Dressings for surgical wounds

Cover wounds healing by primary intention for the first 48 hours. These wounds normally seal and dry out within this period. Use a low-adherent or semipermeable island dressing (a dressing with an absorbent pad covered by a conformable adhesive layer) for uncomplicated surgical wounds. Most postoperative wounds heal within 7 to 14 days. Healing should coincide with the removal of clips, staples or fixation devices.

For wounds healing by secondary intention, selection of appropriate local therapy is based on assessment of the wound and its environment. Appropriate dressing is based on the anticipated amount of discharge (ie blood or haemoserous exudate) from the surgical site. A low-adherent island dressing is typically used. Patients with altered coagulation profiles (eg patients taking an anticoagulant) can have significant bleeding at the surgical site, so require a more absorbent dressing and compression.

Waterproof dressings are preferred; most currently available waterproof dressings still have adequate permeability to minimise risk of maceration. For advice on choosing a dressing based on amount of exudate, see Ulcer and wound dressings.

At the time of publication, there is insufficient evidence to suggest one type of dressing is superior to any other for preventing surgical site infections, scarring or pain.

Do not use the following interventions on surgical wounds:

• topical antimicrobial preparations on surgical wounds that are healing by primary intention
• Edinburgh University Solution of Lime (EUSOL) antiseptic solution and gauze, or moist cotton gauze or mercuric antiseptic solutions on surgical wounds that are healing by secondary intention.