Surgical wound care - open
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 is also called a surgical wound. Some incisions are small and others are long. The size of the incision depends on the kind of surgery you had.
Do not wear tight clothing that rubs against the incision while it is healing.
Sometimes, an incision breaks open. This may happen along the entire cut or just part of it. Your doctor may decide not to close it again with sutures (stitches).
If your doctor does not close your wound again with sutures, you need to care for it at home, since it may take time to heal. The wound will heal from the bottom to the top. A dressing helps absorb drainage and keep the skin from closing before the wound underneath fills in.
It is important to clean your hands before you change your dressing. You may use an alcohol-based cleanser. Or you may wash your hands using these steps:
- Take all jewelry off your hands.
- Wet your hands, pointing them downward under warm running water.
- Add soap and wash your hands for 15 to 30 seconds (sing "Happy Birthday" or the "Alphabet Song" one time through). Clean under your nails also.
- Rinse well.
- Dry with a clean towel.
Removing the Old Dressing
Your doctor or nurse will tell you how often to change your dressing. To prepare for the dressing change:
- Clean your hands before touching the dressing.
- Make sure you have all the supplies handy.
- Have a clean work surface.
Remove the old dressing:
- Carefully loosen the tape from your skin.
- Use a clean (not sterile) medical glove to grab the old dressing and pull it off.
- If the dressing sticks to the wound, wet it and try again, unless your doctor instructed you to pull it off dry.
- 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 soap with antibacterial chemicals. These can damage the wound tissue and slow 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 doctor recommends.
- Hold the syringe 1 to 6 inches away from the wound. Spray hard enough into the wound to wash away drainage and discharge.
- Use a soft, dry cloth or piece of gauze 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 on the wound as your doctor or nurse taught you to. You may be using a wet-to-dry dressing.
Clean your hands when you are finished.
Throw away the old dressing 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 any of these changes occur around the incision:
- More redness
- More pain
- The wound is larger or deeper
- The wound looks dried out or dark
- The drainage coming from or around the incision increases or becomes thick, tan, green, or yellow, or smells bad (which indicates pus)
- Your temperature is above 100 °F for more than 4 hours
Lynn PB. Cleaning a wound and applying a dry, sterile dressing. In: Lynn PB. Taylor’s Handbook of Nursing Skills. Philadelphia, PA: Lippincott Williams and Wilkins, Wolters Kluwers. 2011.
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, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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