Once the patient is discharged after head & neck surgery, appropriate care must be take for the surgical wound. In some cases care takers might have to replace the surgical dressing at home since it is not always feasible to visit the hospital. This article is meant for such caretakers. Simple step by step instructions to change the surgical dressing.
Importance of surgical dressing
Once the surgical incision is closed, under strict aseptic condition wound is covered with sterile padding and then taped. It is called as surgical dressing
Role or Advantages of Surgical dressings
- Preventing stitches or staples to catch on clothing by covering them.
- During initial phases , soaks up any fluids that leak from wound
- Protect wound from contamination of germs
- Reduces the risk of infection
- Promotes healing of the wound by providing sterile environment.
Here are instructions for post surgery dressing at home
How often should the dressing be changed?
First week : Surgical wound is cleaned and dressing is changed everyday post surgery for about 1 week. This is done by nursing staff as patient is usually admitted for recovery/observation
Second week : Cleaning and dressing to be done 2- 3days/weeks or as per your primary treating team after until your follow up appointment.
Follow the instructions below when you clean your wound.
You will need the following supplies to clean your wound:
- Hand sanitizer
- Surgical spirit
- Cotton swabs
- Gauze pads
- Betadine solution
- Betadine ointment
- Offsite flexifix/micopore
Changing The Surgical Dressing:
1. Getting prepared:
- Keep all items listed above ready and open before you begin. Also keep a clean towel by your side.
- Have a clean work surface.
- Clean your hands with soap and warm water before touching the dressing. Dry your hands with a clean towel.
- Use hand sanitizer to clean your hands and let it dry on its own.
- If anyone is assisting, they should also wash their hands thoroughly.
2. Remove the old dressing:
- Put on clean medical gloves if your wound is infected (red or oozing).The gloves do not need to be sterile.
- Carefully loosen the tape from the skin, moisten it gently with sterile water if required.
- Put the old dressing in a plastic bag and set it aside. Remove the gloves if you had them on.
- Clean your hands again as explained above
3. Placing a New Dressing:
- Make sure your hands are clean.
- DO NOT touch the inside of the dressing directly with bare hand.
- Apply surgical spirit with help of cotton and forceps over the suture/stitch site and let it dry. Take advise from your primary treating team if the site is bleeding or has foul smelling discharge.
- Discard that piece of cotton now
- Apply betadine lotion over that suture site using cotton swab and let it dry.
- Apply betadine ointment over that suture site with help of a cotton swab .
- Place new dressing pad (gauze piece+cotton) over the wound and tape down all 4 sides using flexifix or micropore.
- When you’re done , wash your hands thoroughly for at least 20 seconds with warm water and soap or simply use a hand sanitizer.
- If you have non-dissolvable stitches or staples, the primary surgical team will remove them. DO NOT pull at your stitches or try to remove them on your own.
NOTE : Your primary surgical team will tell you how often to change or any specific instructions on how to change the dressing. This is the general information to help you remember the steps of changing the dressings in hygienic manner .
Frequently Asked Questions
- Should I let my wound be open to air?
No. Wound has to be covered with sterile dressing to keep it safe from infections. Dressings are usually done such that the balance between moisture and air is maintained inside it. You can only keep the wound open when your primary teams informs you to do so.
- Can I get my wound wet in the shower?
No , Typically you should not be “soaking” your wound especially when have sutures or staples, exposed bone, or your doctor has advised against it. You must take your doctor’s consent before doing so. Using Garbage bag or some plastic cover will help in keeping your wound dry when you take shower.
- What if I forget to change my dressing?
As soon as you remember, change your dressing. Be careful in removing it, as the dressing is usually in such cases dressing is stuck to the wound. Use sterile water to soak it, so that it comes off without causing you any pain. Then redress your wound as explained.
- Can I use a water under pressure to clean my wound?
No. That will harm the wound delay its healing and also risk of infection is increase.
- What things should I be reporting to my wound care doctor?
- Bleeding from your wound
- Please inform your doctor of any of the following:
- Pain from your wound [Especially sudden excruciating type]
- Increase in drainage from your wound or sudden blockade.
- High blood sugar if you are diabetic
- Redness in the skin around your wound
- Changes in your body temperature, blood pressure or mental orientation.
- Need for dressing supplies
- Any new wounds you find on your body
- Any changes in your medications
- Difficulty in completing the prescribed dressing changes
- Any questions or concerns you have about your wound care
- If I am a diabetic, is it important to keep my blood sugar in control?
Yes, it is extremely important. High blood sugar levels can slow down or prevent wound healing. Discuss with your wound care doctor and primary physician dealing with diabetes.
- What does it mean if an area of my skin changes color?
Daily inspection of wound is necessary . Some mild gradual skin changes are normal and might be a sign of healing . Any sudden change in color of wound [especially when associated with pain or itching] has to be reported to your health care provider.
Dr. Chaitanya M Kumar is a Consultant Radiation Oncologist with over 3 years of experience. He believes empowering patients with the right information and educating them is crucial to improve their quality of life.