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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Lifestyle

Wound Care and Dressing Changes

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What it is

What is Postoperative Wound Care?

Postoperative wound care involves the procedures and protocols for managing surgical incisions after they have been closed to promote healing and prevent infection. Proper wound care is a critical part of recovery after any colorectal surgery. The specific instructions for care will vary depending on the type of incision, how it was closed (sutures, staples, or skin glue), and whether the wound was left open to heal by secondary intention.

General Principles:

  • Keep it Clean: The primary goal is to keep the wound clean to prevent bacterial contamination.
  • Keep it Dry: For the first 24-48 hours, the initial surgical dressing should be kept clean and dry. After this period, showering is usually permitted.
  • Monitor for Infection: Patients should monitor the wound for signs of infection, such as increasing redness, swelling, warmth, pain, or purulent drainage.

Am I a candidate?

Who Needs Postoperative Wound Care?

All patients who have undergone colorectal surgery require some form of wound care. This includes patients with small laparoscopic incisions, larger open laparotomy incisions, and perineal wounds from procedures like abdominoperineal resection or fistulotomy. Patients with wounds that are left open to heal by secondary intention, or those who develop a surgical site infection, will require more intensive wound care, often involving packing and frequent dressing changes.

Recovery

What is the Process of Wound Care?

The specific instructions will be provided by the surgical team, but a general protocol is as follows:

  • Initial Dressing: The surgical dressing placed in the operating room should typically remain in place for 24 to 48 hours.
  • Showering: After the initial dressing is removed, patients are usually allowed to shower and let soapy water run over the incision. The area should be gently patted dry. Submerging the wound in a bath or hot tub should be avoided until it is fully healed.
  • Dressing Changes: For most closed incisions, a new dressing is not needed after the first 48 hours. For open wounds, dressing changes with packing are usually performed one to two times daily. This involves gently removing the old packing, cleaning the wound with saline or soapy water, and then loosely packing the wound with fresh gauze.
  • Suture/Staple Removal: Skin sutures or staples are typically removed in the office 10 to 14 days after surgery.

Risks & considerations

What are the Risks of Improper Wound Care?

Improper wound care can lead to several complications, the most common of which is a Surgical Site Infection (SSI). Other potential risks include:

  • Wound Dehiscence: The separation of the layers of a surgical wound, which can range from a small opening in the skin to a complete separation of the fascia, leading to evisceration.
  • Delayed Healing: Wounds that are not kept clean or that are subjected to excessive moisture can be slow to heal.
  • Seroma or Hematoma: A collection of fluid or blood under the incision, which can become infected.
  • Excessive Scarring: Poor wound healing can lead to the formation of hypertrophic or keloid scars.

Sources

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