W

wound care The care necessary, including
cleansing and dressing changes, to keep surgical
incisions, or wounds, healthy as they heal. Most
surgical wounds heal quickly and without compli-
cation and require very little care beyond keeping
them clean and dry for one to five days after sur-
gery. Redness at the incision line is normal,
though the surgeon should evaluate any redness
that extends farther than one half inch from the
incision because this may indicate INFECTION.
Sometimes there is bruising (ECCHYMOSIS) around
the incision site, which typically heals in about a
week.
By the fifth postoperative day the edges of the
wound should be adhered to each other, with or
without an obvious scab. Most scabs fall off 10 to
14 days after surgery, which indicates the incision
is fully closed and about 85 percent healed. Fac-
tors that influence HEALINGinclude DIABETES, ciga-
rette smoking, and OBESITY.
Full healing is complete in three months. The
SCAR may at first appear reddened and raised,
though after about six months most scars are flush
with the SKIN’s surface and are pink or white. A
scar generally continues to fade over time and
remains lighter in color than the surrounding
skin. Incisional scars are more sensitive than the
surrounding skin to sun exposure and should be
protected with SPF (sun protective factor) 30 sun-
screen or clothing to prevent SUNBURN.

Skin Closures

A surgeon closes a surgical wound from the inside
out, typically using fine sutures (threads that sew
the tissue edges together) to bring together the
layers of MUSCLE, FASCIA, and subcutaneous fat.
These sutures, commonly called stitches, dissolve
over 5 to 7 days as the tissues heal. The surgeon

may use sutures, staples (small wires that pull

together the edges of the skin), glue, or adhesive

strips to close the final layer of the skin. The

method of closure depends on the incision’s loca-

tion and length, the tension on the skin edges,

and the surgeon’s preference. The surgeon may

use a combination of closure methods for large or

abdominal incisions. The surgeon must remove

staples and nondissolving sutures, typically 3 to 10

days after the OPERATION, though often recom-

mends leaving the adhesive strips in place until

they fall off on their own, usually in about 5 days.

Staple or suture removal is quick and usually does

not hurt, though some people find the minor

pulling and tugging sensations uncomfortable or

disconcerting.

Dressings and Dressing Changes

At the end of the operation the surgeon will place

a surgical dressing over the incision site. The

dressing is typically absorbent, as it is normal for

the wound to bleed a little, and may be a pressure

dressing to limit the amount of bleeding. The sur-

gical dressing stays on for 24 hours, after which

the surgeon, if the person stays overnight in the

hospital, or the person may remove it. A larger

incision may require replacement dressings for the

next 72 hours, after which most incisions remain

uncovered though some surgeons may instruct

that the incision site remain covered for a longer

period. When applying a fresh dressing, it is

important to wash the hands with warm water

and soap before touching bandages or the surgical

wound. The surgeon may instruct the application

of an antibiotic ointment. The surgeon will

remove nondissolving skin sutures or staples 3 to

10 days after the operation, after which the inci-

sion is fairly well healed.

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