Caring for your surgical wound

This leaflet tells you about caring for your surgical wound after you leave hospital. Below are measures you can take to help lower the chances of your wound getting infected and to promote healing.

Changing the dressing

The original dressing should be left in place for at least two days (48 hours) (or as advised by the nurse/doctor), provided that the wound is not oozing. The wound must be kept dry within 48 hours. If the dressing becomes wet from blood or any other liquid within 48 hours it must be changed. Before you remove and change the dressing you should:

• Wash your hands with soap and water.
• Carefully take the dirty dressing off.
• Not touch the healing wound with your fingers.

If the wound is healing it can be left without a dressing. Some people however prefer to have a dressing to cover the wound for protection, especially when clothing can rub against it. Make sure to remove the dressing when the wound is dry, or as when advised..

We may give you a supply of replacement dressings to use at home. When applying, take care not to touch the inside of the dressing so that it remains clean. There is no need for antiseptic cream under the dressing.

Taking care of stitches / clips / staples

The time dissolving (absorbable) stitches disappear can vary. Most types usually dissolved or fall out within 7-10 days, although it may be a few weeks before they disappear completely. When the dressing is removed, if possible we advise a shower to help wet and aid dissolve the sutures.

Others such as clips or non-dissolvable sutures need to be removed between 5-14 days depending on the site of the operation. The doctor/nurse will tell you on the day of discharge when to have the stitches removed and you will be given a letter for your practice nurse about removing the stitches/staples.

You may see nylon threads (the ends of the stitches) poking out of the healing scar. Please do not pull on these. If the loose ends are catching on clothes, carefully trim the stitch with a clean pair of scissors.

If you are worried about the stitches/ clips or staples, always seek advice from your GP. Otherwise, wait for the stitches to be removed or for them to fall off or dissolve.

Showering and hair washing

You are normally advised to wait 48 hours before showering and/or hair washing, but this depends on the operation you have had, some wound will take longer to heal. The nurse will give you advice on this, but below are some general points about your wound:

• Showering is preferable to bathing. This will also aid dissolve the absorbable sutures.
• Some waterproof dressings can be left in place whilst you take a shower. Other dressings may need to be removed before having a shower.
• Do not put any soap, shower gel, body lotion, talcum powder or other bathing products directly onto the healing wound to prevent your wound from infection.
• Do not worry if you splash the wound with water but do not rub the wound area as this will cause pain and might delay the healing process.
• Pat the wound gently with a clean towel after showering.

Problems with wound healing

Doctors and nurses will do everything that they can to prevent your wound from becoming infected whilst you are in hospital, but it is important that you know how to tell if you are developing an infection after you go home and other unusual signs:

If a wound becomes infected it may:

• Become more painful.
• Look red or swollen.
• Start to open, weep or leak some blood-like fluid, pus or blood.
• Have an unpleasant smell.

Other wound issues we wanted you to be aware of are the following:

• Fluid collection (small bulge over the wound between muscle and nerve)

This can result in recurrence of pre-operative symptoms. This can be expected in some wounds especially in the spinal operation. This will resolve over a few weeks to months as fluid is re-absorbed. However, if you are concern, contact your CNS to give you some advice.

• Cerebrospinal fluid ( CSF): Clear watery fluid from the brain or spine

If there is a small leak from the wound, contact the CNS at the first instance.

If a clear, watery fluid is noted leaking from the wound (including nose) and you develop a headache and or temperature, please attend to A&E urgently.

Contacts / further information

If you develop a high temperature, notice any of the signs mentioned above, or have any concerns about your wound, then contact the named nurse on the number written on your discharge letter or alternatively have your GP refer you back to us for advice.

Ward number: 01223__________________________

Specialist Clinical Nurse (CNS) telephone number: ______________________

CNS Shared Email: e-mail cuh.neurosurgicalspecialists@nhs.net

Neurosurgery 908 Bleep Mobile: 07707293045 (Only for out of hours)