Surgical Wounds

If you have been operated on, the wound needs to be closed. The wound edges are placed next to each other and sewn together with thread or stapled together with small metal clips. Since you have already had anesthesia or been anesthetized before the surgery itself, no further anesthesia is needed. Before you leave the hospital or health center, you will know how to manage the operating wound.

The  skin has  small fine lines. The doctor always tries to make the operation cut in the same direction as the lines, because then the scar usually appears less.

Preparations

When the surgery itself is complete, the operating nurse or assistant will wash the skin around the wound with moisturized compresses. Since you have already been anesthetized or anesthetized before the surgery itself, no additional anesthetic is needed for the wound to close. Sometimes the doctor still injectes anesthetic into the wound edges to reduce the pain in the first hours after surgery.

The operating wound is closed in a sterile environment and if the operation is performed in an operating room, the staff is sterile-clad. No matter where the operation is performed, the person who seals the wound or always assists with sterile gloves and uses sterile instruments and materials.

Then the treatment goes on

If the operating wound is deep, for example if you have an operation in the abdomen, the doctor first sews the tissues under the skin. Then, thread that dissolves by itself is used after a while. In the skin, either such thread can be used or another type of thread which must then be removed. Threads that disappear by themselves are mainly used if the doctor sews inside the skin itself and the thread is not visible on the top. Namely, the thread can only be dissolved if it is in direct contact with the body’s fluids and cells.

Sometimes the doctor only sews into the outermost layer of the skin, sometimes even deeper into the subcutaneous fat. The stitch itself, which is also called suture, can thus be made slightly different depending on how deep the wound is and where it sits.

Once the wound has been sewn together, it is covered with a special wound tape and then with a dressing.

Instead of stitches, some kind of stainless steel or titanium staples are sometimes used, so-called agraphs. These are especially used for long wounds because it is faster to stitch the wound together with a machine than to sew by hand. The staples must always be removed when the wound has healed.

Drainage

In some cases, the doctor leaves a small opening in the operating wound where blood and fluid can drain out, instead of remaining in the body. It’s called drainage.

The doctor inserts a drainage consisting of a small tube of plastic or silicone. The drainage is usually pulled out through the skin a little distance from the wound itself where it is attached with a stitch. The fluids can then be discharged through the hose. The drainage is usually allowed to remain for a few days or so and is then withdrawn.

Some wounds are left open

Some surgical wounds may be left open to reduce the risk of infections. Nearest to the wound are compresses with ointment or moist compresses and on top of these dry compresses that can absorb the liquid that comes from the wound. The wound can then heal itself. The healing takes longer than wounds that are sewn and the scar does not get as nice.

After the treatment

Keep the dressing clean and dry

Before leaving the hospital, you will know how the wound is to be handled, if and when you can shower. You also know if and when the stitches are to be removed and where you should remove them. You also get to know how much you can move with the wound in mind.

It is important to keep the dressing clean and dry. If you want to shower the part of the body where the dressing is located, you may need to plastic it. Special plastic bags with adhesive edge that you can use if you have an operating wound on, for example, the arm or leg are available at pharmacies. You can also use regular freezer bags and freezing tape.

Nowadays there are also dressings that allow you to shower without having to plastic in. You get information about this before you go home.

Restructuring of the wound

Sometimes the entire dressing should remain, sometimes it must be changed. If you need help repairing the wound, you can go to the health center or get a home visit from a district nurse. Often, you get to remove the outer bandage after a while and just keep the wound tape until the stitches are removed. If it looks red and messy when you remove the outer bandage, it may be an indication of an infection. If so, contact the hospital where you were operated or the health center, or a district nurse.

Avoid stress on the wound

How much you get to move depends on both the operation itself and the location of the operating wound. Movements or activities that expose the wound to greater stress, that is to say, which causes the skin to stretch over the wound, should be avoided as there is otherwise a risk of the wound breaking up. You may want to take walks, but first you should consult your doctor considering the surgery you have undergone.

The stitches are removed when the wound has healed

If you have been stitched to be removed, it may vary slightly when it is due. The stitches should be removed when the wound has healed, but where the operating wound is located also determines how long the stitches will remain. On the face, stitches are usually removed on children after four, five days, while adults are allowed to wait around a week. On the body, the stitches may remain for one to two weeks. If the wound sits in an exposed place, such as on the knee, it is better that the stitches remain on an extra day rather than being removed prematurely.

It doesn’t hurt to remove the stitches, but some people feel a little uncomfortable. When the stitches are removed, it is good to cover the wound with wound tape. Plastic surgeons usually recommend that you continue with it for several weeks, or longer, for the scar to look as good as possible. You should also protect the scar from the sun for the first half of the year.

Most scars appear less with time

Initially, scarring is red and can be seen quite clearly, but over time they fade and disappear more and more. Scars on the upper part of the chest often become slightly raised even when healed. Some people find it easier to get scars that appear wherever they are on the body.

Complications

If you experience an infection in the operating wound, healing will be delayed and impaired. The infection is due to the fact that bacteria have entered the wound. The wound becomes red, swollen and sore more than before. The skin around the wound can also feel warm. The wound may be bad and smell bad. You may also have a fever. There may also be an encapsulated joint formation during the wound, a so-called bulge. Such a collection of goods must be emptied by opening the wound again.

It is quite common for larger surgical wounds with a limited wound infection that one or a few stitches or attacks are removed. Rarely does the whole wound need to open up. Scars after infected wounds often appear a little more than other scars.

A wound can crack before it has been able to heal properly, it will be a so-called wound rupture. This may be because the stitches have been removed prematurely, that you have overloaded the wound or that the wound has become infected.

If opening the wound does not help with the wound infection it can be treated with antibiotics, but it is a remedy in the end.

You can also get a small sore knot where a stitch has been sitting, a so-called suture granuloma. The sore knot is usually felt a few weeks or months after surgery and is due to the body reacting to a small piece of the thread that has been left behind. When removed, the trouble disappears after a while.

If the wound has become infected

If you think a wound has been infected, you should first call the medical advice on phone 911 or contact a health care center. Sometimes it is sufficient to clean the wound properly, but you may also need antibiotics. It may also be that the wound must be opened again to be emptied of each.

Reduced feeling

Sometimes you may get a reduced feeling on the scar. This is because small superficial nerve fibers are cut off during surgery, which is difficult to avoid. The feeling usually comes back within a year when the nerve threads heal again.

Good to quit smoking

If you smoke, the winnings are many to  stop before an operation . The wounds heal faster, blood circulation and fitness improve so you recover faster. The best thing is to stop smoking altogether, but if it does not succeed then it is good if you can refrain from smoking before the operation and even the first weeks afterwards. If you need help to quit smoking, your doctor can tell you what support is available.

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