Surgical wound care - open

Proper Handwashing

It is important to clean your hands before you change your dressings. You may use an alcohol-based cleaner like Purell, or you may wash your hands using these steps:

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

Removing the Old Dressing

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

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

Remove the old dressing:

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

Caring for the Wound

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

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

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

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

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

Putting on the New Dressing

Place the clean dressing on the wound as your health care provider taught you to. You may be using a wet-to-dry dressing.

Clean your hands when you are finished.

Throw away all the old dressings and other used supplies in a waterproof plastic bag. Close it tightly, then double it before putting it in the trash.

Wash any soiled laundry from the dressing change separately from other laundry. Ask your doctor if you need to add bleach to the wash water.

Use a dressing only once. Never reuse it.

When to Call the Doctor

Call your doctor if:

• You see any of these changes around the incision:
  • More redness
  • More pain
  • Swelling
  • Bleeding
  • The wound is larger or deeper
  • The wound looks dried out or dark
• The drainage coming from or around the incision:
  • Is increasing
  • Becomes thick, tan, green or yellow, or smells bad (pus)
• Your temperature is above 100 °F for more than 4 hours.

Alternate Names

Surgical incision care; Open wound care

References

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

Update Date: 6/6/2012

Updated by: Ann Rogers, MD, Associate Professor of Surgery; Director, Penn State Surgical Weight Loss Program, Penn State Milton S. Hershey Medical Center. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.