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Caring for surgical wounds

This leaflet provides some information and advice about caring for surgical wounds at home.

There are many different types of surgical wounds, so it's important to follow your doctor's advice.

Surgical wounds

A surgical wound is the cut made in the skin by your doctor during an operation. At the end of the operation, most cuts are stitched to allow the skin edges to come together and heal.

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.

Dressings

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

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

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. Other types of stitches, and clips or staples 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 GP.

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 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 to seal the wound.

Problems with wound healing

Most surgical wounds heal without causing any problems. However, wound infections are one of the most common complications after surgery. This means that germs have started to grow in the wound and this can delay normal healing. Wound infections are usually treated with a course of antibiotics, but occasionally further surgery is needed.

Certain people are more likely to develop wound infections and your doctor will discuss this with you. Those at higher risk include people who:

• smoke
• have diabetes
• have a condition or treatment that affects their immune system, such as leukaemia or chemotherapy
• have a major operation, such as bowel surgery

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

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

If you are concerned about your wound or if you develop a high temperature, or notice any of the signs listed above, you should contact the hospital. Wound infections can be treated successfully if they are diagnosed early.

Caring for your healing wound

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

Changing the dressing

The original dressing can be left in place for up to two days (or as advised by your doctor) providing that it's dry and not soaked with blood or any other liquid.

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

The 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. There is no need to use antiseptic cream under the dressing.

Taking care of stitches

Dissolvable stitches will usually disappear on their own in seven to 10 days. Non-dissolvable stitches may not be removed for up to three weeks, depending on the exact 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 the hospital for advice.

Bathing and showering

It is 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 is not the case following your particular operation.

Some general points to note are outlined below.

• Showering is preferable to bathing.
• Remove any dressing before having 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 the healing wound.
• It's alright to allow the shower water to gently splash onto the healing wound. However don't rub the area, as this will cause pain and might delay the healing process.
• Only have a bath if the healing wound can be kept out of the water. Don't soak the area as this might soften the scar tissue and re-open the wound.
• Dry the healing area carefully by patting it gently with a clean towel.
• 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, do not hesitate to contact the hospital or your GP.

Sources

• Collier M. Recognition and management of wound infections. World Wide Wounds.
  www.worldwidewounds.com
  accessed 17 October 2006
• Thomas S. A structured approach to the selection of dressings. World Wide Wounds.
  www.worldwidewounds.com
  accessed 17 October 2006

Published by BUPA's health information team, healthinfo@bupa.com, November 2006.

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