckered in?
How does this sound to anyone? I have not managed to find many wound photos on Internet, but when I have they seem to be fairly neat and even? Thanx...Julie

11 Comments

Pacemaker wound/scar

by Diamond Jules - 2012-09-07 03:09:20

Hi PacerRep and Zia,

thanks for your positive words...yes it's still a wound and not a scar yet, but I am just concerned about the bit that is almost tucked under the stitch line (the puckered bit that is indented) but I can ask the nurse next week. I was told to put on fresh gauze each day and I will certainly keep it protected and dry.
Would anyone say that their wound changes very much in appearance over the weeks/months?
Thanks...Julie

Scar?

by Zia - 2012-09-07 03:09:22

I would echo PacerRep's comment above. Scar so soon? At the risk of getting into semantics here, it seems to me that it's still a healing incision at this point. But, for what it's worth I've had my PM for a little over two years and I can hardly find the scar any more, it's that insignificant. So maybe you just need to give it a little more time and be careful of it for a few more days.

I hope your result is as good as mine has been.

give it time

by polrbear - 2012-09-07 05:09:55

The orientation and location of the wound depends on details of the procedure (angle of approach, for one aspect). If the scar is reasonably small and not showign signs of infect, the location isn't often a big deal.

By all means, keep an eye on it. The wound phase may look a bit strange (PacerRep's comment about a dressing is right, although one might see the wound during dressing changes).

As the wound heals, these changes can become more noteworthy. Ideal scar healing isn't noticeable at all, but this isn't realistic. Good scar healing normally has a fine ridge (a "valley" leaves a shadow and makes the scar more obvious), minimal width, and flexes well with movement of nearby joints/muscles/etc. Obviously, it needs to stay closed. One of the downsides to dissolving sutures is that they may open and allow the wound to gape. Drainage usually isn't good, and staying gaped is bad as well.

If your scar is excessively wide, you may be prone to keloid scarring. You won't be able to have minimal scars if this happens, but injecting steroids may help minimize the stiffness and outward growth of these. It needs to be done early, but discuss with your cardiologist about this. Not all of them are comfortable having this done, since the risk of infection goes up any time the wound is handled.

Good luck!

Dustin

Pacemaker wound/scar

by Diamond Jules - 2012-09-07 06:09:15

Thank you Dustin,

Yes I do seem to have a bit of a valley in one part of the wound.....but when the consultant doing the implantation was talking (to another doc with him, prob doing some if the work!) he was saying things like how this was the way he did sutures in a way so as its not tight, heals well etc etc so all that sounded good to me at the time....it was the "clamping open" and also the ''making the pocket" that I wasn't prepared for!!!!!!! (no words to describe it the feelings!

But I am drinking lots of water and being really careful of wound....I still can't believe it's inside me....flipping amazing!

Horizontal Scar

by PacerRep - 2012-09-07 11:09:46

I've never seen a verticle scar, I think maybe the nurse meant to say horizontal, or she thinks verticle is horizontal (yikes). It should be about 2-3 inchesw long going from the center of your body tword your side. Lumps are ok the first day or so, your body should even it out, its usually just form all the shifting around and fatty tissue being displaced. I'm not sure what you mean by puckered in, I'd have to see it and obviously thats not really possible on here lol.

Did they tell you to take your bandage off already? Usually you leave it on for 3 days? Dont' get the wound wet for 3 days and even after that when you shower or take a bath, I would cover it until its been 7 days. you can get waterproof bandages at any drug store like CVS or Walgreens.

Pacemaker wound

by Diamond Jules - 2012-09-08 02:09:31

Ha ha yes Frank, ripping skin from chicken flesh! Except mine was incredibly uncomfortable and amazingly painful!!! .....and felt like doc was trying to shove it into every direction including down my leg? I even got a sharp shooting pain in my ear at one point?
But I am now just concentrating on keeping arm down (and being thankful that such thing as a pacemaker exists)...good luck for your future too :-)

healing

by Tracey_E - 2012-09-08 03:09:28

Mine changed how it appeared steadily for about the first year. Now I barely see it and it looks nothing like it did before the stitches dissolved. And it's horizontal!

Making the pocket

by ElectricFrank - 2012-09-08 07:09:16

My description of having the pocket made is that it is like tearing the skin off a chicken breast.

I was wide awake during the procedure and felt the pressure. The local pain shots made it painless, but it helped me understand that it might be a bit sore for a few days. I'm thin skinned and mine is on my left chest just under the clavicle. The scar looked a bit vicious afterwards, but even after having it opened again for a replacement it isn't that noticeable anymore.

I drive a 4wd in the desert with my shoulder harness over the pacer sight where it gets a workout, but it really isn't sensitive.

best wishes and quick healing,

frank

That dip you speak of

by PacerRep - 2012-09-09 01:09:12

It sounds like its just your skin pulled together tight from the running sutre, it kinda clamps the skin together and pulls both sides of the wound against itself and kinda makes it look funky at first. don't sweat it, it will buff out just fine. I was thinking you meant it was way below the pacemaker site which would be a slightly different problem. (and by slightly i really mean significant).

skin from flesh

by polrbear - 2012-09-09 10:09:50

Is quite accurate! It's usually blunt dissection, either with an instrument (probe, clamp, scissors, etc) or even fingers. I'm thankful I con't remember either of mine (too much midazolam the first time, and the second time involved an EP study, so they don't usually keep people awake for those).

Leaving some slack in the wound makes some sense, but the body normally has some slack and will adjust. Keep an eye on the wound in case it starts to gape. If so, follow-up with primary physician or your cardiologist.

Scar and Pain

by Snix - 2012-09-12 10:09:18

So my scar is basically completely the opposite of how it "should be" as described by PacerRep. Mine is mostly vertical but slightly diagonal. It starts from close to my left armpit and goes upwards towards my clavicle. Unfortunately, mine is a Hypertrophic Scar (often confused with a Keloid scar). It has improved a little but is still VERY sensitive 8 years later.

Also, when I use my left arm a lot and when the weather changes, it feels like the PM is hitting my collar bone. It's VERY uncomfortable and causes pain. I spoke w/ Dr. about it and he basically said bad luck, deal with it. He would try to relocate when the battery is replaced, but I will most likely get same scarring issue as I'm apparently prone to them.

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