Surgical wound care - closed

When you come home after surgery, you may have a dressing on your wound. Dressings do several things, including:

• Protect your wound from germs
• Reduce the risk of infection
• Cover your wound so that stitches or staples do not catch on clothing
• Protect the area as it heals
• Soak up any fluids that leak from your wound

You can leave your original dressing in place for as long as your surgeon says. You will want to change it sooner if it becomes wet or soaked with blood or other fluids.

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

Your surgeon will tell you how often to change your dressing. Your surgeon likely gave you specific instructions on how to change the dressing. The steps outlined below will help you remember.

Getting prepared:

• Clean your hands before touching the dressing. Wash your hands with soap and warm water. Also clean under your nails. Rinse, then dry your hands with a clean towel.
• Make sure you have all the needed supplies handy.
• Have a clean work surface.

Remove the old dressing.

• Put on clean medical gloves if your wound is infected (red or oozing), or if you are changing the dressing for someone else. The gloves do not need to be sterile.
• Carefully loosen the tape from the skin.
• If the dressing sticks to the wound, moisten it gently with water and try again, unless your surgeon instructed you to pull it off dry.
• Put the old dressing in a plastic bag and set it aside.
• Remove the gloves if you had them on. Throw them in the same plastic bag as the old dressing.
• Wash your hands again.

When you put on a new dressing:

• Make sure your hands are clean. Put on clean gloves if your own wound is infected, or if you are putting on dressing for someone else.
• Do not touch the inside of the dressing.
• Do not apply antibiotic cream or other products unless your surgeon tells you to.
• Place the dressing over the wound and tape down all 4 sides.
• Put the old dressing, tape, and other trash in the plastic bag. Seal the bag and throw it away.

If you have non-dissolvable stitches or staples, your health care provider will remove them. Do not pull at your stitches or try to remove them on your own.

Your surgeon will let you know when it is OK to shower or bathe after surgery. Usually it is fine to shower after 24 hours. Keep in mind:

• Showers are better than baths because the wound doesn't soak in the water. Soaking the wound could cause it to reopen or become infected.
• Remove the dressing before bathing unless told otherwise. Some dressings are waterproof. Your surgeon may suggest covering the wound with a plastic bag to keep it dry.
• If your surgeon gives the OK, gently rinse the wound with water as you bathe. Do not rub or scrub the wound.
• Do not use lotions, powders, cosmetics, or any other skin care products on the wound.
• Gently pat dry the area around the wound with a clean towel. Let the wound air dry.
• Apply a new dressing.

At some point during the healing process, you will not need a dressing anymore. Your surgeon will tell you when you can leave your wound uncovered.

Contact your surgeon if there are any of the following changes around the incision:

• More redness or pain
• Swelling or bleeding
• The wound is larger or deeper
• The wound looks dried out or dark

You should also contact your surgeon if the drainage coming from or around the incision increases or becomes thick, tan, green, or yellow, or smells bad (pus).

Also contact your surgeon if your temperature is above 100°F (37.7°C) for more than 4 hours.

Surgical incision care; Closed wound care

Boukovalas S, Aliano KA, Phillips LG, Norbury WB. Wound healing. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 6.

Woelfel SL, Armstrong DG, Shin L. Wound care. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 118.

Updated by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.