Incision & Surgical Wound Care

What is incision and surgical wound care?

Incision and surgical wound care are instructions that you follow to prevent infections and help your body heal. You get these instructions after a surgery or procedure where a surgeon or healthcare provider made an incision (entry point) to access the inside of your body. You’ll need to clean and protect your incision site until it heals completely. If you notice any pain, swelling, warmth around the site or fluid oozing out of your wound, visit a healthcare provider, as you may have an infection.

What is an incision?

An incision is a cut that’s made in your skin during a surgery or procedure. This is also known as a surgical wound. The size, location and number of incisions can vary depending on the type of surgery you receive. When a surgeon closes the incision, your surgical wound will need special care and time to heal.

How are incisions closed?

Your surgeon or healthcare provider will close an incision with one of the following:

• Sutures: Sutures, or stitches, hold your tissue together using surgical thread. A surgeon will use a surgical needle to sew your skin back together in the same way that you’d sew two pieces of fabric together. Your surgeon may choose dissolvable stitches (absorbable stitches) that disappear into your skin when your surgical site heals. Nonabsorbable stitches are stronger but your healthcare provider will have to remove those when your wound heals.
• Staples: Surgical staples close line-like (linear) wounds on your scalp or arms and legs. A healthcare provider can apply staples quickly to stop bleeding with a special surgical stapler that isn’t the same as a paper stapler that you have in your home or office. Surgical staples are made of stainless steel and titanium, or plastic if you have a metal allergy.
• Adhesives: Adhesives include special tapes and glues that use their stickiness to hold your skin together. A healthcare provider may choose adhesives to close wounds from needles (percutaneous wounds), pediatric wounds or apply them in addition to deep sutures. Adhesives are painless. A common adhesive tape is Steri-Strips®.

What is a dressing?

A dressing is another name for a bandage. A sterile dressing keeps your surgical wound clean and dry while it heals. This bandage protects your incision, creating an ideal environment for healing.

How often should I change my dressing?

You can change your wound dressings according to your healthcare provider’s instructions. The length of time varies based on the type and location of your wound. You may need to change the dressing daily or every few days.

How do I care for an incision after surgery?

Your healthcare provider will give you specific instructions to follow after surgery to care for your incisions, which may include:

• Always washing your hands before and after touching your incisions.
• Inspecting your incisions and wounds every day for signs of infection like swelling, pus or color changes.
• Looking for bleeding. If your incisions start to bleed, apply direct and constant pressure to the incisions. If you experience any unexpected bleeding, you should call your healthcare provider for instructions.
• Avoiding wearing tight clothing that might rub on your incisions.
• Avoiding participating in activities that can interfere with healing, like running or strength training and some household chores that involve twisting, bending or lifting.
• Avoiding scratching your wounds. Your incisions might feel itchy as they heal — this is normal. If the itchiness gets worse instead of better after a few days, call your healthcare provider.

How do I bathe with surgical incisions?

If you have a surgical wound, your healthcare provider may give you specific instructions about how to bathe and not irritate your incisions. These may include:

• Staples and Stitches (Sutures): You can wash or shower 24 hours after surgery unless directed otherwise by your healthcare provider. Clean the area with mild soap and water and gently pat dry with a clean cloth.
• Steri-Strips: You can wash or shower with Steri-Strips in place. Clean the area with mild soap and water and gently pat dry with a clean towel or cloth. Don’t pull, tug or rub Steri-Strips.
• Tissue adhesive (glue): Keep the adhesive dry for the first five days. While the glue is waterproof, cover the area while bathing until five days are up, then you can bathe normally. Avoid soaking your surgical site in water; showers are the best method to wash. Pat the wound dry if it gets wet.

How do I change a wound dressing?

Your healthcare provider will give you detailed instructions and will usually show you how to change your dressing. If you have any questions, call your provider.

Wound dressing supplies

There are a few basic supplies you’ll need to change a dressing. These supplies include:

• Gauze pads.
• Disposable medical gloves (optional).
• Surgical tape.
• Scissors.
• Paper towels or a clean cloth.

Steps to change a wound dressing

There are several steps involved in changing the dressing for your incision.

Step 1: Prepare an area to change a dressing.

First, clean a surface, like a table or counter, to work on. If you have pets, move them to a different room during this process and remove any jewelry you’re wearing. After washing the surface where you’ll store your supplies with soap and water (and/or sanitizing wipes), cover that surface with a clean cloth or paper towel.

Step 2: Remove the old dressing.

Gently remove the old dressing from your skin as instructed by your healthcare provider.

Step 3: Clean and rinse the incision.

You need to clean and rinse your incision site with a gentle (unscented) soap and water. If you take a shower, you can clean the incision during the shower. You can apply the dressing after your shower. If you aren’t showering, you should clean the incision as instructed by your healthcare provider.

Always inspect your incisions for signs of infection, like swelling or color changes to your skin.

Step 4: Apply a new dressing.

To apply a new dressing, follow these steps:

1. If your surgeon prescribed a topical ointment, apply a very thin layer of the ointment to the incision.
2. Hold a clean, sterile gauze pad by a corner and place it over the incisions
3. Tape all four sides of the gauze pad to your skin.
4. Wash your hands with soap and water again.

How do I apply a butterfly bandage?

A butterfly bandage, Steri-Strip or a butterfly closure, is an adhesive bandage that has two long and wide ends connected by a thin center. This type of bandage treats small and shallow cuts in an area of your skin that doesn’t move around a lot.

To apply a butterfly bandage, follow these steps:

1. Wash your hands with soap and water then clean the wound and your skin around it.
2. Open the butterfly bandage.
3. Pinch the skin of your cut together by sticking half of the bandage on one side of the cut. The thin part of the bandage should rest over the cut. Then, stick the other side of the bandage on your skin on the opposite side of the cut. You may need to apply more than one butterfly bandage to your cut depending on its size.
4. Keep the area clean and dry until your skin heals.

If you have a large cut or a cut on your skin that continues bleeding after you place a bandage on your skin, contact a healthcare provider.

What are the benefits of incision and surgical wound care?

Caring for an incision or surgical wound prevents complications, especially infections. Your healing time is also shorter and you’re more likely to have minimal scarring with proper care.

What are the risks or complications of not taking care of an incision?

The biggest risk that could happen to an incision is an infection. An infection occurs when bacteria enter your surgical wound and prevent it from healing. Infections can spread throughout your body (sepsis) if left untreated and they’re life-threatening.

What are the signs of an infection?

Signs of an infection include:

• A wound that has thick, cloudy discharge. This is a white or cream color.
• A bad odor from the incision.
• An opening of the incision line — it gets deeper, longer or wider.
• Redness or color changes to your skin that go beyond the edge of the incision.
• A warm temperature around the incision.
• Fever (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius), sweating or chills.

It’s important to know the signs of an infection when you’re caring for an incision. Keep track of any possible signs of an infection and let your healthcare provider know if you experience any.

Who is at a higher risk of infection?

You may be at a greater risk of developing an infection after surgery if you:

• Have diabetes.
• Have a history of smoking tobacco products.
• Have excess weight.
• Experience poor nutrition.
• Have a weakened immune system (for example, if you’re undergoing chemotherapy or taking immune-suppressing medications).
• Had a recent emergency surgery or a long surgical procedure.

How do I reduce my risk of infection?

There are several things you can do to reduce your risk of infection, including:

• Always washing your hands before and after touching your incisions.
• Following your healthcare provider’s instructions.
• Changing your dressing as instructed.
• Avoiding removing the tape strips, picking at staples, glue or stitches, or itching your skin.
• Keeping your incisions dry.

How long does it take for an incision to heal?

In most cases, a surgical incision heals in about two weeks. More complex surgical incisions will take longer to heal. Your healthcare provider will guide you on your healing progress during routine checkups after surgery.

If an infection happens, visit a healthcare provider quickly for treatment. Infections don’t go away on their own. Infections can delay your healing time, and they can spread and cause severe complications without timely treatment.

How long do sutures (stitches) and staples stay in?

Your healthcare provider will remove your sutures (stitches) or staples when your wound heals or closes. The amount of time depends on the size, depth and location of your wound. It could take anywhere from three days to 14 days.

How long does it take for stitches to dissolve?

It usually takes one to two weeks before absorbable stitches dissolve. These stitches can last for a few months, depending on how your body heals.

Dissolvable stitches may be held in place by strips of tape (Steri-Strips). This tape falls off on its own within a couple of weeks.

A healthcare provider may remove dissolvable stitches before they dissolve if they bother you. Don’t try to remove these stitches at home.

When do Steri-Strips fall off?

Steri-Strips will fall off on their own within two weeks. After two weeks, gently remove any remaining Steri-Strips from your skin. If the strips start to curl before it’s time to remove them, you can trim them instead of peeling them from your skin. Peeling off Steri-Strips could irritate your skin.

When will surgical adhesive (glue) go away?

Surgical adhesives (glue) will dry and fall off within five to 10 days. During this time, keep your incision site out of direct sunlight. While the glue is waterproof, avoid soaking the area of your body in a bath to keep it secure on your skin.

Do I need to limit my activity after surgery?

Yes and no. Staying active improves how your body heals by increasing your blood flow. If approved by your healthcare provider, taking short walks may help. After some types of surgery, your healthcare provider may recommend continued rest and limited activity. You should avoid lifting, pulling, straining exercises or sports for a month after surgery or until your provider approves your activities. This could include going back to work or school. Following these instructions will prevent opening the incision again and it promotes healing.

When should I call my healthcare provider?

Call your healthcare provider if you experience:

• Bleeding that doesn’t stop with pressure.
• Color changes to your skin around the wound.
• Increasing wound size.
• Drainage from the wound.
• A fever.

If you ever have questions about your incision care instructions, call your healthcare provider.

How do I suture a wound?

You shouldn’t attempt to suture a wound together on your own or at home. If you have a wound that won’t stop bleeding, is deep or shows signs of an infection, visit a healthcare provider immediately. If you self-treat your wound, you increase your risk of infection, which can affect your healing time and, in some cases, be life-threatening.