Surgical wound care - open

Answer 1

Alternate Names

Surgical incision care; Open wound care

What to Expect at Home

An incision is a "cut" through the skin that is made during surgery. It also called a "surgical wound." Some incisions are small, and others are very long. The size of the incision will depend on the kind of surgery you had.

Do not wear tight clothing that rubs against the incision while it is healing.

Sometimes, a surgical wound will break open (wound dehiscence). This may happen along the entire cut or just part of it. Your doctor may decide not to close it again with sutures, or stitches.

If your doctor does not close your wound again with sutures, you will need to learn how to care for it at home, since it may take time to heal. The wound will heal from the bottom to the top. The dressings help to soak up any drainage and to keep the skin from closing before the wound underneath fills in.

Proper Handwashing

It is important to clean your hands before you change your dressings. You make use an alcohol-based cleaner like Purell, or you may wash your hands using these steps:

• Take all jewelry off your hands.
• Wet your hands, pointing them down under warm running water.
• Add soap and wash your hands for 15 to 30 seconds (sing "Happy Birthday" or the "Alphabet Song" 1 time through). Clean under your nails also.
• Rinse well.
• Dry with a clean towel.

Removing the Old Dressing

Your doctor will tell you how often to change your dressing. Be prepared before starting the dressing change:

• Clean your hands before touching the dressing.
• Make sure you have all the supplies you will need handy.
• Have a clean work surface for all of the equipment you will need.

Remove the old dressing:

• Carefully loosen the tape.
• Use a clean (not sterile) medical glove to grab the old dressing and pull it off.
• If the dressing sticks to the wound, get it wet and try again.
• Put the old dressing in a plastic bag and set it aside.
• Clean your hands again after you take off the old dressing.

Caring for the Wound

You may use a gauze pad or soft cloth to clean the skin around your wound:

• Use a normal saline solution (salt water) or mild soapy water.
• Soak the gauze or cloth in the saline solution or soapy water, and gently dab or wipe the skin with it.
• Try to remove all drainage and any dried blood or other matter that may have built up on the skin.
• Do not use skin cleansers, alcohol, peroxide, iodine, or soaps with antibacterial chemicals. These can damage the wound tissue and slow your healing.

Your doctor may also ask you to irrigate, or wash out, your wound:

• Fill a syringe with salt water or soapy water, whichever your health care provider recommends.
• Hold the syringe 1 to 6 inches away from the wound, and spray hard enough into the wound to wash away drainage and discharge.
• Use a soft, dry cloth to carefully pat the wound dry.

Do not put any lotion, cream, or herbal remedies on or around your wound without asking your doctor first.

Putting on the New Dressing

Place the clean dressing in the wound as your health care provider taught you to. You may be using a wet-to-dry dressing. See also: Wet to dry dressing changes

Clean your hands when you are finished.

Throw away all the old dressings and other used supplies in a waterproof plastic bag. Close it tightly, then double it before putting it in the trash.

Wash any soiled laundry from the dressing change separately from other laundry. Ask your doctor if you need to add bleach to the wash water.

Use a dressing only once. Never reuse it.

When to Call the Doctor

Call your doctor if:

• You see any of these changes around the incision:
  • More redness
  • More pain
  • Swelling
  • Bleeding
  • The wound is larger or deeper
  • The wound looks dried out or dark
• The drainage coming from or around the incision:
  • Is increasing
  • Becomes thick, tan, green or yellow, or smells bad (pus)
• Your temperature is above 100 °F for more than 4 hours.

References

Fonder MA, Lazarus GS, Cowan DA, Aronson-Cook B, Kohli AR, Mamelak AJ. Treating the chronic wound: A practical approach to the care of nonhealing wounds and wound care dressings. J Am Acad Dermatol. 2008 Feb;58(2):185-206.

Reviewed By

Review Date: 06/27/2010

Debra G. Wechter, MD, FACS, General Surgery practice specializing in Breast cancer, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.