The operation can be carried out either on an inpatient or outpatient basis.

■ The dressing is removed on the first postoperative day. The Steri-Strips are left in place for 8 days and can be removed by the patient. During this time there should be antibiotic prophylaxis and the arm should be elevated. The patient should avoid physical exertion for a period of 2-3 weeks in order to permit undisturbed wound healing. To prevent congestion of the lymphatics, lymph drainage can be carried out from the 8th postoperative day.

After removing the Steri-Strips, the patient should treat the scar with dexapanthenol ointment for 2 weeks and then with silicone ointment for a further 2 months. If after 2 months it can be seen that scarring is disturbed, it can be treated, as with all scars, with intralesional injections of triamcinolone crystal suspension 40 mg. With any scar this treatment should be carried out as soon as possible, as these injections improve erythema and bulging scars considerably in the first few months. In extreme cases hypertrophic scars must be excised after a period of 12 months and treated with stimulating radiation in divided doses for several days immediately after excision. Cooperation with an experienced radiologist is necessary for this.

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