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Caring for a surgical wound


Expert reviewer, Mr Christian Macutkiewicz, Consultant General and Hepato-Pancreatico-Biliary Surgeon
Next review due February 2023

Caring for a surgical wound is important to lower your risk of infection and ensure your wound heals in the best way possible. You’ll have a surgical wound after an operation, during which your surgeon made a cut into your skin and tissues. Your operation or surgical procedure may have been done by a surgeon or you may have had minor surgery by your GP or another doctor. For simplicity, we refer to ‘your surgeon’ throughout this topic. We’re giving some general information about caring for a surgical wound here, but it’s important to follow the individual advice your surgeon gives you.

A group of surgeons with surgical gear

Wound healing

Types of wound healing

A surgical wound is a cut made to your skin and tissues during an operation. Usually, after your surgeon finishes your operation, they’ll bring the edges of the cut together and secure them with stitches, staples or glue. This is called primary wound healing and is what we’re focusing on in this topic.

Sometimes, it’s best for your surgeon to leave the wound open to heal up by itself. This might be if your wound is infected or if the edges couldn’t be brought together easily. This is called secondary wound healing. Examples include a wound left after having a bite cleaned or having an abscess drained. If you have this type of wound, your surgeon will tell you how to look after it.

How a wound heals

In healthy people, most wounds heal within a couple of weeks but this can vary depending on the type of operation you had.

The way a wound heals can be divided into several phases, which may overlap.

  • Immediately after the cut, cells called platelets in your blood form clumps and release chemicals to stop the bleeding.
  • In the first few days, blood flow to your wound increases and white blood cells arrive to fight infection and remove dead tissue. New cells arrive to start repairing the wound.
  • From three days to three weeks, new blood vessels grow to bring nutrients to your wound and new tissue starts to develop.
  • Finally, from three weeks up to about a year, the new tissues laid down in the wound are gradually replaced and re-organised. Your scar gradually gets stronger, paler and more like normal skin.

If your surgeon closes your wound surgically (with stitches, clips or staples), it’s likely to heal faster.

Monitoring your wound

While your wound is healing, it’s important to keep an eye on it and check for signs of infection. You can learn what to look out for in the section below: Wound infections.

Sometimes a lump can form around your scar. This is called a haematoma – let your GP or surgeon know if you can feel any lumps.

You may wish to keep your wound out of the sun while it’s healing. While sunlight doesn’t affect healing, the top layer of your skin produces a pigment called melanin that gives your skin its colour. So if you expose your skin to the sun while your wound is healing, the scar might look different from the skin around it.

Dressings

It’s not always necessary to have a dressing on a surgical wound but if you do need one, it’s purpose is to:

  • absorb any fluid weeping from your wound
  • provide the best conditions for healing
  • protect the area as your wound heals
  • apply pressure (if required)

Changing the dressing

Depending on where your wound is, you can leave your original dressing in place for up to seven days. Your surgeon or nurse will tell you how to care for a surgical wound at home and when you should remove the dressing.

  • Before you remove the dressing, wash your hands with soap and water and then dry them.
  • Carefully take off the dressing, trying not to touch the healing wound with your fingers.
  • Put the used dressing in the bin – you may want to put it in a waste bag first.
  • You might then be able to leave your wound without a dressing. But you might like to keep one over the area for protection and comfort, particularly if your clothes are rubbing against it. Your hospital may give you a replacement dressing to use at home.
  • Put the dressing on carefully and don’t touch the inside of it.
  • Don’t use antiseptic cream under the dressing. These creams may damage your tissue rather than help it heal. It’s best to keep your wound dry until it has sealed.

Stitches, clips and staples

The medical term for stitches is sutures. Other methods that can be used to close a surgical wound include metal clips or staples and adhesive dressings, tapes or glue. The method your surgeon uses will depend on where your wound is, how big it is and how strong the closure needs to be.

If you have stitches, you may see small pieces of the stitch material poking out of your wound. Usually this dissolves and falls off but sometimes your doctor or nurse will need to cut it and remove it once your wound has healed. Don’t be tempted to pull on these. As your skin heals, it’s natural for your stitches and wound to itch – it’s part of the healing process. Try not to scratch the area and don’t put any moisturiser or other ointments on your skin to ease the irritation. If the stitches cause you pain or discomfort, contact your GP or hospital for advice.

Some stitches are dissolvable so you won’t need to have them removed. Dissolvable stitches usually disappear in about four to eight weeks, depending on the type you have.

A nurse or doctor will usually remove non-dissolvable stitches, clips and staples after three to 14 days, and will then clean your wound. When they need to come out depends on where they are and the type of operation you had. Your nurse will arrange a follow-up appointment at your hospital for this.

Adhesive-strips

Your surgeon may close your wound with strips that stick to your skin. You need to keep these dry if you have a shower, so put a waterproof dressing over the strips because they could come off in water. They’ll usually come off by themselves after a week to 10 days.

Skin glue

Your surgeon may use skin glue to close your wound, especially if you have a small wound. An advantage of skin glue is that it brings the edges of your skin together very quickly. This helps to seal the wound and form a barrier that lowers the risk of infection.

Although skin glue is waterproof, it will come off with repeated washing so don’t soak your wound in water. The glue usually peels off by itself in seven to 10 days so you don’t need to return to the hospital to have it removed. If any glue is still there after a couple of weeks, you can remove it with soap and water or petroleum jelly.

Its’ important not to use any ointment or moisturiser near your wound as it may cause the glue to peel off too soon. It’s also important to keep your wound out of the sun until the glue is gone and your wound has healed.

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Surgical drains

Your surgeon may put a temporary surgical drain in place during your operation. This is a thin plastic or rubber tube that drains blood and fluids from the site of your operation so that they don’t collect there. The fluids may drain into a dressing, bag or container that can be emptied. The tube may be held in place by one or two stitches in your skin.

If you have a surgical drain, your nurse will check it regularly to see how much is draining. They’ll also check the area around the drain for signs of infection. Your surgeon or nurse will usually remove your drain when the amount of fluid drained becomes very small or stops altogether.

If the drain is still draining fluid but you’re otherwise well, you may be able to go home with your drain still in place. If so, your nurse will tell you exactly how to look after it. You may be given a hospital number you can call if you have concerns about your drain or if you get problems once you’re home.

When you’re at home, contact the hospital if:

  • you have signs of infection (see our section: Wound infections below)
  • the drained fluid suddenly changes colour or smells
  • the tube comes loose where it leaves your skin

Your surgeon or nurse will let you know the plan for removing the drain when you no longer need it.

Bathing and showering

It’s usually possible to have a shower about 48 hours after surgery but this will depend on what operation you had. Here are some general points to remember.

  • If possible, have showers rather than baths so that your wound doesn’t soak in water. This could soften the scar tissue and cause your wound to reopen. Only have a bath if you can keep your wound out of the water.
  • Remove any dressing before you have a bath or shower, unless your surgeon or nurse gives you different advice. Some dressings are waterproof and can be left on.
  • You can gently wash the area surrounding your wound with mild soap. Don’t use any soap, shower gel, body lotion, talcum powder or other bathing products directly over your wound though.
  • You can let the shower water gently splash onto your healing wound. But don’t rub the area, as this might be painful and could delay the healing process.
  • Dry the surrounding area carefully by patting it gently with a clean towel – but allow your wound to air dry.

Ask your doctor or nurse if you can have a shower or bath, and how long you should keep your wound dry. Always follow their advice – they’ll know what’s best for your circumstances.

Keeping yourself healthy

Your surgical wound stands the best chance of healing well if your body is as healthy as possible. There’s a lot you can do to help yourself.

Smoking

If you smoke, try to give up before you have your surgery. Smoking reduces the amount of oxygen that gets to your tissues, which slows down wound healing. Ask your GP practice nurse for advice and support to help you give up smoking.

Diet

Your body needs energy and the right nutrients to heal quickly so it’s important that you eat well. Eating a healthy balanced diet should give you all the nutrients your wound needs to heal. You don’t normally need to take supplements if you were in good health before surgery and you recover normally. Make sure you drink enough too because if you’re dehydrated, your wound may take longer to heal.

Weight

It’s useful to lose any excess weight, preferably before you have surgery. Being overweight can increase the time it takes for your wound to heal and increase the risk of getting a wound infection.

Diabetes

If you have diabetes, it’s important that your blood sugar is well controlled because having high blood sugar can slow down the healing process.

Wound infections

Most surgical wounds will heal without causing any problems, but it’s possible that your wound may become infected after surgery. You can ask your surgeon how likely this after your operation, and what to look out for.

If you get an infection, you’ll usually be treated with a course of antibiotics. Very occasionally, you may need to have further surgery.

Your doctors and nurses will do everything they can to prevent your wound from becoming infected. But it’s important that you know what to look out for after you go home. If your wound becomes infected, it may:

  • become more painful
  • feel tender
  • look red, inflamed or swollen
  • smell unpleasant

Your wound might also leak or weep liquid, pus or blood. If there’s a bit of oozing from your wound within the first few hours that’s nothing to worry about. But if the bleeding or oozing continues or there’s a swelling developing under your wound, seek medical advice.

You may also have a high temperature.

A surgical wound infection can develop two to three days after an operation but it can also happen up to two or three weeks later. It can even happen several months after an operation but this is rare. If you have any of these symptoms or are worried about how your wound looks, contact the hospital ward you were on or your GP surgery.

For more information about wound infections see our FAQs below.

Frequently asked questions

  • An abscess is a collection of pus, which your body produces if you get an infection. It’s uncommon but if you get an infection in your surgical wound, the pus formed may collect under your skin and form an abscess. This can feel swollen and painful and you may also feel feverish.

    If you think you have an abscess, you should contact your hospital ward or your GP surgery because you’ll need treatment. If the abscess isn’t very big or deep, it might be possible to treat it with antibiotics. But you may need to have the abscess drained of pus and cleaned to remove damaged or infected tissue. Your doctor may give you antibiotics to take after your abscess has been drained but this is usually only if the infection has spread.

    If you had an infection before your surgery, such as with perforated (ruptured) diverticulitis or appendicitis, you may get a deeper abscess. Your surgeon may then recommend further surgery to drain and clean it. Or you may have a CT or ultrasound scan to help your surgeon insert a drain. 

  • Cellulitis is a bacterial infection that spreads to the deep layers of your skin. Your skin has many bacteria living on it and these don’t usually cause problems. But if your skin is damaged – such as when you have a surgical wound – these bacteria can enter your body. Your immune system fights them off, but sometimes that’s not enough and the bacteria grow and cause cellulitis.

    If your wound becomes infected, you may notice that it becomes red, inflamed or swollen. If you have cellulitis, the area of affected skin may start to spread. You may also feel unwell, with a high temperature and chills or shivers. Later on, your skin may get blisters, which may be filled with clear fluid or blood.

    If you have any of these symptoms, see your GP. If you have cellulitis, it’s important to start antibiotics early to stop the infection spreading. If your infection is severe, you may need to go into hospital for treatment.

    The antibiotic used for cellulitis is usually a type of penicillin, so it’s important to tell your doctor if you’re allergic to penicillin.

  • Every year, hospitals collect information about how many patients get wound infections after surgery. In England, this monitoring of wound infections is co-ordinated across the country by Public Health England (PHE). This is a government organisation dedicated to improving people’s health.

    While you’re in hospital, your nurse or surgeon will regularly check your wound for signs of infection. If your hospital is one that takes part in this monitoring scheme, they may contact you about a month after you leave hospital. They’ll ask you if you’ve had any problems with your wound. This is because they’re interested in all wound infections, including those that happen after you leave hospital.

    The hospital passes information about wound infections to the experts at PHE. They tell PHE about things like the type of operation you had, your age, and how well you were before the operation. All the information about individual patients is treated as strictly confidential.

    PHE analyses all this information and publishes yearly reports. All hospitals can use these to help them make sure fewer and fewer people get wound infections. If you want to read these reports, you can find them on the GOV.UK site or search online for ‘surgical site infection surveillance’.

    Hospitals in Wales, Northern Ireland and Scotland also record information about wound infections. There are arrangements in each country for this information to be collected and used to reduce the number of wound infections in their hospitals.



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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, February 2020
    Expert reviewer, Mr Christian Macutkiewicz, Consultant General and Hepato-Pancreatico-Biliary Surgeon
    Next review due February 2023

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