Updated: Mar 6, 2020
Following orthopedic surgical procedures, there are a few simple steps to know so that you can help your healing, reduce scarring & pain, and reduce the risk of postoperative wound complications like infection.
Your doctor may have used suture (absorbable or non-absorbable), skin glue (Dermabond), staples, or skin closure systems (e.g. Prineo). As a patient, it is very important to follow your doctor’s postoperative care recommendations.
Depending on the type of surgery, your doctor typically wants you to follow a few simple steps, including:
Keep the incision site clean and dry.
Perform dressing changes as instructed by your doctor or post op instruction sheet.
Watch for signs of possible infection.
REDUCE RISK OF POSTOPERATIVE COMPLICATIONS: Following surgical procedures, it is very important you follow your doctor’s instructions in order to reduce the risk of postoperative infection. Commonly, your doctor may tell you to keep the surgical incision/dressing clean and dry until your first postoperative follow-up visit. If you are not allowed to get your incision wet, then a sponge bath or a watertight plastic bag are the best options to keep the incision site perfectly dry. Once your doctor says it is OK to shower, then you may let the water run over your surgical incision, but it is typically best not to scrub the actual incision until about 5-6 weeks after surgery.
FOLLOW THIS ADVICE UNTIL SPECIFICALLY CLEARED BY YOUR SURGEON (USUALLY 5-6 WEEKS AFTER SURGERY):
Do NOT submerge or soak underwater the surgical site/incision
Do NOT scrub the surgical incision
Do NOT use lotions, oils, or creams over incision
Do NOT expose incision to excessive sunlight for up to 9 months following surgery (this will help reduce the risk of sunburn and worsen the look of the scar)
Do NOT remove any Steri-strips that were placed by your doctor over the incision site (these will typically fall off on their own after a couple of weeks)
DRESSING CHANGES: Following surgery, your doctor may want you to perform daily dressing changes over your surgical incision. If so, here are a few simple steps you should use when changing your dressing. Note, if your doctor instructs you to perform dressing changes differently, make sure you follow his/her specific instructions.
Have necessary supplies available as recommended by your doctor - gauze, Kerlix gauze wrap, ABD pad, ACE wrap, etc.
Properly wash and dry hands
Wear sanitary gloves if necessary to avoid soiling your hands
Gently remove the old dressing and dispose of it properly
Try to avoid touching the incision site directly, and certainly do NOT pick at it
Place dry gauze on the incision followed by tape or an ACE (or other) wrap
Properly wash and dry hands after the dressing change
SIGNS OF INFECTION: After surgery, patients can experience some redness, bruising, swelling and feelings of numbness, tingling or itching (a common part of healing) around the incision site. These can all be normal parts of healing and should not raise alarm themselves. As a patient, watch out for signs of infection. Call your doctor if you notice any signs or symptoms of infection, including:
Amount of drainage. Any drainage from the incision site beyond about 4-5 days after surgery. Ideally, incisions are completely dry by then and if it is not, then your surgeon will want to know about it sooner rather than later. A few days of light drainage similar to cranberry juice color and consistency is normal after surgery; it should clear up by the 4-5 day post-op mark at the most. If the drainage is enough that dressing changes are having to take place multiple times a day in order to keep the outer bandage dry then you should contact your surgeon.
Color of drainage. Cloudy yellow, gray, brownish (dirty dishwater type), or greenish drainage from the incision. Smelly drainage can also be a sign of infection.
Color around the incision. Significant bright redness to surrounding skin that is warm/hot to the touch and very tender might be concerning. Some pinkness around the incision that is not significantly tender is almost always a normal part of healing.
Your temperature. Fever of 100.4 degrees F (or higher) might be concerning, but fevers of 101.5 degrees F or higher certainly warrant more urgent evaluation.
Pain level. Rarely, an increase in pain 4-7 days after surgery could be one of the signs of infection, but this alone should not raise concern necessarily. Many times an increase in pain at this time point after surgery is related to increasing swelling or activity level. Consult with your surgeon if you are concerned.
If you have any questions or concerns regarding postoperative wound care, do not hesitate to contact and discuss with your doctor’s office! They want to help you prevent infection as much as you want to avoid it!