Surgical wound care - open

If your surgeon does not close your wound again with sutures, you need to care for it at home, since it may take time to heal. The wound will heal from the bottom to the top. A dressing helps absorb drainage and keep the skin from closing before the wound underneath fills in.

It is important to clean your hands before you change your dressing. You can use an alcohol-based cleanser. Or, you can wash your hands using these steps:

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

Your health care provider will tell you how often to change your dressing. To prepare for the dressing change:

• Clean your hands before touching the dressing.
• Make sure you have all the supplies handy.
• Have a clean work surface.

Remove the old dressing:

• Carefully loosen the tape from your skin.
• Use a clean (not sterile) medical glove to grab the old dressing and pull it off.
• If the dressing sticks to the wound, wet it and try again, unless your provider instructed you to pull it off dry.
• Put the old dressing in a plastic bag and set it aside.
• Clean your hands again after you take off the old dressing.

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

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

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

• Fill a syringe with salt water or soapy water, whichever your provider recommends.
• Hold the syringe 1 to 6 inches (2.5 to 15 centimeters) away from the wound. Spray hard enough into the wound to wash away drainage and discharge.
• Use a clean soft, dry cloth or piece of gauze to carefully pat the wound dry.

Do not put any lotion, cream, or herbal remedies on or around your wound, unless your provider has said it is OK.

Place the clean dressing on the wound as your provider taught you to. You may be using a wet-to-dry dressing that requires moistening the dressing before applying it.

Clean your hands when you are finished.

Throw away the old dressing 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 provider if you need to add bleach to the wash water.

Use a dressing only once. Never reuse it.

Contact your provider if:

• There is more redness, pain, swelling, or bleeding at the wound site.
• The wound is larger or deeper, or it looks dried out or dark.
• The drainage coming from or around the wound increases or becomes thick, tan, green, or yellow, or smells bad (which indicates pus).
• Your temperature is 100.5°F (38°C) or higher.

Surgical incision care; Open wound care

Boukovalas S, Aliano KA, Phillips LG, Norbury WB. Wound healing. In: Townsend CM Jr, Beauchamp RD, Evers M, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier, 2022:chap 6.

Updated by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.