Caring for surgical wounds

Published by Bupa's Health Information Team, April 2011.

This factsheet is for people who have a healing surgical wound, or who would like information about caring for surgical wounds.

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

Proper care of a surgical wound can lower risk of infection and help the wound to heal.

About surgical wounds

You may have a surgical wound after any type of operation that involves making a cut into your skin, including minor procedures carried out by GPs and other doctors. However, for simplicity, we just refer to operations carried out by surgeons in this factsheet. 

The position and size of the cut your surgeon makes will depend on the type of operation and surgery you have. For example, if your surgeon does keyhole (laparoscopic) surgery, he or she will make very small cuts to your skin, which will be closed 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 surgeon's advice.

Wound healing

The process by which your surgical wound heals is complex and 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 your wound and remove dead tissue.
  
• Maturation – new skin seals your wound and forms a scar.

Skin edges usually form a seal within a day or two of an operation, but this can vary from person to person and from operation to operation. Closing your wound surgically (with 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 from your wound
• improve conditions for healing
• reduce the risk of infection
• protect the area until your wound has 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 may include metal clips or staples, and adhesive dressings, or tapes. The method your surgeon uses to close the cut on your body depends on its location, its size and the strength that it's likely to need.

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

You will usually need to have stitches, clips and staples removed between three and 21 days after your treatment, depending on the type of operation you have.

Tissue adhesive (skin glue)

Your surgeon may use special skin glue to close your skin, especially for smaller wounds. Although the glue is waterproof, don't let your wound soak in water. The glue usually peels off in seven to 10 days.

Complications of wound healing

Most surgical wounds will heal without causing you any problems.

However, your wound may become infected after surgery. This means that micro-organisms, such as bacteria start 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 or a condition that affects healing
• have a condition or treatment that affects your immune system, such as leukaemia or chemotherapy

Your doctors and nurses will do everything 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

You may also have a high temperature.

If you have any of these symptoms, see your doctor. Wound infections can usually be treated successfully if they are diagnosed early.

Caring for a 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

You can leave the original dressing in place for up to five days (or as advised by your surgeon) 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. Try not to touch the healing wound with your fingers.

Your wound may then be left without a dressing. However, you might like to continue wearing a dressing over the area for protection, especially if your clothing rubs against it.

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

Taking care of stitches

Dissolvable stitches will usually disappear in around one to three weeks, but it can take longer, depending on the type of stitches you have. Non-dissolvable stitches are usually removed after three to 21 days, depending on the type of operation you have.

During this time you may see small pieces of the stitch material poking out of your healing wound. Don't be tempted to pull on these. If there are loose ends that are catching on clothing, you may 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 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 enough 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 48 hours after surgery, but this will depend on the particular operation you have – ask your nurse at the hospital for advice.

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 your hospital or GP.

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.