Surgical wound care - open
Surgical incision care; Open wound care
An incision is a cut through the skin that is made during surgery. It is also called a surgical wound. Some incisions are small, others are long. The size of the incision depends on the kind of surgery you had.
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).
What to Expect at Home
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 can use an alcohol-based cleanser. Or, you can 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 health care provider 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 provider 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 provider 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 (2.5 to 15 centimeters) away from the wound. Spray hard enough into the wound to wash away drainage and discharge.
- Use a clean 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, unless your provider has said it is OK.
Putting on the New Dressing
Place the clean dressing on the wound as your provider 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 provider 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:
- There is more redness, pain, swelling, or bleeding at the wound site.
- The wound is larger or deeper, or it looks dried out or dark.
- The drainage coming from or around the wound increases or becomes thick, tan, green, or yellow, or smells bad (which indicates pus).
- Your temperature is 100.5°F (38°C) or higher.
Breast lump removal
Intestinal obstruction repair
Open gallbladder removal
Parathyroid gland removal
Thyroid gland removal
Tracheoesophageal fistula and esophageal atresia repair
Umbilical hernia repair
Congenital diaphragmatic hernia repair
Large bowel resection
Small bowel resection
Heart bypass surgery
Congenital heart defect - corrective surgery
Pectus excavatum repair
Carotid artery surgery - open
Varicose vein stripping
Angioplasty and stent placement - carotid artery
Knee joint replacement
Hip joint replacement
Carpal tunnel release
Abdominal wall surgery
Breast augmentation surgery
Patent urachus repair
Testicular torsion repair
Transurethral resection of the prostate
Bladder exstrophy repair
Heart bypass surgery - minimally invasive
Gastric bypass surgery
Knee microfracture surgery
Ventricular assist device
Endoscopic thoracic sympathectomy
Pediatric heart surgery
Leg or foot amputation
Laparoscopic gallbladder removal
Foot amputation - discharge
Leg amputation - discharge
Pediatric heart surgery - discharge
Leg or foot amputation - dressing change
Closed suction drain with bulb
Lymphedema - self-care
Phantom limb pain
Heart pacemaker - discharge
Heart bypass surgery - discharge
Ventriculoperitoneal shunt - discharge
Large bowel resection - discharge
Small bowel resection - discharge
Total colectomy or proctocolectomy - discharge
Central venous catheter - dressing change
Central venous catheter - flushing
Peripherally inserted central catheter - flushing
Ankle replacement - discharge
Elbow replacement - discharge
Knee arthroscopy - discharge
Spleen removal - child - discharge
Laparoscopic spleen removal in adults - discharge
Open spleen removal in adults - discharge
Thyroid gland removal - discharge
Kidney removal - discharge
Wet-to-dry dressing changes
Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Wound care and dressings. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2016:chap 25.
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Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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