TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION Surgical Wound An information guide
Surgical Wound A surgical wound is the cut made into the skin by the doctor during an operation. At the end of the operation the cut is closed to allow the skin edges to come together and heal. Sometimes metal clips or staples are used to keep the skin edges together. The skin edges usually form a seal within a day or two of the operation. The time this takes varies from person to person and from operation to operation. On rare occasions a surgical wound is allowed to remain open (not closed) and heals from the base of the wound up. If this is the plan for your wound, you will receive specific information from your surgical, nursing and/or midwifery team prior to being discharged home. Closure of the wound A wound can be closed by a range of different materials including stitches (aslo known as sutures), metal clips, staples, adhesive dressing (glue), steri-strips or tapes. Most types of stitches and clips or staples have to be removed by a nurse or doctor, but some stitches don t need to be removed because they dissolve. Stitches, clips and staples are usually removed between 5 and 21 days after treatment, depending on the type of operation you have had. Changing the dressing The original post-operative dressing can be left in place for up to 48 hours after your operation (or as advised by the nurse/doctor), provided it is not oozing. If the dressing becomes very wet from blood or any other liquid, it must be changed. Your nurse, midwife or doctor will take special care when changing or removing your wound dressing to prevent infection. If your wound has been left open to heal and does not have stitches or 2
clips, your health care team will use dressings that help it to heal and protect it from microorganisms that can cause infection. Your nurse, midwife or doctor will give you advice. You may shower safely 48 hours after surgery if appropriate. During your stay in hospital, the nurse or midwife who changes your wound dressings will check for any signs of infection. If you are concerned about your wound, tell the nurse or midwife who is looking after you. Do not be tempted to remove your dressing or touch your wound. You could accidentally transfer germs from your fingers to your wound. Dressings Once the initial post-operative dressing is removed and the suture line is clean, dry and healing well you may not require further dressings. The purpose of a dressing is to: absorb any leakage from the wound provide ideal conditions for healing protect the area until the wound is healed prevent stitches or clips catching on clothing. 3
What are surgical wound infections? Most surgical wounds heal up rapidly without complications. However a minority of surgical wounds are complicated by infection. This occurs when germs (micro-organisms such as bacteria) enter the incision (cut) that the surgeon makes through your skin in order to carry out the operation. Many germs live in and on our bodies and also in our environment. Most are harmless or even useful. Our bodies have natural defences against the germs that can cause harm. Our skin normally prevents germs from entering our bodies, but any break in the skin (whether due to injury or surgical incision) can allow them to enter and cause an infection. When do these infections develop? A surgical wound infection can develop at any time from 2 to 3 days after surgery until the wound has healed. Very occasionally, an infection can occur several months after an operation. Many surgical site infections are not very serious affecting only the skin however, some can occasionally spread to deeper tissues. Infections are more likely to occur after surgery on parts of the body that harbour lots of germs, such as the gut. 4
Some people are more likely to develop wound infections than others and the doctor, nurse or midwife will discuss this with you. Those at higher risk include people who: smoke have diabetes have a condition or treatment that affects their immune system, such as leukaemia or chemotherapy have a major operation, such as bowel surgery, where diet is not giving enough nutrients for wound healing. For certain types of operation, where there is a higher risk of infection, you may be given antibiotics before surgery to help prevent infection. For many operations a single dose of antibiotics will be enough; you may need extra antibiotics if your surgeon finds any infection. Your nurse, midwife or doctor will do everything that they can to prevent your wound from becoming infected while you are in hospital, but it is important that you know how to tell if you are developing an infection after you go home. 5
Signs to look for you feel generally unwell/or feverish, or you may have a temperature your wound suddenly becomes more painful the skin around your wound becomes red or it feels hot and swollen your wound has a green or yellow discharge (Pus) your wound develops an unpleasant smell. If you develop a high temperature, notice any of the signs mentioned above, or have any concerns about your wound contact your District Nurse or Practice Nurse (if you are under their care ) alternatively contact your General Practitioner or attend your local walk in centre for advice. Wound infections can be treated successfully if we catch them early. What happens if I develop symptoms? If the nurse, midwife or doctor suspects that you have a surgical wound infection, they may take a sample from the surface of your wound with a swab and send it to the laboratory for tests. Your nurse, midwife or doctor may prescribe treatment with antibiotics. The wound may be dressed with special antimicrobial dressings to help to reduce the bacteria on the wound. 6
References National Institute for Health and Clinical excellence (NICE) guidelines 2008 Clinical guidelines on surgical site infection Public Health England 2014: surgical site infection surveillance service, surgical site infection guidance data & analysis. 7
If English is not your frst language and you need help, please contact the Ethnic Health Team on 0161 627 8770 Jeżeli angielski nie jest twoim pierwszym językiem i potrzebujesz pomocy proszę skontaktować się z załogą Ethnic Health pod numerem telefonu 0161 627 8770 For general enquiries please contact the Patient Advice and Liaison Service (PALS) on 0161 604 5897 For enquiries regarding clinic appointments, clinical care and treatment please contact 0161 624 0420 and the Switchboard Operator will put you through to the correct department / service Date of publication: September 2016 Date of review: September 2019 Ref: PI (SU) 985 The Pennine Acute Hospitals NHS Trust Wood pulp sourced from sustainable forests www.pat.nhs.uk