You may have one or more wounds from your surgery. This leaflet will give you a general guide to looking after your surgical wound. Your surgeon will give you specific advice for your operation.
How is the wound closed? At the end of your operation your surgeon will close your surgical wound. This may be done with stitches, staples, Steristrips (adhesive skin-closure tapes) or special skin glue. Your surgeon will make the best choice for you depending on the type of surgery you have had. Stitches: Otherwise known as sutures, these are the most common way to close wounds. They are made of nylon or other material that looks like fine fishing line. The stitches may either be visible outside the skin (blue or black in colour) or may be placed within or just under the skin so that they cannot be seen from the outside (subcuticular technique). Your nurse or surgeon usually removes the ones that are visible outside the skin after the wound has healed. The ones under the skin are commonly colourless, are dissolving and do not usually need removal though there may be knots at each end that need to be cut off when the wound has healed.
Staples: Are small metal clips that hold the wound edges together. These need to be removed when the wound has healed. Steristrips: Are small strips of sticky paper tape that are stuck across the wound to hold the edges together. These can be used alone on small wounds (for example after an arthroscopy) or with dissolving stitches. Skin glue: May be used on a small wound or to support the edges of a skin graft.
How long will healing take? This depends on your general health, nutrition and the type of operation you have had. In healthy people, most wounds heal within 2 weeks. Healing may take longer if you have a health problem such as diabetes, are taking certain drugs (such as steroids, immunosuppressants or chemotherapy drugs) or have a weakened immune system.
What can I do to help my wound heal? Eat a nutritious diet high in vitamin C, protein and zinc to promote wound healing. You can find vitamin C in citrus fruits and green vegetables such as broccoli, spinach and Brussel sprouts. Meat and milk products are high in protein and zinc. Rarely, your doctor may recommend multivitamins and nutritional supplements if you have a particular nutritional problem, wound healing difficulty or gut-related disease; however, for most people taking a balanced diet, these are not necessary.
How do I care for my wound? Your surgeon will give you specific directions about the care of your wound, which may be a little different from these. As a rule, keep the wound clean and dry until stitch removal.
Can I take a shower and get my wound wet? Avoid baths, swimming pools and hot tubs until your incision is completely healed or you might get an infection. Only when the wound is healed and the stitches are removed will you be allowed to get the wound wet.
Your wound may be bandaged with gauze or another type of dressing. Just before you go home, the surgeon or nurse may change the dressing, check the wound, and put on a new dressing, depending on the surgery.
Do I need to change my dressing? It is normal in orthopaedic surgery to leave the dressings undisturbed until the wound has healed. Unnecessary manipulation of the wound may risk infection.
When will my stitches be removed? Stitches, staples and Steristrips are usually removed 12 – 14 days after the operation when the wound has healed. This may be done at your GP’s surgery or at the hospital depending on whether or not your surgeon needs to see the wound. If you have Steristrips, they may peel slightly at the ends after a few days. This is ok. Leave them alone until they fall off or for at least two weeks.
Experiences with a healing wound Discomfort: You may have discomfort or numbness around the wound at first; this is normal. Your surgeon will give you pain-reducing medicine. For the first few days after your operation take your pain medicine regularly or at the first sign of discomfort, as directed. Do not wait until your pain is extremely bad. Notify your surgeon immediately if pain suddenly gets worse or if the pain from the operated area is worsening rather than improving in the couple of weeks after the surgery.
Itching: The wound may itch. This is often normal. If severe and uncomfortable it may be a sign of a problem, such as infection or stitches that are too tight. Do not scratch the area; call your surgeon or dressings clinic nurse if you’re particularly uncomfortable. Bleeding: A little blood may stain the dressings in the first 24 to 48 hours after the operation. If there is significant blood loss that is soaking the dressing or continued bleeding after 72 hours, seek advice as below. Weeping: If the wound is weeping fluid or pus there may be an infection. Seek urgent advice as below.
Warmth and redness: A little warmth and slight redness is normal in a healing wound as the blood flow to the area increases during healing. However, if the area of redness is spreading, is painful or swelling around the wound is increasing seek advice.
Thread poking out of the wound: Occasionally there appears to be a spot appears on the wound and then the end of a deep wound stitch pokes out. If this happens contact the hospital dressings clinic nurse as this can often be easily removed.
If your wound needs to be looked at for one of the reasons above, contact:
The dressings clinic nurse at the hospital where your surgery was carried out
As a last resort the local hospital emergency department if there is a major and immediate problem.
When should I seek urgent help? Call your treating hospital or surgeon immediately if you experience any of the following symptoms:
Chills or fever over 38.2oC (101oF).
Warmth, swelling, redness or increasing pain at the wound.
Drainage from the wound 48 hours or more after the operation, pus or a bad smell.
Sudden, excessive bleeding from the wound.
Any opening of the stitches or staples.
In the unlikely event that your wound pops open, cover it with gauze or a clean towel. Call your surgeon or treating hospital immediately or go to the nearest emergency department as a last resort.
When can I get back to normal? Moving around is good for you but while your wound is healing avoid placing too much strain on it. Avoid excessivebending, lifting, or being too active. If you have had surgery on your feet or hands, keep them as elevated high as possible for a week or two after surgery. For hand surgery, you will often be advised to move the digits rather than keep them still.
Your surgeon will tell you when you can resume work, pick up small children, do heavy household chores, drive or carry shopping. Your surgeon will also advise you on when you can start sports again. After 7 – 10 days, if you feel well enough, you can do light housework and activities depending on where the wound is located. Talk with your surgeon about your normal activities so you know which ones are safe to do and when.
Scars from surgical wounds are prone to sunburn so keep them covered or apply sunscreen once the wound is healed.
Consider using green-colored concealer makeup to help hide a red scar but only after it has healed.
Lotions and skin moisturisers can help to soften scars when they are healed. Firm massage of the healed scar area and around it is a good idea and is soothing.
Occasionally scars are a little thick or stiff. If this happens, particularly on the hand, then you may be given specific treatment to help to thin the scar and make it more flexible.
Whilst this is not an exhaustive guide, we hope that you have found this it useful.
Remember to ask your surgeon if you have any questions. Your surgeon will give you specific advice.
Independent Hospital contact numbers: Thornbury hospital: 0114 266 1133 Barlborough Treatment Centre: 0333 200 4066 Claremont Hospital: 0114 263 0330