Suture or Staple Removal:
So you’ve had surgery and you’re being sent home to heal. Perhaps the staples and/or sutures that were used to close your incision were removed before you were discharged. With the current trend of sending patients home earlier rather than later, this is not every patient’s reality. If the staples or sutures have not been removed while you are still in the hospital, you will probably have an appointment with your surgeon for that purpose within the first week of being discharged. Although this process of removal should not be painful in and of itself, there are times when it can be uncomfortable, especially when the wound is still fresh and tender. It is suggested that you time your pain medication with the removal process. Take your medication about one hour before your appointment. Make sure you have someone drive you to the appointment as you don’t want to be driving while taking pain medication.
Surgical Wound Infections:
Expect your wound to be quite painful and red for 2-4 days post-op. This is normal. The area should return to its normal color within a few days of the surgery. Check it frequently to see if there are any signs & symptoms of infection, including: increasing redness, drainage of yellow pus or other foul-smelling drainage, bleeding from wound, swelling, increasing tenderness/pain, or fever. CALL YOUR SURGEON IMMEDIATELY if you experience any of these signs & symptoms. Apply antibiotic ointment to the wound and cover it with dry gauze ( sterile if possible) while you wait to see the surgeon.
Care of Your Incision:
You can also apply warm moist compresses over the incision while you wait to see the surgeon. This may reduce swelling and give you some comfort. Heat up a small towel or wash cloth in the microwave for 20-3- seconds. Be sure not to put the warm compress directly on the skin. Use a thin towel as a barrier between the compress and your skin. Leave on for 15-20 minutes. You can do this as often as needed if it brings you some relief of your signs & symptoms.
While your health care team strives to make your surgical experience as safe and sterile as possible, there are those times when a patient will get a post-op wound infection. This is not considered malpractice unless proof exists indicating that standard operating procedure wasn’t followed. It’s usually just bad luck. If you have a post-op wound infection while you are still in the hospital, your surgeon will probably have to re-open your incision to allow the wound to drain and you may be sent home with a drain and an open incision. Expect to be put on Intravenous (IV) antibiotics while you are in the hospital. Once you are discharged, continue to take the entire prescription even if you start seeing an improvement. If you are a patient in a large hospital, you and/or a significant other may be counseled by a Certified Wound Care Nurse on how to care for your wound at home. If you are in a hospital that has no such nurse, you will be taught that information by the Registered Nurse (RN) assigned to your care.
Post-Op Self Care:
As part of your patient education while you were in the hospital, you were most likely taught the importance of coughing and deep breathing every 2 hours after your surgery and you may be expected to do this at home for a week or so. Use a pillow to splint your chest or abdominal incision while doing this in order to reduce discomfort. If you’ve had such surgery, bring a pillow in the car with you for your trip home. You can use it as a splint against your incision to make the ride home less uncomfortable.
Rare Wound Opening:
There are rare occasions when abdominal wounds do open up spontaneously. This is called dehiscence. If you feel something ” funny… like something just gave way ” around your incision, lie down immediately. If you find that the wound has opened or that any of your abdominal organs are protruding ( evisceration), cover it with clean towels and keep it moist with water. Call 911 immediately. You will need to go back to the hospital to have the open incision cared for as soon as possible to prevent infection.
Anecdotes:
My niece, Elise, had a Caesarian Section and was discharged 3 days later. During a phone conversation with her on her 5th post-op day, she complained that the skin around her incision was very red and she was very uncomfortable. She denied any fever, drainage or swelling. I suggested that she call her doctor. She went in the next day and the doctor diagnosed a staph infection of the skin and put her on antibiotics. Being overwhelmed with both being a new mom and the trauma of major abdominal surgery, Elise needed help in finding her voice.