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Surgery - Incision Symptoms

Is this your symptom?

Concerns about a surgical wound or incision site.
A common concern is wound infection. Symptoms of infection include spreading redness or red streaks, pus, and increasing pain or swelling.

Key Points

Most surgical wounds heal without any problems.
Mild swelling and pain at the incision site are normal.
It is important to keep the site clean and protected as it heals.
Watch the site for signs of infection such as spreading redness or red streaks, pus, and increased pain or swelling.

Problems - Surgical Wound or Incision

Wound infection is the most common problem that can occur with surgical wounds. Symptoms of wound infection include:

Fever
Lymph node near wound becomes large and tender
Pain or swelling that gets worse 48 hours after surgery
Pus or bad-smelling fluid drains from wound
Spreading redness occurs around the wound (cellulitis)
Red streak is spreading from the wound toward the heart (lymphangitis)

Wound infection occurs more often with abdomen (belly) and emergency surgeries. Other risk factors for surgical wound infections include:

Diabetes
Older age
Overweight
Smoking
Weak immune system

Less common surgical wound problems include:

Bleeding
Surgical wound hematoma (collection of blood in tissues)
Surgical wound starts to open up

Causes

Bacteria on the skin cause most wound infections.
Your skin is a natural barrier that keeps out germs (bacteria).
Surgery causes a break in the skin barrier. This allows bacteria to enter and cause infection.

Prevention

Follow your post-op instructions for wound care and activity restrictions.
Keep your wound clean.
Protect the incision from injury during the first month.
Avoid vigorous exercise or strenuous work for the first month (or longer for some surgeries).
Do not smoke for the first month after surgery. Smoking slows wound healing.

When Should Stitches (Staples) Be Removed?

Your surgeon should tell you when your stitches (or staples) need to be removed. These are general guidelines for when they should be taken out:

Face: 4 to 5 days
Neck: 7 days
Scalp: 7 to 10 days
Back, chest, and abdomen: 7 to 10 days
Arms and back of hands: 7 days
Legs and top of feet: 10 days
Fingers and toes: 10 to 14 days
Palms and soles of feet: 12 to 14 days
Overlying a joint: 12 to 14 days

When to Call for Surgery - Incision Symptoms

When to Call for Surgery - Incision Symptoms
Call 911 Now Stomach or abdomen incision has burst open Severe bleeding from surgical wound You think you have a life-threatening emergency Call Doctor or Seek Care Now Incision looks infected (increasing pain, swelling, redness, pus or smelly discharge) Fever or chills; feeling hot or shivery Incision starts to bleed You feel weak or very sick You think you need to be seen, and the problem is urgent	Contact Doctor Within 24 Hours Suture came out early, but wound is still closed Suture removal is overdue Pain from incision is getting worse after 48 hours Blood-tinged or watery fluid draining from incision You think you need to be seen, but the problem is not urgent Contact Doctor During Office Hours You have other questions or concerns	Self Care at Home Stitched or stapled wound with no other problems

Call 911 Now

Stomach or abdomen incision has burst open
Severe bleeding from surgical wound
You think you have a life-threatening emergency

Call Doctor or Seek Care Now

Incision looks infected (increasing pain, swelling, redness, pus or smelly discharge)
Fever or chills; feeling hot or shivery
Incision starts to bleed
You feel weak or very sick
You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

Suture came out early, but wound is still closed
Suture removal is overdue
Pain from incision is getting worse after 48 hours
Blood-tinged or watery fluid draining from incision
You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

You have other questions or concerns

Self Care at Home

Stitched or stapled wound with no other problems

Care Advice

General Care Advice for Incisions

Follow Your Surgeon's Instructions:

Closely follow all the instructions your surgeon gave you.
If the care advice below is different, follow your surgeon's instructions instead.

Keep Incision Clean and Dry:

Keep the incision dry for first 24 hours after surgery (use a sponge bath).
Your surgeon will tell you when you can remove your dressing. When the dressing is removed, you can shower. Avoid water pressure directly on the incision. Pat the incision area dry with a clean towel.
Apply a small amount of petroleum jelly (Vaseline) on the wound daily. You can buy this at the store. This helps protect the wound and limits scarring. Exception: if your doctor recommended an antibiotic ointment, use that instead.
Do not bathe or swim for 2 weeks (or whenever the surgeon says it is ok).

Changing a Dressing:

Change the wound dressing if it gets wet or dirty.
Follow the dressing directions your surgeon gave you.
A dressing that works well is a Telfa dressing covered by gauze. Telfa is a dressing that does not stick to the skin. You can buy it at the drugstore. Place a piece of Telfa on the wound and cover it with a gauze pad.
Keep the dressing in place in the same way the surgeon did (such as tape or ace wrap).
In most cases, a dressing is no longer needed when the edges of the wound close (usually 48 hours). However, your surgeon may instruct you leave the dressing on longer. This can help protect the wound and catch any drainage.

Cold Pack for Pain:

Use cold pack for the first 24 to 48 hours after surgery.
Cold helps reduce pain and swelling.
Apply the cold pack (or an ice bag wrapped in a towel) to the incision area for 15 minutes.
Repeat this once an hour as needed.

Pain Medicine:

To help with the pain, take an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
Use as needed, but do not take more than the maximum recommended dosage as stated on the package.
If you are not sure what to take, ask a pharmacist.

Mild Itching:

As the incision heals, mild itching is common.
Do not scratch. This increases the risk of infection.

Do Not Smoke:

Do not smoke during the first month after surgery.
Smoking slows wound healing.

Protect the Wound:

Protect the wound from injury during the month after surgery.
Avoid any vigorous activity or heavy lifting for 4 weeks. Follow your surgeon's instructions for other activity restrictions.
At one week after surgery, the incision tissue strength is only 10% of normal. At one month after surgery, the strength is 50% of normal.

What to Expect:

Pain and swelling: incision pain and swelling are often worst on day 2 and 3 after surgery. The pain should slowly get better during the next 1 to 2 weeks.
Redness: mild redness along the incision is common. It should gradually get better and go away. Call your doctor if the red area spreads (gets larger) or red streaks occur. These could be signs of an infection.
Drainage: small amounts of clear drainage or a few drops of blood from the incision are common in the first few days. Call your doctor if the drainage increases, becomes cloudy (pus), or smells bad. These could be signs of an infection.
Itching: mild itching is common as the incision heals. It should go away when the wound is healed.

Call Back If:

Incision looks infected (increasing redness, tenderness, pus-like drainage)
Incision edges start to gape open
Fever occurs
You think you need to be seen
Your symptoms get worse

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

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