SURGICAL WOUND CARE

Caring for Your Post-Surgery Wounds

Incision care after surgery

After surgery, you need to care for your incision as it heals. Your doctor used staples, stitches, or tape strips to close your incision, and you must keep the area clean, change the dressing according to your doctor's orders, and watch for signs of infection.

After surgery, the suture line and wound edges will appear pink to red in color but the area will lighten a little every day. Surgical sutures need to be removed in a few weeks. Sometimes, the sutures are all under the skin and will eventual dissolve on their own and do not need to be removed. 

If you doctor didn't give specific wound care orders, you can follow these routine wound care instructions.

• Leave the original bandage that was applied at the time of your surgery in place for 48 hours. If the bandage should loosen, carefully put it back in place and reinforce the dressing with surgical tape.
• After approximately 48 hours, you can gently remove the bandage.
• Keep any steri-strips in place until they begin to fall off on their own. Do not pull the steri-strips off because this stresses the incision line. When the steri-strips do start to peel off, they can be gently washed off with mild soap and water.
• Please try to keep the incision line clean and dry. 
• It is not necessary to apply antibiotic ointment, alcohol, hydrogen peroxide, or a new bandage to the incision line.
• If your sutures get caught on your clothing or there is a small amount of drainage from the incision, you can cover it with a small gauze. If so, please use as little tape as possible to hold the gauze in place as tape can irritate the skin.

You may notice some soreness, tenderness, tingling, numbness, and itching around the site of your incision. There may also be mild oozing and bruising, and a small lump may form. This is not unusual is no cause for concern.  However, if you should notice bleeding from the surgical site, apply firm direct pressure for ten minutes. If the bleeding persists, reapply firm direct pressure for an additional ten minutes. If the bleeding does not stop after 20 minutes, call your physician's emergency contact number or go to the nearest emergency room for assistance.

Tips for reducing the risk of infection

• Do not wash the area for at least 24 hours. You may need to wait longer, depending on the type of surgery. Follow your doctor's instructions exactly.
• Look at the incision every day, checking for signs of infection (see below).
• Change the dressing as your physician recommended.

Do not:

• Scrub or rub incisions.
• Remove the tape strips (such as Steri-Strips) from incisions.
• Use lotion or powder on incisions.
• Expose incisions to sunlight.
• Take a bath unless you can keep the incision dry. Take showers until your doctor says it's okay to take baths. Before you shower, cover the dressing with a plastic bag or use another method of keeping it dry.
• Do not participate in any vigorous activities or exercises that may put stress on the incision.
• Do not take aspirin, ibuprofen, or any other non-steroidal anti-inflammatory medication that may cause problems with bleeding unless instructed by your doctor.
• Do not apply perfumes or scented lotions to the sutures as this may cause irritation.

Signs of infection

Call your health professional, if you notice any of the following:

• Signs of an infection, such as:
  • A yellow or green discharge that is increasing.
  • A change in the odor of the discharge.
  • A change in the size of the incision.
  • Redness or hardening of the surrounding area.
  • The incision is hot to the touch.
  • Fever.
  • Increasing or unusual pain.
  • Excessive bleeding that has soaked through the dressing.
  • Fevers, chills, or night sweats
  • Bleeding that does not stop with firm pressure

Managing Pain

Post-operative pain is usually minimal. Take 2 tablets of Extra-Strength Tylenol every 4 hours as needed. Your physician can prescribe a stronger pain medication should you require it. Do not take products containing aspirin or ibuprofen because these may increase bleeding. An ice pack can lessen pain as well.

Post-operative pain usually resolves within the first week following surgery but you may experience discomfort in and around the wound as it heals over the next several weeks

Changing a dressing

Before you start, make sure you have gauze pads, surgical gloves, surgical tape, a plastic bag, and scissors. Then:

1. Prepare supplies by opening the gauze packages and cutting new tape strips.
2. Put on surgical gloves.
3. Loosen the tape around the old dressing.
4. Remove the old dressing.
5. Remove the surgical gloves. At this point, you may want to clean the incision.
6. Wash your hands and put on another pair of surgical gloves.
7. Inspect the incision for signs of infection.
8. Hold a clean, sterile gauze pad by the corner and place over the incision.
9. Tape all four sides of the gauze pad.
10. Put all trash in the plastic bag, including gloves.
11. Seal plastic bag and throw it away.
12. Wash your hands.

Cleaning an incision

• Gently wash it with soap and water to remove the crust.
• Do not scrub or soak the wound.
• Do not use rubbing alcohol, hydrogen peroxide, iodine, or mercurochrome, which can harm the tissue and slow wound healing.
• Air-dry the incision or pat it dry with a clean, fresh towel before reapplying the dressing.

Caring for stitches, staples, or adhesive strips

Stitches or staples normally cause some redness and swelling where the stitch enters the skin, along with mild irritation and itching. Some drainage from the incision may be expected for the first few days after surgery. However, if the discharge does not decrease after a few days, becomes bright red with blood, or contains pus, contact your health professional.

The incisions may be protected with small adhesive strips (such as Steri-Strips) instead of a dressing or bandage. You usually do not have to change these strips. Leave them in place until they become loose or fall off on their own.

Understanding special instructions

After some surgeries, you may be given special instructions other than these for taking care of your incision. Be sure to follow those instructions carefully. If you are confused by the instructions or have a question, call your doctor's office. If the office is closed, leave a message with the answering service. Call your doctor if you suspect an infection or your pain has increased.

Follow-up care

You should have been scheduled for a follow-up appointment with your physician at the time of your discharge from surgery. This appointment is an important part of your post-surgical care.  You should see your surgeon at least once following your procedure, so he can evaluate your progress and answer your questions.