Post-Operative Wound Care

You will be given some general instructions about what to do after your surgery. Your surgeon may also give you some special instructions on how to care for the surgery area. Be sure to follow those instructions carefully. 

Your surgeon will want to talk to you post-operatively if you:

• Have questions about you home care instructions, such as wound care, diet or activity level, therefor you need to schedule a follow up appointment at the rooms after the surgery.
• Have problems with your prescription medicines. These problems may include rash, hives, nausea, vomiting or stomach problems (diarrhoea).
• Histology and operation procedure will be discussed on this appointment.

If the instructions from your surgeon are not clear or do not cover your particular problem, contact your surgeon immediately. If your symptoms or problem occur after office hours, go to your nearest casualty unit.

PLEASE do not smoke or use tobacco products. Smoking slows healing because it decreases blood supply and delays tissue repair.

Write down your symptoms or problem.  It may help you become more aware of your specific symptom or problem or give you an idea about its cause.  It will also help to prepare you to talk to your surgeon about what you are experiencing.

Like all wounds, healing may be affected by intrinsic and extrinsic factors that may result in post-operative wound complications, such as surgical site infections, which delay healing. 

Surgical site infection (SSI) is the most common post-operative incisional complication. Others include post-operative blistering and wound dehiscence, which may often be related to surgical site infection and comprises approximately 20% of all healthcare associated infections.
SSI can range from a spontaneously limited wound discharge, recognised usually with 7-10 days of an operation, to a life threatening post-operative complication, such as abdominal wound dehiscence.

To support our patients, a strategy for the prevention of SSI (Surgical Site Infection) is provided and specific guidelines have been issued to prevent and manage complications. They highlight the importance of a thorough and structured approach to post-operative care.

All patients get educated regarding the optimal wound care, how to identify a wound that is failing to heal and who to contact if they are concerned about a possible Surgical Site Infection.

Bathing / Showering

Patients are being advised that they can shower or bath safely 48 hours after their surgery. Cover the dressing with a plastic bag or take sponge baths to prevent dressings from pulling away from the skin.

Preparation

• Wash your hands thoroughly with an antiseptic soap (Dettol or Bio scrub) and put on your medical gloves if provided in the wound pack.
• Prepare supplies by opening the gauze packages and necessary cleaning equipment.
• Loosen the tape around the old dressing.
• Use an aseptic, non-touch technique for changing and removing dressings and remove it from the wound area.
• Keep the frequency of dressing changes to a minimum to avoid disrupting healing tissue.

Clean the Incision

At this point clean the incision if your doctor told you to do so:

• Gently wash it with soap and water to remove the crust. Do not scrub or soak the wound.  Do not use rubbing alcohol, hydrogen peroxide or iodine until you are instructed to do so, which can harm the tissue and slow wound healing.
• Use sterile Saline for wound cleansing up to the first 48 hours after surgery.
• Hibitane and Water will also be provided in the post-operative wound care pack on discharge to clean all wounds
• Coarse salt sits baths can be used to clean all anal and vaginal wound areas. Remicaine jelly needs to be applied after each salt bath, because the salt water can dry out the anal wound area and cause the skin to crack, therefor it needs to stay moist by applying the jelly. Air-dry the incisions or pat it dry with a clean, fresh towel before reapplying the dressing.
• When skin staples are used to close the wound, each staple needs to be cleaned thoroughly when assessing the wound. If staples run through the navel area, the navel also need to be cleaned and kept dry at all times to prevent infection.

Suture and Staple Recommended Removal Times

Inspect the Incision for Signs of Infection

Call your doctor if you notice signs of an infection, such as:

• A yellow or green discharge that is increasing.
• A change in the odour of the discharge.
• A change in the size of the incision.
• Redness or hardening of the surrounding area caused by cellulitis, a collection of pus or seroma fluid. If these occur antibiotics are needed. The incision is hot to the touch.

You may notice some soreness, tenderness, tingling, numbness and itching around the incision.  There may also be mild oozing and bruising, and a small lump may form.  This is normal and no cause for concern.

Apply the Antibiotic Ointment

Apply the antibiotic ointment (Bactroban/Supiroban 15gr) on the incision area and cover the wound with the transparent waterproof dressing with absorbent pad. Remicaine jelly (local anaesthetic) will be prescribed after anal procedures, (Haemorrhoidectomy and anal Fissurectomy.) In some cases Meloderm ointment will be prescribed in septic wounds. This must only be used on doctor’s instructions.

Clean Up

After wound care is done put all trash in a plastic bag and throw it away. Wash your hands and apply an antiseptic solution like D-Germ or hand sanitiser.