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Caring for surgical wounds

Published by Bupa's health information team, May 2009.

This factsheet is for people who would like information about caring for surgical wounds at home.

A surgical wound is a cut made in the skin during an operation.

About surgical wounds
Dressings
Stitches, clips and staples
Tissue adhesive (skin glue)
Problems with wound healing
Caring for your healing surgical wound
Questions and answers
Related topics
Further information
Sources

About surgical wounds

At the end of the operation, your doctor will close the surgical wounds with stitches, clips or skin glue to bring the skin edges together to heal. There are many different types of surgical wound, so it's important to follow your doctor's advice.

Wound healing

The process by which your surgical wound heals is a complex process that involves three main steps.

Inflammation - this lasts for a short time as the blood flow is increased to your wound.
Proliferation - new blood vessels grow to bring nutrients to the wound and remove dead tissue.
Maturation - new skin seals the wound and forms a scar.

The skin edges usually form a seal within a day or two of the operation. This time varies from person to person and from operation to operation. Closing your wound surgically (see Stitches, clips and staples) encourages your wound to heal faster.

Dressings

Not all surgical wounds need dressings. The purpose of a dressing is to:

absorb any leakage or smell from the wound
provide ideal conditions for healing
prevent infection
protect the area until the wound is healed
prevent stitches or clips catching on clothing

Some wounds don't have a dressing, for example, if they become infected at the time of surgery.

Stitches, clips and staples

The medical term for stitches is sutures. Other methods used to close a surgical wound include metal clips or staples, and adhesive dressings or tapes.

Some stitches are dissolvable and don't need to be removed. Clips, staples and some types of stitches have to be removed by a nurse or doctor. If this is necessary, your nurse will arrange a follow-up appointment at the hospital or with your practice nurse.

Stitches, clips and staples are usually removed between three and 21 days after treatment, depending on the type of operation you have.

Tissue adhesive (skin glue)

Special skin glue can be used to close small wounds that are less than 5cm (two inches) long. Although the glue is waterproof, the area needs to be kept dry for at least five days. The glue usually peels off in five to 10 days.

Sometimes for larger (longer) skin cuts, glue is used together with stitches or special self-adhesive skin-closure strips (Steri-strips) to seal the wound.

Problems with wound healing

Most surgical wounds heal without causing any problems.

Wound infections are one of the most common complications after surgery. This means that bacteria have started to grow in your wound. If you develop an infection, you will usually be treated with a course of antibiotics but occasionally further surgery is needed.

You're more likely to develop an infection if you:

smoke
have diabetes
have a condition or treatment that affects your immune system, such as leukaemia or chemotherapy

Your doctors and nurses will do everything that they can to prevent your wound from becoming infected, but it's important that you know how to tell if you're developing an infection after you go home. If your wound becomes infected, it may:

become more painful
look red, inflamed or swollen
leak or weep liquid, pus or blood
smell unpleasant

If you're concerned about your wound or if you develop a high temperature, or notice any of these symptoms, contact the hospital or doctor's surgery where the operation was performed. Wound infections can be treated successfully if they are diagnosed early.

Caring for your healing surgical wound

There are a number of things that you can do to look after your wound, lower your risk of infection, and encourage healing.

Changing the dressing

The original dressing can be left in place for up to five days (or as advised by your doctor) providing that it's dry and not soaked with blood, and that there are no signs of infection.

Before you remove the dressing, wash your hands with soap and water and then carefully take the dressing off. Don't touch the healing wound with your fingers.

Your healing wound can then usually be left without a dressing. However, some people like to continue wearing a dressing over the area for protection, especially if clothing is going to rub against it.

The hospital may supply a replacement dressing for you to use at home. Apply the dressing carefully and don't touch the inside of the dressing. Don't use antiseptic cream under the dressing.

Taking care of stitches

Dissolvable stitches will usually disappear in around one to three weeks, but this can take up to six weeks, depending on the type of stitches you have. Non-dissolvable stitches are usually removed after seven to 10 days, depending on the type of operation you have.

During this time you may see small pieces of the stitch material poking out of the healing scar. Don't be tempted to pull on these. If there are loose ends which are catching on clothing, trim the stitch carefully with a clean pair of scissors. Otherwise wait until they are removed or fall out on their own. If the stitches cause you pain or discomfort, contact your doctor or hospital for advice.

Eating and drinking properly

Your body needs energy to heal quickly so it's important that you eat well. Your body will use a lot of energy, vitamins and protein when healing so make sure that you eat a balanced diet. You should also make sure that you drink plenty of water. If you're dehydrated, your wound may take longer to heal.

It's important that you lose any excess weight before your operation, as being overweight can increase the time it takes for your wound to heal.

Bathing and showering

It's usually possible for you to have a bath or a shower about 24 hours after surgery. Your nurse at the hospital will advise you if this isn't the case following your particular operation.

Some general points to remember are as follows.

Showering is preferable to bathing, so that your wound doesn't soak in water.
Remove any dressing before you have a bath or shower, unless your doctor gives you different advice. Some dressings are waterproof and can be left in place.
Don't use any soap, shower gel, body lotion, talcum powder or other bathing products directly over your healing wound.
You can let the shower water gently splash on to your healing wound. However, don't rub the area, as this might be painful and could delay the healing process.
Only have a bath if your wound can be kept out of the water. Don't soak the area as this might soften the scar tissue and re-open your wound.
Dry the surrounding area carefully by patting it gently with a clean towel but allow your wound to air dry.
If you had surgery on your face, don't wear make-up over the scar until it has fully healed.

Once you get home, if you have any concerns about your surgical wound, contact the hospital or your GP.