Support Your Healing and Prevent Complications

Different surgical wounds heal in different ways. There are simple, clean wounds that heal with the edges lined up neatly. There are also complicated wounds that can't be closed during surgery. In either case, you can take steps to support healing.

Wound types

Whether a surgical wound is clean depends on where it is and what led to surgery.

Clean

Clean wounds have no infection and are in areas that are not likely to get infected.

Clean-contaminated

Clean-contaminated wounds are not infected at the time of surgery but are more likely to get infected because of their location. If a surgeon had to repair an internal organ, it is more likely to lead to an infection.

Contaminated

Surgeons consider a wound contaminated if it could have exposure to bacteria but is not actively infected, such as wounds from accidents or surgery where the gastrointestinal tract was open.

Dirty-contaminated

Dirty-contaminated wounds have the highest chance of developing complications. These wounds are in tissue that was already infected at the time of surgery.

When to Call Your Doctor

Call your surgeon or inform your care team if you have any of these symptoms:

Bleeding that does not stop with direct pressure.
A fever of 101 degrees or greater.
Foul smelling drainage from your wound.
Redness and heat around your wound.
Wound tissue changing from pink to yellow, white, or black.
Staples or sutures that have come out, or a new opening.
Pain that does not go away with medication.

Higher Risk

You may heal slower and be at higher risk of infections if you:

Have diabetes. You can help by keeping your blood sugar under control.
Are taking medications called corticosteroids. Talk to your doctor about their risks and benefits.
Are a smoker. For resources to help you quit, visit smokefree.gov or call 1-800-QUIT NOW.

Set Goals

After surgery, your wound care goals are:

Avoiding complications.
Regaining the best function and appearance.

Closures

Not all wounds can be closed during surgery due to their shape and size or because of a high risk of infection. When surgeons do close a wound, they can use several methods.

Sutures

Sutures may dissolve on their own, or your healthcare provider may need to remove them. Talk to your surgeon about the type of sutures you have.

Staples

Staples close the last layer of skin. Dissolvable sutures usually close the layers underneath. A healthcare provider will remove staples after several days. When they’re removed depends on the wound’s location.

Steri-Strips®

Steri-Strips are thin strips with adhesive backing. Avoid getting them wet for the first 24 hours after surgery. Leave them in place until they fall off — often in 7 to 10 days. You may trim loose ends if they start to peel back but do not pull them off.

Adhesives

You surgeon may close your wound with glue — called a skin adhesive. Leave the adhesive in place until it comes off on its own — often in 5 to 10 days.

How to Support Healing

Keep the following in mind to give your surgical wound the best environment for healing:

Do not strain. Straining to lift or move can pull apart the edges of your wound.
Ask your surgeon when you may shower. With a closed, clean wound, you can usually shower after 24 hours.
Do not bathe or get into a hot tub or swimming pool until your wound heals. You could get an infection.
Only use ointments if your surgeon instructs you to.

Changing your dressing

Keep your wound covered with a clean dressing if your surgeon recommends it. Change the dressing if it becomes wet or soiled, when you shower, and as often as your surgeon recommends. There are many types of dressings. Ask your surgeon about yours.

Follow these steps to change your dressing:

Clean your hands with soap and water before changing your dressing.
Peel back the tape edges carefully.
Put on clean gloves after removing the tape and before removing the dressing.
If your dressing gets stuck to the wound, moisten it with water before removing it. You do not need to use sterile water unless your surgeon tells you to.
Clean the wound using either of the following methods:

Take a shower for 5 to 10 minutes, using warm water. Avoid straining. Do not point the water stream directly onto your wound. Gently pat your wound dry.
Use clean gauze moistened with tap water, or sterile water if your surgeon specifies it. Gently clean the wound closure line, removing any drainage. Rinse carefully and pat dry.

Cover your clean, dry wound with a fresh dressing.

Special care

Depending on its type, size, and location, your wound may need special care. Open-wound surfaces heal best when kept moist and free of drainage.

Packing. Wounds with tunneled areas are packed with moist gauze to absorb drainage and help with healing. Your care team may train you or a caregiver to perform dressing changes with packing.
Surgical drains. If your wound has a lot of drainage, you may have a surgical drain for some time. There are several types. Usually, you will have a thin tube inside your wound leading out to a collection bag, bulb, or container. Many drains use gentle suction. If you go home with a drain, your nurse will teach you or a caregiver how to empty and care for it.
Negative pressure wound therapy. You may hear this referred to as a wound vac. A nurse will pack your wound with foam material and seal it with an adhesive covering. A tube connects the sealed wound to a vacuum pump that removes drainage. Wound vacs help promote healing and pull the wound edges together. A nurse will perform all dressing changes.

Resources:

Wound Management Home Skills Program. American College of Surgeons.
Surgical Patient Education Program. American College of Surgeons.
Quit Smoking before Your Operation. American College of Surgeons.
Surgical Site Infection (SSI) . Centers for Disease Control.
Surgical Site Infections. Agency for Healthcare Research and Quality.

Surgical Wound Care