Overview of management of surgical wounds

Management of the wound is an important component of postoperative patient care. Key elements of postoperative wound management include:

• regular wound review (depending on patient risk factors and surgical risk factors)
• appropriate cleansing (see Practice points for preventing surgical site infection)
• appropriate dressing selection (see Dressings for surgical wounds)
• early recognition and intervention for wound complications.

For 72 hours after surgery, erythema (up to 2 cm from the wound edge) and mild swelling represent a normal inflammatory response. Surgical wounds are expected to have minimal exudate. Warning signs of surgical site complications include erythema that persists for longer than 72 hours, heat, pain, swelling, separation of wound edges and an unexpected amount of exudate.

Debridement of nonviable tissue and delayed primary closure are indicated for surgical wounds with minor dehiscence.

Removal of sutures or clips at an appropriate time reduces the risk of infection, scarring and pain. As a general guide, sutures or clips can be removed after 10 days. Removal can be earlier (eg after 5 days) for wounds in well-vascularised areas (such as the face or neck), or later (eg 14 days) for areas with poor vascularisation or over a joint.

For wounds that do not heal as expected, consider the factors affecting wound healing.