Linear Closure Wound Care
MATERIALS:
Hydrogen peroxide, cotton applicators or Q-tips, ½ inch or 1-inch paper tape, nonstick dressing pads (example–telfa), and Vaseline.
WOUND CARE:
The pressure dressing we apply after surgery should remain in place for 24 hours. If the dressing comes loose before then, re-tape it carefully. After 24 hours, remove the pressure dressing but leave the white tape directly over the sutures. As long as the tape remains in place, no wound care or dressing is necessary. If there is no tape directly over the sutures, please follow wound care instructions as directed below.
Do not wet the pressure dressing for 24 hours. After that, you may shower but do not let the forceful stream of the shower hit the wound directly. If the tape comes off, perform wound care for one week, as directed below.
If the tape comes off, perform wound care as follows. The suture line should be cleansed twice daily with diluted hydrogen peroxide (mix half and half with tap water). Let the moisture bubble away loose crusts and drainage. You may gently loosen these crusts with a Q-tip and pat dry. For stubborn crusting, place gauze wet with peroxide over the wound for 15 minutes to soak and loosen the debris. The first day the wound may be tender and may bleed slightly or seep a small amount of clear fluid. After cleansing the wound, apply a thin layer of Vaseline over the stitches. You may leave the wound uncovered if you will be home and the wound will stay clean. Be sure to keep the wound edges moist by applying Vaseline several times a day. Otherwise, cover the wound with a nonstick dressing cut to the necessary size. Tape the dressing in place with paper tape.
BLEEDING:
Careful attention has been given to your wound to prevent bleeding. The initial dressing you have on is a pressure dressing to also help prevent bleeding.
You may notice a small amount of blood on the edges of the dressing the first day which is normal. If bleeding is persistent and soils the dressing, apply firm, steady pressure over the dressing with gauze for 20 minutes. If the bleeding continues, hold pressure for an additional 20 minutes. If bleeding persists, call the doctor or go to the nearest Emergency Room while continuing to hold pressure on the wound. Marked swelling at the surgical site may indicate blood accumulation and the doctor should be notified.
PAIN:
Post-operative pain is usually minimal. Plain Tylenol, Extra Strength Tylenol, or Advil, usually relieves any pain you may have. Please take these according to package directions or as directed by your primary care physician. If needed, apply an ice pack (or frozen bag of vegetables) over the dressing to help minimize swelling and pain, you may do this for 15-20 minutes every hour as needed for symptoms.
APPEARANCE:
There may be swelling and bruising around the wound, especially if near the eyes. The suture line may appear bright pink to purple and the edges of the wound may be reddened. This will lighten day by day. Slight tenderness to touch is normal. If the wound develops increasing pain, redness, heat, swelling or pus-like drainage, call the office. Those are signs of infection.
As your surgical site heals, you may have occasional sharp brief pains. Itching is common but if it is severe and associated with a rash, please call. Numbness may be present but slowly fades away over several months.
DO NOT TAKE ANY MEDICATION CONTAINING ASPIRIN OR DRINK ALCOHOL 3 DAYS AFTER SURGERY (unless otherwise instructed). Continue to take all other prescribed medication.
CARE AFTER SUTURE REMOVAL:
There will be white paper tape strips placed over the incision after the sutures have been removed. These should stay in place for about 1 week. The edges of the strips often curl up after a few days and if you would like, you can snip them. The tape can be gently removed after one week. You can gently pull on the edge of the tape and it should lift easily off the incision. If it does not lift off easily, apply a warm compress over the area for approximately 15 minutes, and then remove the tape. While the tape remains in place, no wound care or dressing is necessary. Once the tape comes off or is removed, you should see that your incision site is healing well. You can expect there to be slightly pink discoloration and swelling of the incision line. The color of the incision line should slowly fade over the next few weeks. This is all a normal part of the healing process. Approximately 3 weeks after surgery, or when the incision line is no longer tender, you should apply sunscreen daily. The suture lines will be more sensitive to the sun than the surrounding skin and therefore sunscreen should always be worn. Scar massage may be discussed with you either at the time of surgery or at the time of suture removal. Scar massage can be started 6 weeks after surgery and would be continued for 12 weeks (weeks 6-18 following surgery). Scar massage is performed by applying firm pressure using your fingertip, moving in a circular motion up and down the incision line for 5-10 minutes continually per day.
NOTES:
- Never place a used applicator back into the hydrogen peroxide.
- If the wound site is near the eye, saline eyewash (example-Dacriose) may be used on an applicator to clean the corner of the eye and eyelids.
- Make sure you clean your scissors with alcohol before each dressing change.
- You may have a low-grade fever (99-100 F) for which Tylenol may be used.
- You may have some clear drainage from the wound. This will stop after a few days. If not, please call the office.
- It is a MYTH that wounds heal better with a scab. If a scab begins to form soak the wound with hydrogen peroxide and gauze for 15 minutes and gently rub it away with a Q-tip.
IF THERE ARE ANY QUESTIONS, PLEASE CALL OUR OFFICE AT (828) 274-4880 MONDAY-FRIDAY (8 AM TO 5 PM).
ON WEEKENDS OR EVENINGS, PLEASE CALL (828)259-5008.
