Surgical incision care; Wound dehiscence care

An incision is a "cut" through the skin that is made during surgery. It also called a "surgical wound." Some incisions are small, and others are very long. The size of the incision will depend on the kind of surgery you had.

Do not wear tight clothing that rubs against the incision while it is healing.

Sometimes, a surgical wound will break open (wound dehiscence). This may happen along the entire cut or just part of it. Your doctor may decide not to close it again with sutures, or stitches.

If your doctor does not close your wound again with sutures, you will need to learn how to care for it at home, as it heals slowly.

You will need to wash your hands many times when you change your wound dressing and clean your wound. Follow these steps:

• Take all jewelry off your hands.
• Wet your hands, pointing them down under warm running water.
• Add soap and wash your hands for 15 to 30 seconds (sing "Happy Birthday" or the "Alphabet Song" 1 time through). Clean under your nails also.
• Rinse well.
• Dry with a clean towel.

Your doctor will tell you how often to change your dressing. Be prepared before starting the dressing change:

• Wash your hands before touching the dressing.
• Make sure you have all the supplies you will need handy.
• Have a clean work surface for all of the equipment you will need.

Remove the old dressing:

• Carefully loosen the tape.
• Use a clean medical glove to grab the old dressing and pull it off.
• If the dressing sticks to the wound, get it wet and try again.
• Put the old dressing in a plastic bag and set it aside.
• Wash your hands with soap and water again after you take off the old dressing.

You may use a gauze pad or soft cloth to clean your wound:

• Use a normal saline solution (salt water) or mild soapy water for most wound cleaning.
• Soak the gauze or cloth in the saline solution or soapy water, and gently dab or wipe the wound with it.
• Try to remove all drainage and any dried blood or other matter that may have built up around the wound.
• Do not use skin cleansers, alcohol, peroxide, iodine, or soaps with antibacterial chemicals. These can damage the wound tissue and slow your healing.

Your doctor may also ask you to irrigate, or wash out, your wound:

• Fill a syringe with salt water or soapy water, as your doctor or nurse taught you to.
• Hold the syringe 1 to 6 inches away from the wound, and spray hard enough into the wound to wash away drainage and discharge.
• Be careful not to harm the wound tissue.
• Use a soft, dry cloth to carefully pat the wound dry.

Do not put any lotion, cream, or herbal remedies on or around your wound without asking your doctor first.

Place the clean dressing on the wound as your doctor or nurse taught you to. You may be using a wet-to-dry dressing. See also: Wet to dry dressing changes

Wash your hands well with soap and water when you are finished.

Throw away all the old dressings 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 doctor if you need to add bleach to the wash water.

Use a dressing only 1 time. Never reuse it.

Call your doctor if:

• You see any of these changes around the incision:
  • More redness
  • More pain
  • Swelling
  • Bleeding
  • The wound is larger or deeper
  • The wound looks dried out or dark
• The drainage coming from or around the incision:
  • Does not decrease after 3 to 5 days
  • Is increasing
  • Becomes thick, tan, or yellow, or smells bad (pus)
• Your temperature is above 100 °F for more than 4 hours.

Fonder MA, Lazarus GS, Cowan DA, Aronson-Cook B, Kohli AR, Mamelak AJ. Treating the chronic wound: A practical approach to the care of nonhealing wounds and wound care dressings. J Am Acad Dermatol. 2008 Feb;58(2):185-206.