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IF YOU RECENTLY had surgery, you may have questions about caring for your surgical wound. Here's what you need to know.

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How is the wound closed?

After surgery, the surgeon may close your wound with stitches, staples, butterfly bandages (flexible skin-closure tapes), or adhesive glue. Your surgeon will make the best choice for you depending on the type of surgery you had.


Stitches, the most common way to close wounds, are made of nylon or silk suture material that looks like thread or fishing line. Some types of stitches dissolve after several days; others must be removed by your nurse or surgeon after the wound has healed.


Staples are metal clips that hold the wound edges together. Wounds closed with staples may heal faster than those closed with stitches.


Butterfly bandages are small strips of paper tape that are put across the wound edges to hold them together. These bandages can be used alone or with staples and stitches. They aren't as secure as stitches or staples, so your surgeon may not use them if you've had surgery in the area before or have other medical conditions that may delay healing.


Adhesive glue may be used on a small wound that's not too deep.


How long will healing take?

This depends on your general health and the type of surgery you had. In healthy children and adults, most wounds heal within 2 weeks. But healing will probably take longer if you have a health problem such as diabetes, are taking certain drugs (such as steroids or chemotherapy drugs), or have a weakened immune system.


What can I do to help heal?

Eat a nutritious diet high in vitamin C, protein, and zinc to promote wound healing. You can find vitamin C in citrus fruits and green vegetables such as broccoli and brussels sprouts. Meats and milk products are high in protein and zinc. Your health care provider may recommend multivitamins and nutritional supplements depending on how well you're eating.


How do I care for my wound?

Following your surgeon's directions, keep the wound clean and dry for the first 72 hours. Your surgeon will tell you if you can shower after that. Avoid baths, swimming pools, and hot tubs until your incision is completely healed, or you might get an infection.


Your wound may be bandaged with gauze or another type of dressing. Just before you go home, the surgeon or nurse may change the dressing, check the wound, and put on a new dressing, depending on the surgery.


If you go home with a dressing on your wound, you'll need to change it every 1 to 2 days, as directed, and inspect the wound for redness, weeping, swelling, or other problems. Wash your hands thoroughly with soap and water before and after touching or changing the dressing. Keep the dressing clean and dry while it's still on.


If you have butterfly bandages, they may peel slightly a few days after surgery. Leave them alone until they fall off.


You may have discomfort or numbness around the wound at first; this is normal. Your surgeon will give you medicine to keep you comfortable. For the first few days after your operation, take your pain medicine regularly or at the first sign of discomfort, as directed. Notify your surgeon immediately if pain suddenly gets worse.


The wound may itch for a few days after surgery. This may be normal, or it may be a sign of a problem, such as infection or stitches that are too tight. Don't scratch the area; call your surgeon if you're uncomfortable.


What about drains?

You may have a tube (drain) in the surgical site to remove excess fluid or blood, which is collected in a bag or small container. Over about a week, you should see less drainage, and it may change color; for example, from dark red to pink to yellow. Many surgeons will remove the drain when drainage is less than 30 mL (1 ounce). If you have a drain, empty the drainage bag three times a day, following the procedure you were taught in the hospital and taking care not to dislodge or separate the drain from the bag.


When can I get back to normal?

Moving around is good for you, but while your wound is healing, avoid placing any strain on it. Also avoid bending, lifting, or being too active. Your surgeon will tell you when you can resume picking up small children, doing heavy household chores, or carrying groceries. In the meantime, if you feel well enough, you can continue light housework and activities depending on where the wound is located. Light exercise will also help you recover faster. Talk with your surgeon about your normal activities so you know which ones are safe to do.


Scars from surgical wounds are prone to sunburn, so keep them covered or apply sunscreen once the wound is healed. Consider using green-colored concealer under makeup to help hide a red scar. Lotions and skin softeners also can soften scars.


When should I call my doctor?

Call your surgeon immediately if you experience any of the following signs and symptoms:


* chills or fever over 101[degrees] F (38.3[degrees] C)


* warmth, swelling, redness, or more pain at the wound


* pus, a bad smell, or more drainage from the wound or drain


* sudden, excessive bleeding from the wound or drain


* a feeling of hardness or fullness around the wound or any opening of stitches or staples.



If your wound pops open, cover it with gauze or a clean towel moistened with saline or clean water. Call your surgeon right away for more directions or go to the nearest emergency department.


This patient-education guide has been adapted for the 5th-grade level using the Flesch-Kincaid and SMOG formulas. It may be photocopied for clinical use or adapted to meet your facility's requirements. Selected references are available upon request. For more tips on writing education guides, see the first article in this series: "Writing Easy-to-Read Teaching Aids" (March 2002).


Special thanks to Tracy Kane, MEd, patient-education coordinator, Albert Einstein Health Care Network, Philadelphia, Pa.