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Wound healing after stitches: How to Take Care of Your Incision After Surgery

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How to Take Care of Your Incision After Surgery

When you’re back home after your operation, make sure the cut made by your surgeon doesn’t get infected. Get familiar with some simple rules for taking care of your healing wound.

When do I take off the bandage?

Your doctor will give you exact instructions on when and how to change it. Most wounds don’t need one after a few days, but if you keep the area covered, it may help protect the cut from injury and it may heal faster.

If you do keep a bandage on, change it every day. Wash your hands well with soap and water before and after.

How do I keep my wound clean?

You can clean the skin around the cut with a soft cloth or gauze pad.

First, soak the cloth or gauze in soapy water or in a mixture of sterile water and salt. Then, gently wipe or dab the skin around the wound.

Don’t use skin cleansers, antibacterial soaps, alcohol, iodine, or peroxide. They can damage the skin in the wound and delay healing. Also, don’t put on any lotion, cream, or herbal product unless you’ve checked with your doctor first.

Your doctor will tell you how to wash out your wound. They may say to fill a syringe with salt water or mild soapy water. This will help rinse away any pus that’s draining out. Last, pat it dry with clean gauze or a clean cloth.

Do I need to keep the wound dry?

Don’t let it get wet for the first 24 hours after your surgery. So skip a bath or shower on the first day, though a sponge bath is usually OK.

You might be able to shower by the second day, but it depends on the type of operation you had, so check with your doctor.

Once you have the go-ahead to get your whole body wet, it’s better to shower than to take a bath. That’s because soaking your wound can soften it and may cause it to open up again. Ask if you need to put on a waterproof dressing.

Don’t put soap or any other bath products directly onto your wound while it’s still healing. After you shower, gently pat the area dry with a clean towel.

Should I limit my activities?

It’s best to avoid movement that affects the area surrounding your wound. That way, you’ll lower your risk of pulling the cut apart.

Your doctor might tell you to stay away from lifting and some exercises and sports for about a month after surgery. If your cut opens up, call your doctor.

What should I do if my wound bleeds?

Replace the bloody bandage with a new one. If you apply pressure directly to the cut for a few minutes, it will usually put an end to the bleeding. Call your doctor if it doesn’t stop right away.

When will I get my stitches removed?

If you have the dissolving type of stitches, you won’t need to get them pulled out. They disappear on their own in 7 to 10 days. Your doctor can remove other kinds of stitches or staples in 5 to 21 days, depending on the surgery you had.

Should I keep my wound out of the sun?

Sunburn can darken a healing scar and make it more noticeable. For the first 6 months after your operation, try to keep it out of sunlight. When you’re outside in daylight, cover it with tape or put on sunscreen.

When should I call the doctor?

Call if you see any signs that you’re getting an infection around your wound. Some things to watch out for:

  • Pain that gets worse
  • Redness or swelling
  • Bleeding or oozing pus
  • Increasing drainage from the wound (may become thick, tan, green, or yellow)
  • A bad smell
  • Your wound looks larger, deeper, dried out, or dark.
  • Your temperature goes above 100 F for more than 4 hours.

How to Know Your Surgical Cut Is Healing Right

When you’re resting at home after your operation, you’ll need to keep an eye on the wound your surgeon left behind. It’s going to go through some changes in the next month, and you’ll probably find yourself wondering: Is this normal, or am I getting an infection?

Learn a little bit about how your will cut heal to help you figure out when to relax and when you need to call the doctor.

Stages of Healing

Your wound will go through three phases.

Stage 1: Swelling. The first steps toward healing start right away. Blood vessels in the area of the cut begin to form clots that keep you from losing too much blood.

White blood cells in your body move into the wound. Think of them as infection-control agents. Their job is to fight bacteria.

When you’re in this phase, which can go on for up to 6 days after your surgery, it’s normal to see some redness and swelling. Your doctor can tell you how much is OK. Also, your wound may feel warm, and it may hurt around the site.

Watch out for oozing pus that smells bad. It could be a sign that an infection is starting. Another tip-off: Your pain, redness, and swelling don’t go away or are getting worse. Call your doctor if this happens.

Stage 2:Rebuilding. This part of your healing lasts from about 4 days to a month after your surgery. A scar starts to form on the cut. The edges will pull together, and you might see some thickening there. It’s also normal to spot some new red bumps inside your shrinking wound.

You might feel sharp, shooting pains in your wound area. This may be a sign that you’re getting sensations back in your nerves. The feeling should become less intense and happen less often over time, but check with your doctor if you’re concerned.

Stage 3: Remodeling. You’re in the home stretch: Your wound has filled in and a new surface has formed.

This final period can last from 6 months to 2 years. You’ll see some changes in your scar. It will go from looking thick, red, and raised to thinner, flatter, and more like your usual skin color.

Infections

They’re rare, but they do happen. If you’re going to get an infection, it’s usually in the first month after your surgery.

Your wound could be infected if you have:

  • Fever
  • Delay in your healing
  • Pus, redness, and pain getting worse
  • Tenderness, warmth, and swelling near your wound

Most of the time, infections in the area of your wound can be treated with antibiotics.

Incision Care: Steri-Strips, Staples & Stitches

Overview

What is an incision?

An incision is a cut that’s made in your skin during a surgery or procedure. Sometimes, this is also called a surgical wound. The size, location and number of incisions can vary depending on the type of surgery.

What is a dressing and how often should dressings be changed?

A dressing is another name for a bandage. This bandage protects your incision, keeping the wound clean and creating an ideal environment for healing. Dressings should be changed according to your healthcare provider’s instructions.

Procedure Details

How are incision(s) closed?

Incisions can be closed in several ways, including:

  • Stitches (sutures).
  • Staples.
  • Tissue glue.
  • Steri-Strips™ (a special kind of adhesive tape).

A sterile dressing is usually placed over your closed incision to keep it clean and dry while the wound heals.

How do I care for my incisions after surgery?

It’s important to follow your healthcare provider’s directions when it comes to caring for your incisions after surgery. Taking care of your incision(s) as instructed promotes healing, reduces scarring and reduces your risk of infection.

Some general tips for incision care include:

  • Always wash your hands before and after touching your incisions.
  • Inspect your incisions and wounds every day for signs your healthcare provider has told you are red flags or concerning.
  • Look for any bleeding. If the incisions start to bleed, apply direct and constant pressure to the incisions. If you experience any bleeding, you should call your healthcare provider for instructions.
  • Avoid wearing tight clothing that might rub on your incisions.
  • Try not to scratch any itchy wounds. Your incisions might feel itchy as they heal — this is normal. Don’t scratch them. If the itchiness gets worse instead of better, call your healthcare provider.

A few general tips to keep in mind for different types of incision closures can include:

  • Staples and Stitches: You can wash or shower 24 hours after surgery unless you’re directed otherwise by your healthcare provider. Clean the area with mild soap and water and gently pat dry with a clean cloth. Your provider will remove your staples when your wound is healed. Some stitches dissolve over time — others need to be removed by your provider. Dissolvable stitches may be held in place by strips of tape (Steri-Strips).
  • Steri-Strips: You can wash or shower with Steri-Strips in place. Clean the area with mild soap and water and gently pat dry with a clean towel or cloth. Do not pull, tug or rub Steri-Strips. The Steri-Strips will fall off on their own within two weeks. After two weeks, gently remove any remaining Steri-Strips. If the strips start to curl before it’s time to remove them, you can trim them.
  • Tissue glue: The glue should be kept dry and the incisions should be kept out of direct sunlight. The glue will dry out and fall off within five to 10 days.

What supplies are needed to change a dressing?

There are a few basic supplies you will need to change a dressing. These supplies include:

  • Gauze pads.
  • Disposable medical gloves (optional).
  • Surgical tape.
  • Plastic bag (for disposing of old dressing, tape, etc.).
  • Scissors.

What steps are involved in changing a dressing?

There are several steps involved in changing the dressing for your incision. Your healthcare provider will give you detailed instructions and will usually show you how to change your dressing. If you have any questions, call your provider.

Step 1: Prepare the area for changing a dressing.

First, you or the caregiver who is changing your dressing needs a clean surface to work on. Pets should be moved to a different room and your caregiver should remove any jewelry. Wash the surface where supplies will be with soap and water and cover with a clean cloth or paper towel.

Step 2: Removing the old dressing.

First, you’ll prepare your new dressing. Open the gauze package(s) without touching the gauze. Next, cut new tape strips. Set aside.

To remove the old dressing:

  1. Wash your hands by wetting them down, adding soap and washing for 30 seconds (about the time it takes to sing “Twinkle, Twinkle Little Star”). Make sure to also clean under your nails.
  2. Rinse your hands well and dry them with a clean towel.
  3. Put on medical gloves (if available) and loosen the tape holding the dressing in place.
  4. Remove the old dressing. Unless your doctor has said to remove the dressing dry, you can wet it if it sticks to the wound to help remove it. Throw the old dressing and dirty medical gloves into a plastic bag.
Step 3: Cleaning and rinsing the incision.

If you are showering, the incision will be cleaned during your shower. You can apply the dressing after your shower as instructed by your healthcare provider. If you aren’t showering, you should flush the incision as instructed by your healthcare provider.

Always inspect your incisions for signs of infection.

Step 4: Applying a new dressing.
  • If your surgeon prescribed a topical ointment, apply a very thin layer of the ointment to the incision.
  • Hold a clean, sterile gauze pad by a corner and place it over the incisions. (This is the gauze that you opened and set aside in step 2.)
  • Tape all four sides of the gauze pad. (This is the tape that you already cut and set aside in step 2.)
  • Put all trash in the plastic bag, remove your gloves and add them to the trash bag.
  • Seal the plastic bag and throw it away.
  • Wash your hands.
  • Wash any soiled laundry separately. Ask your provider if you should add bleach during the wash cycle.

What can I do to reduce the risk of infection?

There are several things you can do to reduce your risk of infection when you’re healing, including:

  • Always wash your hands before and after touching your incisions.
  • Follow your healthcare provider’s instructions.
  • Follow your provider’s instructions about changing the dressing.
  • Avoiding removing the tape strips, picking at staples, tissue glue or stitches.
  • Keep your incisions dry (make sure the incision sites have been patted dry after washing).

Risks / Benefits

What are the signs of a possible infection in an incision?

It’s important to know the signs of an infection when you’re caring for an incision. Infection is always a risk of surgery. Keep track of any possible signs of an infection so that if you notice a possible infection it can quickly be treated.

Signs of a possible infection can include:

  • A wound that has thick, foul-smelling, opaque discharge. This is often a white or cream color.
  • A bad odor from the incision.
  • Opening of the incision line — it gets deeper, longer or wider.
  • Redness that goes beyond the basic edge of the incision — site should show signs of improvement and not getting more red.
  • Warmth, hardness, around the incision.
  • Fever (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius), sweating or chills.
  • Swings in blood sugar levels in a diabetic patient.

What are the general risk factors for developing an infection?

Patients at higher risk of developing an infection are those who have:

  • Diabetes.
  • A history of smoking.
  • Excess weight.
  • Poor nutrition.
  • Weak immune system (for example, a patient on chemotherapy or an elderly patient).
  • Recent emergency surgery or a long surgical procedure.

Recovery and Outlook

What are the limits on activity while an incision is healing?

Staying active improves healing by improving blood flow. After some types of surgery, your healthcare provider may recommend avoiding lifting, pulling, straining, exercise or sports for a month after surgery. Following these instructions will prevent opening of the incision line and promote healing.

How long does it take for an incision to heal?

Good incision care can help ensure that it heals well and infection doesn’t develop. In most cases, a surgical incision heals in about two weeks. More complex surgical incisions will take longer to heal. If you have other medical conditions or are taking certain medications, your healing time may differ.

When to Call the Doctor

When is it important to call the doctor?

Call the doctor if you experience:

  • Bleeding that does not stop with pressure.
  • If there is any sign of infection.

If you ever have questions or confusion about your incision care instructions, call your healthcare provider.

A note from Cleveland Clinic

When you’re caring for an incision, it’s important to follow your healthcare provider’s instructions closely. If you have any questions about your instructions, reach out to your provider.

Incision Care: Steri-Strips, Staples & Stitches

Overview

What is an incision?

An incision is a cut that’s made in your skin during a surgery or procedure. Sometimes, this is also called a surgical wound. The size, location and number of incisions can vary depending on the type of surgery.

What is a dressing and how often should dressings be changed?

A dressing is another name for a bandage. This bandage protects your incision, keeping the wound clean and creating an ideal environment for healing. Dressings should be changed according to your healthcare provider’s instructions.

Procedure Details

How are incision(s) closed?

Incisions can be closed in several ways, including:

  • Stitches (sutures).
  • Staples.
  • Tissue glue.
  • Steri-Strips™ (a special kind of adhesive tape).

A sterile dressing is usually placed over your closed incision to keep it clean and dry while the wound heals.

How do I care for my incisions after surgery?

It’s important to follow your healthcare provider’s directions when it comes to caring for your incisions after surgery. Taking care of your incision(s) as instructed promotes healing, reduces scarring and reduces your risk of infection.

Some general tips for incision care include:

  • Always wash your hands before and after touching your incisions.
  • Inspect your incisions and wounds every day for signs your healthcare provider has told you are red flags or concerning.
  • Look for any bleeding. If the incisions start to bleed, apply direct and constant pressure to the incisions. If you experience any bleeding, you should call your healthcare provider for instructions.
  • Avoid wearing tight clothing that might rub on your incisions.
  • Try not to scratch any itchy wounds. Your incisions might feel itchy as they heal — this is normal. Don’t scratch them. If the itchiness gets worse instead of better, call your healthcare provider.

A few general tips to keep in mind for different types of incision closures can include:

  • Staples and Stitches: You can wash or shower 24 hours after surgery unless you’re directed otherwise by your healthcare provider. Clean the area with mild soap and water and gently pat dry with a clean cloth. Your provider will remove your staples when your wound is healed. Some stitches dissolve over time — others need to be removed by your provider. Dissolvable stitches may be held in place by strips of tape (Steri-Strips).
  • Steri-Strips: You can wash or shower with Steri-Strips in place. Clean the area with mild soap and water and gently pat dry with a clean towel or cloth. Do not pull, tug or rub Steri-Strips. The Steri-Strips will fall off on their own within two weeks. After two weeks, gently remove any remaining Steri-Strips. If the strips start to curl before it’s time to remove them, you can trim them.
  • Tissue glue: The glue should be kept dry and the incisions should be kept out of direct sunlight. The glue will dry out and fall off within five to 10 days.

What supplies are needed to change a dressing?

There are a few basic supplies you will need to change a dressing. These supplies include:

  • Gauze pads.
  • Disposable medical gloves (optional).
  • Surgical tape.
  • Plastic bag (for disposing of old dressing, tape, etc.).
  • Scissors.

What steps are involved in changing a dressing?

There are several steps involved in changing the dressing for your incision. Your healthcare provider will give you detailed instructions and will usually show you how to change your dressing. If you have any questions, call your provider.

Step 1: Prepare the area for changing a dressing.

First, you or the caregiver who is changing your dressing needs a clean surface to work on. Pets should be moved to a different room and your caregiver should remove any jewelry. Wash the surface where supplies will be with soap and water and cover with a clean cloth or paper towel.

Step 2: Removing the old dressing.

First, you’ll prepare your new dressing. Open the gauze package(s) without touching the gauze. Next, cut new tape strips. Set aside.

To remove the old dressing:

  1. Wash your hands by wetting them down, adding soap and washing for 30 seconds (about the time it takes to sing “Twinkle, Twinkle Little Star”). Make sure to also clean under your nails.
  2. Rinse your hands well and dry them with a clean towel.
  3. Put on medical gloves (if available) and loosen the tape holding the dressing in place.
  4. Remove the old dressing. Unless your doctor has said to remove the dressing dry, you can wet it if it sticks to the wound to help remove it. Throw the old dressing and dirty medical gloves into a plastic bag.
Step 3: Cleaning and rinsing the incision.

If you are showering, the incision will be cleaned during your shower. You can apply the dressing after your shower as instructed by your healthcare provider. If you aren’t showering, you should flush the incision as instructed by your healthcare provider.

Always inspect your incisions for signs of infection.

Step 4: Applying a new dressing.
  • If your surgeon prescribed a topical ointment, apply a very thin layer of the ointment to the incision.
  • Hold a clean, sterile gauze pad by a corner and place it over the incisions. (This is the gauze that you opened and set aside in step 2.)
  • Tape all four sides of the gauze pad. (This is the tape that you already cut and set aside in step 2.)
  • Put all trash in the plastic bag, remove your gloves and add them to the trash bag.
  • Seal the plastic bag and throw it away.
  • Wash your hands.
  • Wash any soiled laundry separately. Ask your provider if you should add bleach during the wash cycle.

What can I do to reduce the risk of infection?

There are several things you can do to reduce your risk of infection when you’re healing, including:

  • Always wash your hands before and after touching your incisions.
  • Follow your healthcare provider’s instructions.
  • Follow your provider’s instructions about changing the dressing.
  • Avoiding removing the tape strips, picking at staples, tissue glue or stitches.
  • Keep your incisions dry (make sure the incision sites have been patted dry after washing).

Risks / Benefits

What are the signs of a possible infection in an incision?

It’s important to know the signs of an infection when you’re caring for an incision. Infection is always a risk of surgery. Keep track of any possible signs of an infection so that if you notice a possible infection it can quickly be treated.

Signs of a possible infection can include:

  • A wound that has thick, foul-smelling, opaque discharge. This is often a white or cream color.
  • A bad odor from the incision.
  • Opening of the incision line — it gets deeper, longer or wider.
  • Redness that goes beyond the basic edge of the incision — site should show signs of improvement and not getting more red.
  • Warmth, hardness, around the incision.
  • Fever (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius), sweating or chills.
  • Swings in blood sugar levels in a diabetic patient.

What are the general risk factors for developing an infection?

Patients at higher risk of developing an infection are those who have:

  • Diabetes.
  • A history of smoking.
  • Excess weight.
  • Poor nutrition.
  • Weak immune system (for example, a patient on chemotherapy or an elderly patient).
  • Recent emergency surgery or a long surgical procedure.

Recovery and Outlook

What are the limits on activity while an incision is healing?

Staying active improves healing by improving blood flow. After some types of surgery, your healthcare provider may recommend avoiding lifting, pulling, straining, exercise or sports for a month after surgery. Following these instructions will prevent opening of the incision line and promote healing.

How long does it take for an incision to heal?

Good incision care can help ensure that it heals well and infection doesn’t develop. In most cases, a surgical incision heals in about two weeks. More complex surgical incisions will take longer to heal. If you have other medical conditions or are taking certain medications, your healing time may differ.

When to Call the Doctor

When is it important to call the doctor?

Call the doctor if you experience:

  • Bleeding that does not stop with pressure.
  • If there is any sign of infection.

If you ever have questions or confusion about your incision care instructions, call your healthcare provider.

A note from Cleveland Clinic

When you’re caring for an incision, it’s important to follow your healthcare provider’s instructions closely. If you have any questions about your instructions, reach out to your provider.

How Long Does It Take a Surgical Incision to Heal?

Surgical incision healing is facilitated in the operating room by the surgeon who often provides initial closure of the wound edges through the use of surgical glue, sutures, or staples. However, some surgical wounds cannot be closed in this manner in order to allow for drainage or other needs of the surgical site. An open surgical wound may have been left open intentionally after surgery or re-opened at a later time because of infection. This opening may be along the entire cut or just part of it. Once a wound has opened, your doctor may decide to let the wound heal from the inside out. There is no cut-and-dry answer to healing time. The type and location of the surgical procedure, your underlying health, and incisional care may all impact the time to heal. Whether the wound was left open or closed, it will still proceed through specific phases to achieve healing.

How Surgical Incisions Heal

Normal surgical incision healing will proceed through several phases. The first phase involves the management of bleeding and begins in the operating room. Platelets in the blood cluster together making a type of plug, while proteins such as collagen and fibrin work together to firmly hold it in place to stop the bleeding.

During the next phase which can take up to 6 days after surgery, you may notice some pain, swelling, and slight redness. This is a normal response of the body to an injury. During this phase, the body focuses on destroying bacteria and removing debris with the influx of oxygen, nutrients, and white blood cells. The white blood cells help to keep the wound clean and protect the wound by fighting off bacteria that may try to invade the wound.

The rebuilding phase is one in which the body can start reparative activities to the damaged area. This phase lasts from about 4 days to a month after surgery. It includes the normal development of a thickening area along the incisional line indicating deposition of new collagen in the wound, often referred to as a healing ridge. This firmness will cover the entire incision line and begin to soften and flatten about 2-3 weeks following surgery.

The last phase is often referred to as the remodeling phase. This phase lasts from 21 days up to 2 years. In this final and longest phase, collagen synthesis is ongoing in order to strengthen the tissue. Remodeling occurs as the wound continues to contract and fibers are being reorganized, with a reduction in capillaries and scar formation. The scar will change in color as it matures from red to a lighter color.

Incision Type and Size

An incision is a cut made into the tissues of the body to expose the underlying tissue, bone, or organ so that a surgical procedure can be performed. It varies from surgery to surgery based on the area and the severity of the problem. It allows the surgeon enough room to work and visualize the area as well as insert the necessary surgical instruments to perform the surgery.

Laparoscopic incisions are much smaller than the traditional open incision and are just large enough to allow surgical instruments to be inserted into the body. Instead of having one incision that is three inches long, you may have three or four that are less than an inch long. It may seem odd that multiple incisions are better than one, but it is harder for the body to heal one large incision than multiple small incisions.

It is also important to note that incisions are not just a cut into the skin, but are actually much deeper than they appear on the surface. This is also why an incision may appear to have healed on the surface in only a week or two but can take months to reach full strength as the underlying muscle and tissues continue to heal. It is also why your surgeon may give you restrictions to not lift anything heavy that last well beyond when the wound appears healed.

Health of the Patient

Another factor that may speed or slow healing time is the patient’s state of health.

If the patient is deemed to be in good health by the surgeon and the pre-operative tests concur, then it’s fairly easy to predict an estimated healing time, depending on the incision type and barring complications. Patients who have underlying health conditions such as diabetes, or extrinsic factors that are known to delay healing such as smoking or radiation to the surgical site, are at a much higher risk for problems with healing. Other factors impacting healing include the patient’s age, nutritional status, certain medications, and obesity.

After undergoing a surgical procedure, you’ll need to follow your surgeon’s directions for care of the surgical incision site for the timeliest healing outcome. Your surgeon will direct not only your post-operative surgical site care, but should be able to give you specific information on when you can exercise again, and return to your daily routine. As you’re recovering from surgery, you may be prescribed wound dressings and cleansers to keep the healing process on track.

To learn more about a product that is indicated for the management of surgical wounds, please visit https://sanaramedtech.com/surgical/celleraterx-surgical.

Johnson Dermatology Clinic in Fort Smith, Arkansas

Caring for Wounds with Stitches

 

Clean & Bandage the Wound
  • Leave the initial bandage in place and keep the area completely dry for 24 hours unless otherwise advised.

  • Clean with tap water and a Q-tip twice a day.

  • After cleaning apply white petrolatum (Vaseline) or bacitracin (Polysporin) to keep the area moist. If using Vaseline, buy new Vaseline if the supply you already have is more than three months old. Then cover with a band-aid. If the area is too large to be covered with a band-aid, then use Telfa and paper tape to bandage the wound. Your pharmacy will have these bandage supplies. Do not let the area dry out and become scabbed.

  • Continue the above steps until all of the stitches are removed.

  • Two weeks after the stitches are removed you may begin using an over-the-counter scar pad to improve the appearance of the scar if desired. These can be purchased in any pharmacy without a prescription.

Limit Physical Activity
  • Avoid vigorous physical activity while the stitches are in place – this includes heavy lifting, running, and other sporting activities. Avoid activities that pull or stretch on the area with stitches.

  • Do not put the stitches completely under water – this means no swimming and no bathing in a bath. In the shower, the area can be exposed to running water for a few minutes each day.

  • If the wound is on the lower leg, keep the affected leg elevated to the level of the hip as much as possible and avoid unnecessary walking. This is to avoid excessive swelling and slow wound healing.

Stop Smoking
  • Smoking interferes with wound healing. If you smoke after your skin surgery, you have a greater risk of infection and poor wound healing. This can result in excessive scarring. Do not smoke for at least two weeks after your skin surgery.

  • Please use this as an opportunity to quit smoking forever.

Manage Pain
  • You may take Tylenol for the pain associated with the procedure. The Tylenol is most effective if you take the first dose before the numbing medicine has worn off. You may take the Tylenol as often as directed on the bottle. If the pain is not controlled by the Tylenol, then call our office.

Handle Problems
  • If you have bleeding from the wound, then elevate the area and apply firm and constant pressure to the wound with a clean gauze or cloth. You should hold pressure for fifteen minutes without looking. Use a clock or a timer to count the fifteen minutes. If bleeding continues, then repeat the above procedure but use an ice pack over the cloth to hold pressure. If this does not work, then contact us.

  • If you have excessive swelling, elevate the area and apply an ice pack for fifteen minutes out of every hour while awake. If the swelling continues, then contact us.

  • Excessive redness, swelling, pain or drainage from the wound are possible signs of an infection. If you notice any of these signs, then contact us.

  • If you have these or any other problems, contact us.


Wound Healing Instructions

 

General Information

 

Allowing wounds to heal naturally after surgery is sometimes the best option. This process is called second intention wound healing. The wound healing process may take many weeks or months to complete depending on the initial size of the wound. The following instructions will guide you through the process.

 

Supplies for Wound Care

 

The following list of supplies can be purchased at any pharmacy.

  • A large tube of white petrolatum

  • Non-adherent Telfa pads

  • Gauze pads or rolls

  • Bandage tape – preferably paper tape

  • Hydrogen peroxide

  • Cotton Tip Applicators (Q-tips)

Steps for Wound Care

 

Clean & bandage the wound twice a day:

  • Clean the wound with tap water, hydrogen peroxide, q-tips, and gauze.

    • Mix equal parts hydrogen peroxide and tap water in a cup. Clean the wound with this mixture using the gauze and the q-tips.

    • The surface of the wound may bubble due to the hydrogen peroxide.

    • You should apply enough pressure to remove any crusts. The wound bed wound should be pink and moist after cleaning.

  • Bandage the wound with white petrolatum, Telfa pads, gauze, and bandage tape.

    • Apply a thick layer of white petrolatum to the wound. This should be as thick as icing on a cake.

    • Apply a Telfa pad to the wound. You can cut the pad to fit the size of the wound.

    • Apply a layer of gauze over the Telfa pad or wrap a roll of gauze around the wound.

    • Secure the bandage in place with tape. The tape should be strong enough to hold the bandage in place, but not so sticky as to tear the skin when it is removed. Paper tape is a good choice for most people.

What should I do for pain?

 

You may take Tylenol for the pain associated with the procedure. The Tylenol is most effective if you take the first dose before the numbing medicine has worn off. You may take the Tylenol as often as directed on the bottle. If the pain is not controlled by the Tylenol, then call our office.

 

Should I use an antibiotic ointment instead of white petrolatum?

 

Only if specifically instructed to do so by your doctor. The risk for infection in the wound is very low as long as you are following the prescribed wound care regimen. Many people will become allergic to topical antibiotic ointment with repeated exposure, and it can cause a red itchy rash that is uncomfortable and increases the length of time needed for wound healing.

 

Will the wound become infected?

 

Infection is unlikely to occur. The wound may become colonized with bacteria and this can cause a yellowish discharge to form over the wound bed, but this is not an infection. Signs of infection would include redness of the area, warmth, bad smelling discharge, and fever. If any of these symptoms develop, notify your dermatologist.

 

Can I get the wound wet?

 

Brief exposure to water will not harm the wound, but you should not submerge the wound in water for prolonged periods. This means no bathing in a tub or swimming. Letting water run over the area in the shower for brief periods is okay.

 

Should I let the wound dry out and scab?

 

No. Wounds heal best and quickest in a moist and covered environment. Allowing the wound to dry out and scab will slow the wound healing process.

 

Can I leave the wound uncovered?

 

The wound can be left uncovered for brief periods as long as it is kept moist with large amounts of white petrolatum. The wound should always be covered in situations where exposure to dirt or debris is likely.

 

What do I do if the wound bleeds?

 

If you have bleeding from the wound, then elevate the area and apply firm and constant pressure to the wound with a clean gauze or cloth. You should hold pressure for fifteen minutes without looking. Use a clock or a timer to count the fifteen minutes. If bleeding continues, then repeat the above procedure but use an ice pack over the cloth to hold pressure. If this does not work, then contact us.

Post-Op Incision Symptoms and Questions | MedNow Clinics | Denver, CO | Aurora, CO | Lakewood, CO

Is this your symptom?

  • Concerns or questions about a surgical wound or incision site.
  • A common concern is wound infection. Symptoms of infection include spreading redness or red streaks, pus, and increasing pain or swelling.

Key Points

  • Most surgical wounds heal without any problems.
  • Mild swelling and pain at the incision site are normal.
  • It is important to keep the site clean and protected as it heals.
  • Watch the site for signs of infection such as spreading redness or red streaks, pus, and increased pain or swelling.

Problems – Surgical Wound or Incision

Wound infection is the most common problem that can occur with surgical wounds. Symptoms of wound infection include:

  • Fever
  • Lymph node near wound becomes large and tender
  • Pain or swelling that gets worse 48 hours after surgery
  • Pus or bad-smelling fluid drains from wound
  • Spreading redness occurs around the wound (cellulitis)
  • Red streak is spreading from the wound toward the heart (lymphangitis)

Wound infection occurs more often with abdomen (belly) and emergency surgeries. Other risk factors for surgical wound infections include:

  • Diabetes
  • Older age
  • Overweight
  • Smoking
  • Weak immune system

Less common surgical wound problems include:

  • Bleeding
  • Surgical wound hematoma (collection of blood in tissues)
  • Surgical wound starts to open up

Causes

  • Bacteria on the skin cause most wound infections.
  • Your skin is a natural barrier that keeps out germs (bacteria).
  • Surgery causes a break in the skin barrier. This allows bacteria to enter and cause infection.

Prevention

  • Follow your post-op instructions for wound care and activity restrictions.
  • Keep your wound clean.
  • Protect the incision from injury during the first month.
  • Avoid vigorous exercise or strenuous work for the first month (or longer for some surgeries).
  • Do not smoke for the first month after surgery. Smoking slows wound healing.

When Should Stitches (Staples) Be Removed?

Your surgeon should tell you when your stitches (or staples) need to be removed. These are general guidelines for when they should be taken out:

  • Face: 4 to 5 days
  • Neck: 7 days
  • Scalp: 7 to 10 days
  • Back, chest, and abdomen: 7 to 10 days
  • Arms and back of hands: 7 days
  • Legs and top of feet: 10 days
  • Fingers and toes: 10 to 14 days
  • Palms and soles: 12 to 14 days
  • Overlying a joint: 12 to 14 days

When to Call for Post-Op Incision Symptoms and Questions

Call 911 Now

  • Major stomach or abdomen incision and wound gaping open and visible internal organs
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Severe pain in the incision
  • Fever
  • Incision looks infected (spreading redness, pain) and large red area
  • Incision looks infected (spreading redness, pain) and on face
  • Red streak runs from the incision
  • Stitch (or staple) came out early and wound has re-opened
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Increasing pain in incision and more than 2 days since surgery
  • Incision looks infected (spreading redness, pain)
  • Pus or bad-smelling fluid draining from incision
  • Pimple where a stitch (or staple) comes through the skin
  • Clear or blood-tinged fluid draining from incision
  • Overdue to have stitches (or staples) removed
  • Stitch (or staple) came out early and wound is still closed
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have other questions or concerns

Self Care at Home

  • Mild pain and swelling at the incision site
  • Questions about sutured or stapled surgical incision

Home Care Advice

General Care Advice for Incisions

  1. Follow Your Surgeon’s Instructions:
    • Closely follow all the instructions your surgeon gave you.
    • If the care advice below is different, follow your surgeon’s instructions instead.
  2. Keep Incision Clean and Dry:
    • Keep the incision dry for first 24 hours after surgery (use a sponge bath).
    • Your surgeon will tell you when you can remove your dressing. When the dressing is removed, you can shower. Avoid water pressure directly on the incision. Pat the incision area dry with a clean towel.
    • Apply a small amount of petroleum jelly (Vaseline) on the wound daily. You can buy this at the store. This helps protect the wound and limits scarring. Exception: if your doctor recommended an antibiotic ointment, use that instead.
    • Do not bathe or swim for 2 weeks (or whenever the surgeon says it is ok).
  3. Changing a Dressing:
    • Change the wound dressing if it gets wet or dirty.
    • Follow the dressing directions your surgeon gave you.
    • A dressing that works well is a Telfa dressing covered by gauze. Telfa is a dressing that does not stick to the skin. You can buy it at the drugstore. Place a piece of Telfa on the wound and cover it with a gauze pad.
    • Keep the dressing in place in the same way the surgeon did (such as tape or ace wrap).
    • In most cases, a dressing is no longer needed when the edges of the wound close (usually 48 hours). However, your surgeon may instruct you leave the dressing on longer. This can help protect the wound and catch any drainage.
  4. Cold Pack for Pain:
    • Use cold pack for the first 24 to 48 hours after surgery.
    • Cold helps reduce pain and swelling.
    • Apply the cold pack (or an ice bag wrapped in a towel) to the incision area for 15 minutes.
    • Repeat this once an hour as needed.
  5. Mild Itching:
    • As the incision heals, mild itching is common.
    • Do not scratch. This increases the risk of infection.
  6. Do Not Smoke:
    • Do not smoke during the first month after surgery.
    • Smoking slows wound healing.
  7. Protect the Wound:
    • Protect the wound from injury during the month after surgery.
    • Avoid any vigorous activity or heavy lifting for 4 weeks. Follow your surgeon’s instructions for other activity restrictions.
    • At one week after surgery, the incision tissue strength is only 10% of normal. At one month after surgery, the strength is 50% of normal.
  8. What to Expect:
    • Pain and swelling: Incision pain and swelling are often worst on day 2 and 3 after surgery. The pain should slowly get better during the next 1 to 2 weeks.
    • Redness: Mild redness along the incision is common. It should gradually get better and go away. Call your doctor if the red area spreads (gets larger) or red streaks occur. These could be signs of an infection.
    • Drainage: Small amounts of clear drainage or a few drops of blood from the incision are common in the first few days. Call your doctor if the drainage increases, becomes cloudy (pus), or smells bad. These could be signs of an infection.
    • Itching: Mild itching is common as the incision heals. It should go away when the wound is healed.
  9. Call Back If:
    • Incision looks infected (increasing redness, tenderness, pus-like drainage)
    • Incision edges start to gape open
    • Fever occurs
    • You think you need to be seen
    • You get worse

Over-the-Counter Pain Medicines

  1. Pain Medicine:
    • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
    • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
    • Use the lowest amount of a drug that makes your pain feel better.
    • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
    • Read the instructions and warnings on the package insert for all medicines you take.
  2. Call Your Doctor If:
    • You have more questions
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 12/3/2021 1:00:48 AM
Last Updated: 10/21/2021 1:00:47 AM

Copyright 2021 Amazon.com, Inc., or its affiliates.

Wound treatment

For effective and correct treatment of wounds, it is important to apply a differentiated approach: it is necessary to adjust the treatment of wounds not only depending on the etiology and localization of damage, but also depending on the stage of the wound process, as well as the biological processes currently taking place in the wound.

Healing of any wound occurs in two ways: by the method of primary tension with a small area of ​​the wound surface due to the adhesion of the edges of the wound and its linear shape, and by the method of secondary tension with a large area of ​​the wound and the presence of areas of necrosis.

Regardless of the type of wound and its etiology, the physiological stages of the wound process will proceed in the same way:

  • Inflammatory, or exudation stage. Characterized by edema and hyperemia of nearby tissues, as well as specific wound discharge. At this stage, the inflammatory process contributes to the separation of non-viable tissues from the wound and the cleaning of the wound surface. The main task of local treatment is to ensure wound cleansing and removal of excess exudate without injury to the wound surface and its significant overdrying.Dressings from PAUL HARTMANN TenderWet plus (super absorbent multilayer dressing and Sorbalgon (alginant dressing)) successfully cope with this task.

Proliferative stage, or granulation stage. At this stage, in the areas of the wound surface that are best cleaned of dead tissue granulations appear – foci of division of epithelial cells. Such foci of granulations are sensitive to drying out of the wound and it is very easy to injure them, therefore they need reliable protection from damaging factors and additional moisture.During this phase, it is important to maintain the hydrobalance in the wound. Therefore, the wound dressing, on the one hand, should effectively remove excess exudate from the wound, and on the other hand, moisturize. At this stage, spongy dressings with a HydroTac hydrogel coating will be optimal for wound dressing. The absorbent layer of this dressing provides quick removal of excess exudate, and the hydrogel coating provides sufficient moisture for dry wounds. They maintain an optimal moist environment in the wound, prevent secondary infection and reliably protect against mechanical damage.

  • Epithelization, or stage of differentiation. At this stage, the formation and reorganization of the scar occurs when the wound is completely dry or the discharge is very insignificant. Exudation at this stage can occur only as a result of injury to the wound surface or its infection. Hydrosorb hydrogel dressings are the optimal dressing for this stage for uninfected wounds.

At the stage of the wound process, special attention is paid to the healing of wounds by secondary intention.As a rule, all phases of wound healing smoothly flow into one another and do not have clear boundaries – in the same wound, different areas can be at different stages of healing. This must be taken into account when treating wounds.

Dressings in the treatment of wounds are combined with drug and antibacterial therapy, and, if necessary, with surgical treatment. Before applying the dressing, any extensive wound undergoes initial surgical treatment, which consists in removing foreign bodies and non-viable tissues, restoring the disturbed anatomical tissue joints (suturing).If we are talking about the late terms of the primary surgical treatment of the wound (the patient turned 48 or more hours after the injury), a delayed suture is applied – 3-5 days after treatment. This is done in order to avoid the development of anaerobic infection in the wound.

The above method of treatment is used for purulent wounds, but if we are talking about an aseptic wound (postoperative), then it needs to prevent infection, protect against mechanical damage and ensure the rest of the affected area of ​​the body.Here, the use of antiseptics for treating the edges of the wound and sterile gauze dressings or special complex dressings will be justified.

90,000 Antibiotics and antiseptics for the treatment of surgical wounds healing by secondary intention

What are “secondary intention healing” wounds?

These are surgical wounds that are left open to heal by the growth of new tissue, rather than being closed in the usual way with sutures or other methods where the ends of the wound are brought together.Usually this method (wound healing by secondary intention) is used when there is a high risk of infection or a large loss of tissue in the wound area. Chronic wounds in the crease between the buttocks (pilonidal sinuses / sinuses) and certain types of abscesses are often treated in this manner.

Why are antibiotics and antispecics used in the treatment of surgical wounds that heal by secondary intention?

One of the reasons a wound is left to heal by secondary intention after surgery is the perceived high risk of infection in the wound.If the wound is already infected, antibiotics or antiseptics are used to kill or slow down the growth of the microorganisms that cause the infection and prevent further infection and spread. They can also promote wound healing. Even if the wound is clearly not infected, it usually contains populations of microorganisms. It is believed that healing will be better if the number of these populations of microorganisms is reduced with the help of antibacterial agents. However, there is no clear relationship between infection and microbial populations in wounds and wound healing.

What we found

In November 2015, we searched for as many randomized controlled trials as possible looking at the use of antibiotics and antiseptics in participants with secondary intention-healing surgical wounds. We found 11 studies involving 886 people. All studies looked at different comparisons. Several different types of wounds were included. Studies have examined wounds after amputation of the “diabetic foot”, surgical treatment of the pilonidal sinus, treatment of various types of abscesses, surgical treatment of hemorrhoids, complications after caesarean section, and the healing of “holes” formed during surgery by surgeons (such as colostomy).

Most of the studies compared different types of antibiotic treatment with treatment without antibacterial activity, and four studies compared different types of antibiotic treatment. Although some clinical trials suggested that one treatment might be better than another, the evidence was limited by the size of the studies, the way they were conducted and the results presented. The number of participants in all studies was low, and in some cases even very low.Many studies lacked important information about how they were carried out, which does not allow us to speak about the veracity of their results. More research of better quality is needed to elucidate the effects of antimicrobial treatment of surgical wounds that heal by secondary intention.

Data is current up to November 2015.

Features of suturing wounds in the maxillofacial region

Damage to the soft tissues of the maxillofacial region occurs in 70% of all maxillofacial trauma.Facial defects and deformations cause not only anatomical and functional disorders, but also cause severe psychological distress for patients. The degree of these disorders and the nature of the restorative operations depend on the size and localization of the defect, as well as on the combination of damage to individual organs and tissues of the face. Depending on the severity of the injury, destruction of the skeleton of the maxillofacial region, soft tissues, muscles, nerves, as well as oral organs, the victims need various methods of reconstructive interventions: from small local plastic surgeries to long-term and multi-stage plastic surgery with Filatov stems, bone grafts, adipose tissue and allo- and xeno-implants.Surgical treatment of wounds in the maxillofacial region must be carried out at an early date. This can reduce the risk of wound infection and achieve primary wound healing. Depending on the time factor, primary surgical treatment of wounds is divided into early (in the first 24 hours), delayed (after 24-48 hours) and late (after 48 hours).

According to the general principles of suturing wounds in the maxillofacial area, during surgical interventions, the following is provided: careful attitude to the edges of the sutured wound; precision – exact comparison and adaptation of the layers of the same name of the stitched wound; slight lifting of the wound edges to prevent scar retraction during contraction; provision of prolonged dermal support to prevent scar expansion in the postoperative period; exclusion of strangulation marks from decubitus ligatures on the skin surface.

A distinction is made between a primary suture applied immediately after surgery or injury, and a secondary suture applied to a granulating wound. The delayed primary suture is applied 2-4 days after the primary surgical treatment of the wound. Removable sutures are applied to the skin, which are removed after the wound has healed. Surgical sutures made of non-absorbable material placed in deep tissue are usually left permanently in the tissue.

Types of seams

Interrupted seams. The technique of their implementation requires the needle to be held two-moment. Sewing both edges of the wound with one movement is possible only in the case of closing small superficial wounds. It is necessary to bring the edges of the wound closer together atraumatically, using your fingers. If the surgeon uses ophthalmic surgical forceps for this purpose, they cannot press on the edges of the wound, but can only raise the edges from the inside, or from the outside, support the skin against the prick of the needle.

Requirements for tying a knot: 1) each surgeon must master the basic methods of tying knots; the ends of the ligatures in the hands of the surgeon must be constantly and evenly taut.If the pulling force at one end prevails, you will get a sliding knot that can be untied; 2) the knot should be tightened until the thread stops sliding, but not strongly, since the thread may break or ischemia of the stitched tissues occurs, which will lead to excessive scarring and a decrease in the aesthetic effect; 3) when using the dactyl method of tying a knot, it is necessary to help its movement with the index finger; 4) it is impossible to leave a node on the line of matched tissues, as it can provoke additional ischemia; 5) the ends of the ligatures on the skin should be no more than 0.5-0.8 cm.With their shorter ends, the knot can be untied, with longer ends, the surrounding tissues can be injured; 6) the number of nodes is determined by the manipulative properties of the suture material. As a rule, suture manufacturers indicate the optimal number of knots.

Surgical knot is a combination of two horizontal suture crossings and one vertical crossover. The imposition of this knot is necessary with some tension on the tissues, since the first cross prevents the knot from loosening to the second cross.

A simple (female) knot is a combination of two vertically crossing threads.

Marine knot is quite reliable, but in case of increasing tissue swelling, it tightens, which leads to severe ischemia of the connected edges of the wound.

The imposition of interrupted sutures on the oral mucosa has some peculiarities. So, if the surgeon connects the muco-periosteal flaps, then he is faced with the problem of tissue tension, even when the periosteum is mobilized.In this case, the best is the imposition of U-shaped seams, and in areas without tension – nodal.

When suturing such areas as the tongue, palate, buccal region along the line of teeth closing, leaving the knot and the ends of the ligatures directed into the oral cavity can lead to trauma to the suture line (teeth biting) and contacting surfaces (tongue-palate). Therefore, in such cases, it is necessary to give preference to the use of absorbable sutures and a screw-in suture.

When a conventional interrupted suture is applied to a deep wound, a residual cavity may be left.In this cavity, wound discharge can accumulate and lead to wound suppuration. If it is difficult to match the edges of the skin wound, a horizontal U-shaped mattress suture can be used. This can also be avoided by suturing the wound in several floors. Floor-by-floor wound closure is possible with both interrupted and continuous sutures.

Continuous stitch . A continuous suture is applied with one thread. First, a simple knotted suture is applied from one edge of the wound. The knot is tied.Then the entire wound is sutured, making sure that the edges of the wound fit carefully and pulling the thread after each stitch. Having reached the end of the wound, the end is tied with a loop formed from incomplete tightening of the last stitch. The stitches are removed on the 7-8th day, and on the face after 4-6 days.

In addition to floor-by-floor wound suturing, a vertical mattress suture is used (according to Donatti). In this case, the first injection is made at a distance of 2 cm or more from the edge of the wound, the needle is held as deep as possible to capture the bottom of the wound.An injection on the opposite side of the wound is made at the same distance. When the needle is passed in the opposite direction, the injection and injection are made at a distance of 0.5 cm from the edges of the wound so that the thread passes through the layer of the skin itself. When suturing a deep wound, the threads should be tied after all sutures have been applied – this facilitates manipulation in the depth of the wound. The use of Donatti’s suture allows you to match the edges of the wound, even with a large diastasis.

Surgical sutures applied to the wound, but not tightened, are called provisional.They are tied on the 3-4th day after application in the absence of an inflammatory process in the wound.

An extradermal continuous suture is not used to bring the wound edges closer together, but only to accurately match them in the absence of tension on the suture line. When applying such a suture, a thin suture material and means of optical magnification are used.

Double-row continuous stitch . Deep wounds can be closed with double-row continuous sutures. The first row runs in the subcutaneous fatty tissue, approximately in the middle of the plane of the fatty tissue incision, the second row in the skin itself (dermis).The ends of the threads of each row of stitches are brought out to the surface of the skin and tied together.

The needle is inserted into the middle of the dermis when the intradermal suture is applied. In the future, to obtain an optimal postoperative scar, the stitch radius is maintained up to 2 mm. It is always necessary to poke out the needle opposite the place where it was injected so that when the thread is tightened, these two points coincide. Having finished the seam, the two ends of the thread are grasped by the instrument and pulled until the edges of the wound are completely drawn together. A prerequisite for the imposition of such a seam is the elimination of edge tension.Intradermal suture is not recommended for wounds less than 2 cm long.

Suturing wounds with staples . The brackets consist of metal plates several millimeters wide and 1 cm long and slightly larger. The ends of the staples are bent in the form of rings and provided with a sharp point on the inside, which penetrates into the tissue when applied and prevents the staples from slipping.

Bracketing technique. To apply staples, the edges of the wound are grasped with special tweezers, they are brought together, well attached to each other, then the edges of the wound are held with one tweezers, and the staple is grasped with the other in the right hand, applied to the suture line and the ends of the tweezers are squeezed with force, as a result of which the staple bends and wraps around the edges of the wound.The brackets are applied at a distance of 0.5-1 cm or more from each other.

Removing staples. The staples are removed, as well as the stitches, after 6-8 days using special tweezers or hooks. In the absence of special tweezers, the staples can be removed with surgical tweezers by grasping the staple rings.

The absence of significant tension on the suture line plays a vital role in the wound healing process. Neglect of this principle leads to impaired blood circulation in the edges and walls of the wound, causes their necrosis, which is a prerequisite for wound suppuration.Rough and traumatic surgical technique, extensive detachment of the wound edges to reduce the tension of the suture line, also causes the formation of marginal necrosis. All this largely depends on the training of the surgeon and on the availability of the necessary equipment. Maintaining sufficient blood circulation in the tissues that form the wound walls ensures primary wound healing with the formation of a thin, delicate scar.

Keeping all layers of the wound in a position of tight contact during the formation of a strong scar is largely dependent on the correct choice of suture material.An optimal scar is achieved by using special types of sutures applied with suture material, which biodegradates at a later date.

Primary surgical treatment of a wound with suturing

Types of PHO

The sooner the wound is treated, the less the risk of complications. Depending on the age of getting a wound, doctors use 3 types of PHO:

  • Early. The most recommended option. It is carried out up to 24 hours from the moment of injury, includes all stages, and ends with the imposition of a primary surgical suture.If the subcutaneous tissue has been extensively damaged, or it is not possible to finally stop the bleeding from the capillaries, the surgeon leaves a drainage, which is removed after 1-2 days.
  • Delayed. Produced in 1-2 days after receiving damage. It is during this period that inflammation begins to develop, exudate and edema appear. The operation is carried out with the introduction of antibiotic agents into the wound and suture.
  • Late. PHO, which is performed two days after being wounded.At this time, the inflammation in the wound is already maximum, an inevitable infectious process develops. The likelihood of suppuration still remains high, even after the PST, so the patient is prescribed a course of antibiotics without fail, the wound is not sutured during therapy, i.e. remains open. The surgeon will be able to suture only after 1-3 weeks, when the entire surface of the wound is covered with granulations and a persistent resistance to infection develops.

In any case, the long-term existence of the wound can in no way contribute to the early restoration of the functionality of the patient’s body.

Key indications for the procedure

The main indication for PHO is the presence of an accidental deep wound. Cannot be subject to PHO:

  • scratches,
  • abrasions,
  • shallow non-extensive wounds up to 1 cm,
  • multiple wounds (shallow),
  • simple puncture wounds,
  • some cases of bullet wounds affecting only soft tissues.

PST is contraindicated if the wound contains signs of a purulent process, as well as if the patient is in critical condition (for example, shock of the first degree).

How is the procedure

This operation is performed with the obligatory observance of all the necessary antiseptic conditions, it may require anesthesia. Preparation for treatment consists in carrying out a toilet of the wound: the doctor washes away blood and impurities, frees the wound channel from foreign bodies, etc.

The PHO itself consists of several stages:

  1. The wound is cut,
  2. A detailed revision of the wound channel is being carried out,
  3. The surgeon carefully excises the edges, as well as the bottom and all walls of the wound,
  4. Hemostasis of bleeding,
  5. Restoration of the integrity of all structures and organs,
  6. Surgical sutures and wound drainage are performed if necessary.

The first stage is necessary in order to control the revision of the wound channel, as well as to determine the type of accidental injury. The edges, bottom and walls of the wound are excised to eliminate necrotic tissue and any foreign bodies that may have entered the skin. The wound is now completely sterile. The doctor performs all subsequent manipulations only after replacing the instruments and gloves used during the operation (or treating the hands with an antiseptic).

If possible, the edges, as well as the bottom and walls of the wound, should be excised together, in one block, by 0.5-2 cm. The doctor takes into account not only the localization of the wound, but also its depth. If the wound is dirty or inflamed, a fairly wide excision has to be performed. This also applies to wounds on the lower extremities.

If the wound is located on the face, only necrotic tissue should be removed. With a cut wound, the excision stage is skipped altogether. It is also contraindicated to excise the viable walls and bottom of the wound if they are represented by tissues of any internal organs.

After the wound is already open for the procedure, the surgeon performs a detailed hemostasis in order to prevent hematoma, as well as to avoid a possible infectious complication.

The final, namely the recovery stage, includes stitching of nerves, damaged vessels, tendons, and, if necessary, the connection of bone tissues. It is recommended to perform this stage immediately, otherwise you will have to carry out the PST again.

Completion of the operation can have several variations:

  • blind layer-by-layer surgical wound closure (for wounds with a small area of ​​damage to the dermis, for example, stab and cut, as well as lightly contaminated wounds localized on the neck or on the face).
  • suturing the wound with the drainage left (if there is a risk of infection, for example, if the wound is localized on the foot or if the PHO is performed more than 6 hours after the injury was received).
  • the wound is not sutured (if there is a risk of an infectious complication, namely in the case of late PST, profuse wound contamination, massive tissue damage, concomitant diseases, localization on the leg or foot, elderly victim).

Gunshot wounds, in particular, through wounds, are also not sewn up.

Important:

  • Deaf wound closure in the presence of any unfavorable factor is an unjustified risk and is considered a tactical medical error,
  • wound dressing must be carried out under suitable sanitary conditions,
  • should not make a complete excision of the wound with a narrow wound channel,
  • if the salivary gland was damaged as a result of injury, it is necessary to first suture the parenchyma of the gland, then to the capsule, and only then – the fascia and skin,
  • if the wound was on the front part and led to deformation, after the PCO, plastic masking of the defect is done.

Restoration of tissue integrity

Any PHO ends with the approach of the edges of the wound. Most often, this requires the imposition of surgical sutures. This procedure significantly accelerates healing, significantly improves the functional and cosmetic effect, facilitates the subsequent treatment of the wound, and also reduces the likelihood of repeated suppuration.

Skin tissue is sutured using special surgical needles (atraumatic or traumatic), as well as a certain suture material, which is selected by a surgeon depending on the condition of the wound.

The suture material used must be smooth, elastic, flexible, strong, and have a sliding surface. If self-absorbable sutures are used, it is important that the thread does not dissolve faster than the scar has formed. An equally important point is the biocompatibility of the patient’s tissues and suture material.

If the operation is performed on the face, any suture material can be used, except metal staples and wire, as well as silk and lavsan.Any self-absorbable suture is used to suture muscles and mucous membranes.

TREATMENT OF WOUNDS (conventional and surgical sutures)

To begin with, we will discuss the issue of the necessary instruments, firstly, we need a suture material, they can be a silk thread or, in the last case, no matter what thread, it can also be fishing line is not of a huge diameter, secondly, this is a needle, its preferred size is 2-3 cm, and, thirdly, pliers are likely to facilitate sewing.

Suturing wounds should begin with the fact that the “suture material” must be disinfected in vodka, cologne, a little pink solution of potassium permanganate, etc.

All this should lie in the solution for about 10-15 minutes. Well, or if possible, you can boil the “suture material”.

The main part of the suturing of wounds.

Before you need to overstep, bend the needle under the type of fishing hook. The thread, fishing line, or whatever you have, is cut into pieces 15-25 cm long. Then we pull the thread through the needle and clamp it so that the thread does not jump out. You begin to pierce the wound from the outer edge inward, trying to grab only the skin (you need to retreat from the edge of the wound about 5-7 mm), pull the thread, pierce the wound from the inner edge (here you need a needle hook, so as not to snag on the meat, but go under the skin ).

Pull the two ends of the thread, the wound should just come together and tie a knot. Voila, one seam is ready. Sutures should be applied at a distance of approximately two centimeters.

Supplement.

If the wound is very large (lacerated), then
it is necessary to make cuts parallel to the wound at a distance of 2-3 cm. This operation helps to tighten the wound. Additional incisions may not be sutured.

Also, the wound being sutured is not in any way treated with undiluted iodine, because muscles can be burned, and the wound cannot be cauterized with an open fire, this is done to stop bleeding, and the rate of wound healing is miniaturized.

The wound can be treated around, gently wiping with iodine or brilliant green. An anesthetic is likely to be administered to the wounded: ice cream 2-5%, vitamins of group B, vitamin C. Vitamins are put in the buttock, and ice is placed around the wound. These drugs can be used without a “prescription” by a doctor.

* Learning to apply seams. Maybe some of the presented ones will not be needed, but it is useful to know.

Surgical sutures are a more common method of joining bio tissues (wound edges, organ walls, etc.)with the help of suture material, stopping bleeding, bile leakage, etc. Unlike suturing tissues (bloody method), there are bloodless ways to connect them without the introduction of suture material.

Depending on the timing of the imposition of Sh. X. distinguish between:

• primary suture, which is applied to an accidental wound specifically after primary surgical treatment or to an operating wound;
• a delayed primary suture is applied before the development of granulations within 24 hours to 7 days after the operation in the absence of signs of purulent inflammation in the wound;
• provisional suture – a kind of delayed primary suture, when the threads are carried out during the operation, and they are tied after 2-3 days;
• an early secondary suture, which is applied to a granulating wound cleared of necrosis after 8-15 days;
• A late secondary suture is applied to the wound after 15-30 days or more with the development of scar tissue in it, which is excised earlier.

Sutures can be removable when the suture material
is removed after fusion, and immersed, which remain in the tissues, dissolving, encapsulating in the tissues or erupting into the lumen of the hollow organ.

Sutures applied to the wall of a hollow organ can be through or parietal (not penetrating into the lumen of the organ), and as suture material – absorbable and non-absorbable threads of bio or synthetic origin, iron wire, etc.

Mechanical suture is made with the help of staplers, in which the suture material is iron staples.

Depending on the technique of sewing fabrics and fixing the knot, manual Sh. X. subdivided into nodal and continuous.

Ordinary interrupted sutures [puc.1] are usually applied to the skin at intervals of 1-2 cm, more often from time to time, and less often if there is a danger of suppuration. The edges of the wound are painstakingly matched with tweezers [puc.2].

Sutures are tied with surgical, marine or ordinary (female) knots. To avoid loosening the knot, keep the threads taut at all steps in the formation of the seam loops.

The instrumental (apodactyl) method is also used for tying a knot, especially of ultra-thin threads for plastic and microsurgical operations [puc.3].

Silk threads are tied with 2 knots, catgut and synthetic – 3 or more. By tightening the 1st knot, a comparison of the stitched fabrics is achieved without undue effort in order to avoid cutting the seams.

Correctly applied suture firmly connects tissues, leaving no cavities in the wound and without disturbing blood circulation in the tissues, which provides rational conditions for wound healing.

In addition to the usual knotted sutures, other variants of the knotted suture are used. So, when sutures are applied to the wall of hollow organs, screw-in sutures are used according to Pirogov – Mateshuk, when the knot is tied under the mucous membrane [puc.4].

To prevent tissue eruption, looped interrupted sutures are used – U-shaped (U-shaped) everting and screwing (a, b) [puc.5]

and 8-shaped (c). For the best comparison of the edges of the skin wound, use the nodal adaptive U-shaped (loop-shaped) suture according to Donati [puc.6].

When applying continuous seams, the thread is kept taut so that the past stitches do not loosen, and in the latter, a double thread is retained, which, after being punctured, is tied to its free end.

Continuous W x. have different options. Often they use a regular (linear) twisting stitch (a) [puc.7] a twisting stitch according to Multanovsky (b), and a mattress stitch (c).

These sutures twist the edges of the wound if they are applied from the outside, for example, when suturing a vessel, and screw in if they are applied from the inside of an organ, for example, when forming the posterior wall of the anastomosis on the organs of the gastrointestinal tract.

Together with linear, different types of radial seams are used. These include: a circular suture, with the aim of fixing bone fragments, for example, with a fracture of the patella with divergence of fragments; so-called cerclage – bonding with wire or thread of bone fragments in oblique or spiral fracture or fixation of bone grafts (a) [puc.8]

block pulley suture for converging the ribs, used when suturing a chest wall wound (b), a regular purse-string suture (c), and its varieties – S-shaped according to Rusanov (d), and Z-shaped according to Salten (e) …used for suturing the intestinal stump, immersion of the stump of the appendix, plastics of the umbilical ring, etc. the seam.

When suturing wounds and forming anastomoses, sutures can be applied in one row – a single-row (1-storey, single-tiered) suture, or layer-by-layer – in two, three, four rows.

Together with the connection of the wound edges, the sutures also stop bleeding. For this purpose, specially proposed hemostatic sutures, for example, a continuous chain (chipping) suture according to Heidenhain – Hacker [puc.9] on the soft tissues of the head before dissection during craniotomy.

A variant of the interrupted chain suture is the hemostatic suture according to Oppel for liver injuries.

Overlay technique Sh. X. depends on the applied operational techniques.

For example, during hernia repair and in other cases when it is required to obtain a strong scar, they resort to doubling (duplicating) the aponeurosis with U-shaped sutures or Girard-Zika sutures (a) [puc.10].

When suturing eventration or with deepest wounds, removable 8-shaped sutures are used according to Spasokukotsky (b, c).

When suturing wounds of complex shape, situational (guiding) sutures can be used, which bring the edges of the wound closer together in places of greater tension, and after applying unchanged sutures, they can be removed.

If the stitches are tied on the skin with great tension or are meant to be thrown for a long time, so-called lamellar (plate) U-shaped stitches are used to prevent eruption, tied on plates, buttons, rubber tubes, gauze balls, etc. [puc. eleven].

For the same purpose, secondary provisional sutures can be used, when more frequent interrupted sutures are applied to the skin, and they are tied through one, leaving other threads untied: when the eruption of tightened sutures begins, provisional sutures are tied, and the first ones are removed.

Skin sutures are removed in most cases on the 6-9th day after their application, but the timing of removal can vary depending on the location and nature of the wound. Earlier (4-6 days), sutures are removed from skin wounds in areas with good blood supply (on the face, neck), later (9-12 days) on the lower leg and foot, with a significant tension of the wound edges, reduced regeneration.

The sutures are removed by pulling the knot so that a part of the thread hidden in the thickness of the tissue appears above the skin, which is cut with scissors [puc.12] and the whole thread is pulled out by the knot.With a long wound or significant tension on its edges, the sutures are removed first after one, and in the following days – others.

Overlapping III. NS. different types of complications may appear. Traumatic complications include an accidental puncture of a vessel with a needle or a suture passing through the lumen of a hollow organ instead of a parietal suture.

Bleeding from a punctured vessel usually stops when the suture is tied, otherwise it is necessary to put a second suture in the same place, capturing the bleeding vessel; when a large vessel is punctured with a coarse cutting needle, it may be necessary to apply a vascular suture.If an accidental through puncture of a hollow organ is found, this place is additionally peritonized with serous-muscular sutures.

Technical errors when suturing is a poor alignment (adaptation) of the edges of a skin wound or ends of tendons, the absence of the effect of screwing in with the digestive and eversion with a vascular suture, narrowing and deformation of the anastomosis, etc. anastomosis, bleeding, peritonitis, digestive, bronchial, urinary fistulas, etc.

Suppuration of the wound, the formation of external and internal ligature fistulas and ligature abscesses appears as a result of aseptic disorders during sterilization of suture material or during surgery.

Aggravations in the form of delayed-type allergic reactions often appear when using catgug, even less often – silk and synthetic threads.

sources: shkola-v.blogspot.ru stalker-nt.ru

What do we treat | VOKB # 1

The department carries out:

  • Treatment of patients with extensive burns on a fluidizing anti-burn bed;
  • plastics with local tissue using the method of acute dermatosis;
  • plastic surgery with tissues stretched by expander dermathesis;
  • displacement of complex tissue complexes with an axial nature of blood supply;
  • microsurgical autotransplantation of tissue complexes;
  • surgical treatment using a surgical, carbon dioxide laser;
  • The use of modern biodegradable dressings in the treatment of burn wounds;
  • Using the method of preliminary preparation of complex tissue complexes;
  • Surgical treatment of postmastectomy syndrome, including displacement of the TRAM flap.

Skin plastics

All types of skin grafting are divided into two options:

1) Free skin grafting;

2) Non-free skin grafting.

Free skin grafting is subdivided into free vascularized and non-vascularized.

Non-free skin grafting can be divided into two types: 1) wound closure by using the adjacent skin with or without additional incisions; 2) closure of the wound by moving a skin flap on the leg, taken near the wound or from distant parts of the body.The first group is very extensive, the most used for a long time, but has limited capabilities in cases of extensive damage. The second group is subdivided into three main subgroups:

a) insular flaps;

b) flat flaps;

c) tubular flaps

Use of fluidizing beds in the treatment of burns

In 1968, at the University Hospital in Charleston (USA), an aerotherapy device was used for the first time in the treatment of patients with long-term impairment of motor activity. (Video 1). The principle of operation is based on the formation of a pseudo-boiling layer due to the passage of warm air at a pressure of 0.6 m / min through a mass of ceramic microspheres (fluidization effect). As a result, a pressure of 10-15 mm Hg is distributed over the entire area of ​​contact with the bed surface. The patient “soars” in a comfortable environment. Initially, neurological and traumatological patients were positioned in these beds.

The first experience showed the advantage of treating severely burned on a fluidizing bed:

  1. Formation of dry scab as soon as possible (16-48 hours)
  2. Accelerated epithelialization of superficial, borderline burns
  3. Shortening the preparation time for wounds for surgical treatment of deep burns
  4. Expansion of donor resources
  5. Normalization of blood circulation, microcirculation
  6. Decrease in catabolism
  7. Normalization of thermoregulation
  8. Pain reduction
  9. Increase patient rest time
  10. Reduction in the number of painful dressings
  11. Reducing the risk of microbial contamination of wounds through the use of bactericidal granules.

The only drawback, as a result of being in conditions of sensory deprivation, is the effect of dependence on this bed, “dependent” behavior, a decrease in volitional activity of the victim.

Laser surgery

Since the 60s of the last century, a surgical laser has been actively used in medicine.

The use of CO 2 laser allows solving existing problems:

– Creation of methods of “bloodless operations” that ensure minimal bleeding and blood loss;

– tissue healing – optimization of the process and reduction of the wound healing time.

The advantages of using a laser in surgery include sterility, good hemostatic effect, minimal tissue trauma, and good cosmetic results.

The modern level of treatment of burns involves the use of laser radiation, antioxidants and various biologically active materials.

Indication for the use of laser in the treatment of burns:

  1. Laser necrectomy. The atraumatic and bloodless method allows expanding the area of ​​one-stage necrectomy up to 30% of the body surface
  2. Stimulation of wound reparative processes.
  3. Preparation of the wound surface for skin grafting
  4. Laser irradiation of residual wounds at the joints of the transplanted skin and on mesh skin flaps

Benefits of laser scar treatment:

  • high accuracy of impact – both in depth and in area;
  • impact on scar tissue of any size, shape and location;
  • aseptic working conditions.

In addition, indications for the use of CO 2 laser are the elimination of any benign formations, defects after acne, tattoos, various hyperpigmentation, fading facial skin and many other skin pathologies. In addition to external manifestations (improvement of skin color, increased turgor, elimination of pigmentation and wrinkles, etc.) dermabrasion (peeling) with a carbon dioxide laser promotes a qualitative structural change in the skin – an active reduction in degenerative changes in elastin and collagen fibers.

Microsurgery

Reconstructive microsurgery is the most difficult type of skin grafting. Its feature is the restoration of blood circulation in the transplanted tissue complex due to the imposition of microvascular anastomoses under optical magnification using microsurgical techniques.

This method is in demand in combustiology due to the extensive cicatricial process of the reconstruction area.

The method is complex, requiring expensive equipment, long-term training of the entire team in the skills of carrying out the operation itself, and maintaining the postoperative period.As a rule, the operation is performed by two teams.

Despite this, in some cases, microsurgical autotransplantation of a complex of tissues is the method of choice in the treatment of burns in the early or late period.

Here are the cases when there was no alternative to this method

Operative treatment of burns

At the stage of the wound process .

I. Necrectomy – removal of necrotic tissue.

  1. Primary surgical necrectomy (PCN) is a necrectomy performed before the development of purulent-septic processes in the wound (approximate terms – the first 5 days after receiving a burn).
  2. Delayed surgical necrectomy (ACN) – removal of necrotic tissue against the background of a purulent-septic wound process (usually later than 5 days after receiving a burn).
  3. Secondary surgical necrectomy (VCN) – removal of secondary necrosis, after PCN or ACN in case of doubt about their radicality.
  4. Staged surgical necrectomy (EHN) – necrectomy performed in parts, in stages (usually with extensive lesions).

II.Excision of a wound is a method of preparing a burn wound without a scab.

  1. Excision of granulating wounds – radical removal of granulations of varying degrees of “maturity” and type.
  2. Excision of a purulent-necrotic wound – in the absence of reparative processes (for example, as a trophic ulcer).
  3. Excision of a scarring wound.

B. According to the technique of performing the operation.

  1. Tangential – layer-by-layer, “tangential”, removal of scabs, necrosis and pathologically altered tissues to viable, suitable for plastic closure.
  2. Edging incision – when using a vertical incision around the perimeter of the wound within healthy tissue.
  3. Combined method.

V. By the depth of excision.

  1. Dermal – to the remnants of the dermis (“borderline” burns 3A-3B degree).
  2. Subcutaneous fat – to visually viable subcutaneous fat.
  3. Fascial – to a visually viable fascia, leaving it behind.
  4. Fascial-muscular.
  5. Osteonecrectomy.

G. Amputation of limbs or their segments with total lesion.

Reconstructive plastic surgery

The history of surgical treatment of burn wounds goes back a little over 150 years. Since the 60s of the XIX century, the era of combustiology began, when surgeons Reverden, Janovich-Chynsky, Tirsch began to transplant their own skin as a matrix on the affected areas.

And at the present time, autodermoplasty with a split skin graft clearly dominates in the treatment of burns.This method is quite reliable, safe and effective.

However, the results of the treatment of burns in aesthetically and functionally significant areas (head, neck, exposed parts, hands, feet, joints, etc.) cannot satisfy the patient and the doctor, especially at the present time. The development and implementation of new methods of plastic and reconstructive surgery made it possible to more critically evaluate the results of treatment of burn victims.

Until the 60s of the XX century, when filling complex, extensive defects, there was no alternative to using the Filatov stem.Bakamjan V. became the founder of another breakthrough in the development of reconstructive plastic surgery, who in 1965 proposed a method of insular movement of a vascularized complex of tissues. As a result of the conducted anatomical studies, areas of autonomous blood circulation of the tissues of the head, neck, trunk, upper and lower extremities were identified. Moving within the radius of the vascular pedicle allows you to almost completely solve the problems of Filatov’s stem – stages and duration. The last, fundamental step in the development of plastic surgery was made in the 80s of the last century – microsurgical transplantation of a complex of tissues.Immediate restoration of blood circulation of complex flaps due to the imposition of vascular anastomoses made it possible to eliminate all the disadvantages of the earlier proposed methods of plasty. Accelerated rehabilitation treatment of victims with severe thermal injury not only reduces mortality, but also has moral and ethical significance

TREATMENT OF WOUNDS.

Description and assessment of the condition of the wound
To select an adequate treatment tactics when describing the condition of the wound, a comprehensive clinical and laboratory assessment of many factors is required, taking into account:
– Localization, size, depth of the wound, seizure of underlying structures, such as fascia, muscles, tendons, bones, etc.
– Condition of the edges, walls and bottom of the wound, the presence and type of necrotic tissue.
– The quantity and quality of exudate (serous, hemorrhagic, purulent).
– Level of microbial contamination. The critical level is the value of 105 – 106 microbial bodies per 1 gram of tissue, at which the development of wound infection is predicted.
– The time elapsed since the injury.

There are several types of surgical treatment:
1. Primary surgical debridement (PWD) – for any accidental wound in order to prevent the development of infection.
2. Secondary surgical treatment of the wound – according to secondary indications, already against the background of the developed infection.
Depending on the timing of the surgical treatment of wounds, there are:
1. early CT – performed within the first 24 hours, the goal is to prevent infection;
2. delayed CT – performed within 48 hours, subject to prior use of antibiotics;
3. Late CT is performed after 24 hours, and when using antibiotics – after 48 hours, and is directed to the treatment of the developed infection.

XO is completed with sutures.
Distinguish:
1. primary seam – immediately after CT;
2. Delayed suture – after CT, stitches are applied, but not tied, and only after 24-48 hours the sutures are tied if the wound has not developed an infection.
3. Secondary suture – after cleansing the granulating wound after 10-12 days.

for the prevention of wound complications required:

  • gentle tissue handling
  • obliteration of “dead” space
  • close edge matching, tension-free stitching
  • use of monofilament suture material
  • preservation of blood supply to tissues in the wound area
  • thorough hemostasis

Postoperative dressings from the manufacturer.Different sizes. Neofix and Smith & Nephew.

In everyday life, there should always be a first-aid kit with ready-made dressings to close the wound.

How not to get confused, navigate a huge selection of dressings and choose the one that will best help in your case?

If the wound is not very large and does not bleed , sterile film-based dressings without an absorbent pad can be used. Such dressings are thin, transparent and self-adhesive, which makes them invisible on the skin, gives an aesthetic appearance and ease of use.They can be applied to any part of the body and the healing process can be controlled directly through the bandage without prior removal, which gives comfort. Such dressings prevent infection and contamination of the wound, maintain the moist environment in the wound necessary for speedy healing, but do not allow the skin under them to sweat, as they let air vapor through themselves. At the same time, they do not allow water to pass through and make it possible to take short-term water procedures with them in the form of a shower, swim in the sea and in the pool, which makes it easier to use and reduces the economic costs of dressings by reducing the frequency and number of dressings.These dressings include OPSITE FLEXIGRID Film Dressings, IV3000 STANDART, ELECT IV Plasters, and OPSITE SPRAY Liquid Spray Dressing. The aerosol dressing is sprayed onto the wound, hardens and becomes almost invisible. This is important in cases where skin damage has occurred in open areas of the skin and the appearance of dressings is of particular importance.

If wound is wet (exudating) , sterile absorbent pad dressings can be used.Such dressings can be on a waterproof film base, which allows them to take short-term water treatments, and on a traditional non-woven base. Both types of dressings do not require additional fixation, which is very convenient, and have a pad that does not stick to the wound. Film-based dressings include OPSITE POST-OP, OPSITE POST-OP VISIBLE.
Non-woven bandages include PRIMAPORE, NEOFIX POST. I would like to note the OPSITE POST-OP VISIBLE dressing, which has not just an absorbent pad, but an absorbent pad of a cellular structure with increased absorbency.This bandage allows you to monitor the condition of the wound without removing it.


If wound strongly exudates or a dressing is needed for preliminary wetting in a medicinal solution, then a non-adhesive sterile dressing with increased sorption capacity should be used, for example, MELOLIN.