What is an incision?
An incision is a cut through the skin made during surgery. Another name for an incision is a surgical wound. The size, location, and number of incisions depend on the type of surgery.
What is a dressing and how often should dressings be changed?
A dressing is a sterile bandage that protects incisions from bacteria and keeps it clean and dry. Dressings should be changed daily or according to your doctor’s orders.
How are incision(s) closed?
Incisions are held closed using stitches, staples, tissue glue, or a special kind of adhesive tape called Steri-Strips™. A sterile dressing covers the incision(s).
How do I care for my incisions after surgery?
Incisions must be kept clean and dry. Proper care of incisions promotes healing, reduces scarring, and reduces the risk of an infection. Follow your doctor’s instructions for incision care very carefully.Some general tips about caring for incisions include:
- Always wash your hands before and after touching your incisions.
- Always inspect your incisions and wounds every day for signs of infection.
- Bleeding: If the incisions start to bleed, cover them with a clean tissue or towel and apply direct and constant pressure to the incisions for at least 5 minutes. If bleeding stops, remove the bloody dressing, clean the incisions (see instructions below), and apply a fresh dressing. If bleeding does not stop after a few minutes, keep applying direct constant pressure to the incisions and call your doctor or go to the emergency room.
- Clothing: Avoid wearing tight clothes that rub on the incisions.
- Itching: Incisions may feel itchy as they heal; this is normal. Don’t scratch them. If the itchiness gets worse instead of better, call your doctor. This may be a sign of infection or that stitches are too tight.
- Staples and Stitches: You may wash or shower 24 hours after surgery unless you are directed otherwise by your healthcare professional. Cleanse the area with mild soap and water and gently pat dry with a clean cloth. Your staples will be removed when the wound is healed. Some stitches dissolve over time; others need to be removed by your doctor. Dissolvable stitches often are held in place by strips of tape (Steri-Strips).
- Steri-Strips: You may wash or shower with Steri-Strips in place. Cleanse the area with mild soap and water and gently pat dry with a clean towel or cloth. Do not pull, tug, or rub Steri-Strips. The Steri-Strips will fall off on their own within 2 weeks. After 2 weeks, gently remove any remaining Steri-Strips.
- Tissue glue: The glue should be kept dry and the incisions should be kept out of direct sunlight. The glue will dry out and fall off within 5 to 10 days.
What supplies are needed to change a dressing?
The basic supplies needed for changing a dressing are:
- Gauze pads.
- Disposable medical gloves.
- Surgical tape.
- Plastic bag (for disposing of old dressing, tape, etc.).
What steps are involved in changing a dressing?
The steps begin with preparing the area where the dressing will be changed. The next steps are to remove the old dressing, cleanse and rinse the incision, and apply the new dressing.
Step 1: How do I prepare the area for changing the dressing?
First, you or the caregiver who is changing the dressing needs a clean surface to work on. Pets should be moved to a different room, and the caregiver should remove any jewelry. The surface where the supplies will be laid out should be washed with soap and water and covered with a clean cloth or paper towel.
Step 2. How do I remove the old dressing?
First, you’ll prepare your new dressing. Open the gauze package(s) without touching the gauze. Next, cut new tape strips. Set aside.
To remove the old dressing:
- Wash your hands by wetting them down, adding soap, and washing for 30 seconds (about the time it takes to sing “Twinkle, Twinkle Little Star”). Clean under your nails.
- Rinse your hands well and dry with a clean towel.
- Put on medical gloves and loosen the tape holding the dressing in place.
- Remove the dressing. Unless the doctor has said to remove the dressing dry, you can wet it if it sticks to the wound to help remove it. Throw the old dressing and dirty medical gloves into a plastic bag.
Step 3. How do I cleanse and rinse the incision?
First, place a towel under the wound to catch the drainage. Wash your hands with soap and water. Dry with a clean towel and put on new medical gloves.
To cleanse the incision:
- Make mild soapy water or a salt water solution.
- Soak a piece of gauze or soft cloth in the soapy water or saline solution and gently pat or wipe the incision and skin around it with the damp cloth.
- Use the damp cloth to remove dried blood and drainage from the skin around the incision.
- Unless otherwise specified by the doctor, do not use skin cleansers, alcohol, peroxide, iodine, or antibacterial soap. These can damage the tissue and slow healing.
To rinse the incision:
- Fill a syringe with salt water or soapy water, whichever your doctor recommends.
- Hold the syringe 1 to 6 inches away from the incision and gently squeeze the bulb to spray the solution into the incision. This rinsing will wash away any remaining blood or drainage.
- Pat the incision dry using a soft, dry cloth, or piece of gauze.
Always inspect your incisions for signs of infection. (See question, “what are the signs of a possible infection”)
Step 4. How do I apply the new dressing?
- If your surgeon prescribed an antibiotic ointment, apply a very thin layer of the ointment to the incision.
- Hold a clean, sterile gauze pad by a corner and place it over the incisions. (This is the gauze that you opened and set aside in step 2.)
- Tape all four sides of the gauze pad. (This is the tape that you already cut and set aside in step 2.)
- Put all trash in the plastic bag, remove your gloves and add them to the trash bag.
- Seal plastic bag and throw it away.
- Wash your hands.
- Wash any soiled laundry separately. Ask your doctor if you should add bleach during the wash cycle.
What can I do to reduce the risk of infection?
- Always wash your hands before and after touching your incisions.
- Follow your doctor’s instructions about keeping the incisions and dressing dry.
- Follow your doctor’s instructions about changing the dressing.
- Exposing incisions to sunlight for at least 3 months.
- Removing the tape strips; picking at staples, tissue glue, or stitches.
- Keeping the incisions wet (make sure the incision sites have been patted dry after washing).
- Using scented soap, lotion or powder, alcohol, iodine, or peroxide around the incisions.
Risks / Benefits
What are the signs of a possible infection in an incision?
- A wound that has green or yellow drainage
- A bad odor from the incision.
- Opening of the incision line – it gets deeper, longer, or wider.
- Redness that goes beyond the basic edge of the incision – site should show signs of improvement and not getting redder.
- Warmth, hardness, around the incision.
- Fever (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius), sweating, or chills.
- Swings in blood sugar levels in a diabetic patient.
What are the general risk factors for developing an infection?
Patients at higher risk are those who have:
- A history of smoking.
- Excess weight.
- Poor nutrition.
- Weak immune system (for example, a patient on chemotherapy or an elderly patient).
- Recent emergency surgery or a long surgical procedure.
Recovery and Outlook
What are the limits on activity while an incision is healing?
Staying active improves healing by improving blood flow. After some types of surgery, the doctor may recommend avoiding lifting, pulling, straining, exercise, or sports for a month after surgery. Following these instructions will prevent opening of the incision line and promote healing.
How long does it take for an incision to heal?
Good incision care can help ensure that it heals well and an infection doesn’t develop. In most cases, a surgical incision heals in about two weeks. More complex surgical incisions will take longer to heal. Patients with other medical conditions or taking certain medications may need a little extra time to heal.
When to Call the Doctor
When is it important to call the doctor?
Call the doctor if you experience:
- Bleeding that does not stop with pressure.
- If there is any sign of infection (see question, “what are the signs of a possible infection”).
- If you have questions or confusion about incision care instructions.