Surgical wound healing.
After surgery your skin and tissue will take time to heal. This will happen in three overlapping stages that we call respond, repair and refine.
During the response stage, the body helps to re-balance itself after the surgery as platelets help form a blood clot, stopping any bleeding and protecting the surgical site or wound from germs and infections.
With the help of stitches, also known as sutures, or other materials such as glue or staples, your skin is being pulled back together after the surgery and because of this your wound is closed.
Healing is taking place underneath the wound and also on the outside of the skin.
In the first few days after your surgery, you may notice redness and heat around the wound. This means the blood vessels are getting bigger to make room for red blood cells and fluids, which bring oxygen, warmth and protective cells to help your body heal itself.
White blood cells help clean up the area by removing any fluid, dead tissue and bacteria that isn't needed in the healing process.
Sometimes a drain, which is a thin plastic tube placed near the wound, is used for a couple of days to help remove fluid from the wound and keep it clean.
The area where the cut was made may also be swollen and painful because of this increased activity and blood flow.
The heat, redness, pain and swelling are known as inflammation. Inflammation is normal and usually goes away a few days after surgery.
In the repair stage, the body gets to work on the outside of the wound covering it with new cells within 24 hours of the surgery.
Your wound would be covered with a dressing or bandage to protect these new cells and give them time to grow and form new skin and tissue.
Healing will still be taking place underneath the wound for roughly three to seven days.
The refine stage happens in the year following your surgery and this time the structure and strength of the wound improves, and will continue to improve, for months after the wound is closed.
From day one, up to around day 14, the skin and scar tissue gain 30 to 50% of its original strength. When fully healed it will be around 80% of its original strength.
Surgical wounds generally heal quickly when they are well cared for and protected from infection.
Materials to close the wound.
Without addressing covering the wound, you may notice some material along the wound margins which are used to support the incision while it heals.
Your surgeon uses stitches to close the deeper layers of your wound, these do not need to be removed and will dissolve over time.
Depending on which product will help your skin heal best, your surgeon also selects either sutures, staples, glue or tapes to cover the top of the wound.
Sutures and stitches are either dissolvable or non-dissolvable.
Wounds closed with dissolvable sutures do not need anything removed from the incision line. These may be one or two clear plastic like sutures visible usually at the very end or mid incision but these do not need to be trimmed or removed. Please leave them to dissolve naturally over time.
If your skin is closed with non-dissolvable sutures, the dark threats are usually removed by a healthcare professional, usually around 10 to 14 days after surgery.
Surgical clips, which look like staples, sit on top of your skin and are not difficult to remove. These thin, small metal bars are removed by a healthcare professional approximately two weeks after surgery.
If glue or adhesive is used to close your skin, the film will fall naturally from your skin after five to 10 days. Please do not pick or rub the film off and do not let your wound soak in water.
After 10 days, it is a good idea to start rinsing the area gently to help remove the glue residue. Sometimes steri-strips, which are white or brown tapes, are used to bring the skin around the wound together. Avoid getting the tapes wet as this reduces their ability to stick and hold the skin together. When the tape starts to curl or peel away after five to seven days, you may wet and gently remove them.
Have a daily wash with liquid soap, but to help your wound heal, do not rub or actively wash the area for the first weeks, just rinse gently with warm water and pat dry first before the rest of your body.
Avoid any creams, talcs or ointments on the wound for the first months and don't worry if the different products seem confusing. Your doctors and nurses will help and advise you during your hospital stay as well as on any follow-up care.