Post-Operation Granulation Wound Care

Post-Operation Granulation Wound Care

MATERIALS:

Hydrogen peroxide, cotton applicators, or Q-tips, ½ inch or 1-inch paper tape, scissors, non-stick dressing pads (example: telfa), and Vaseline.

WOUND CARE:

The pressure dressing we apply after surgery should remain in place for 24 hours.  If the dressing comes loose before then, re-tape it.  Do not wet the pressure dressing for 24 hours.  After that you may shower but do not let the forceful stream of the shower hit the wound directly.  Wound care should be performed two times each day.

  1. Remove the initial pressure dressing after 24 hours.
  2. Take dry applicators and wipe out any remaining Vaseline.
  3. Take dry applicators dipped in ½ strength peroxide (equal amounts of tap water and peroxide) and thoroughly cleanse in and around the wound.
  4. Dry the wound with a clean applicator.
  5. With a clean applicator, spread a thin layer (approximately 1/8 inch) of Vaseline inside the wound.
  6. Cut the telfa pad to cover the wound.  Also, for approximately one week longer if the wound continues to drain or seep, cut a gauze pad to size and place over the telfa pad.  This is all held in place by paper tape.  If the telfa pad sticks to the wound at the time of the next dressing change, soak the dried telfa pad with diluted peroxide for 15 minutes, then remove.  Use more Vaseline to prevent future sticking.

If you notice increasing pain, swelling, redness, heat or pus-like drainage from the site, these are signs of infection.  Please call our office immediately.

BLEEDING:  

Careful attention has been given to your wound to prevent bleeding.  The dressing you have on is a pressure dressing and will also help prevent bleeding.

You may notice a small amount of blood on the edges of the dressing the first day and this is normal.  If the bleeding seems persistent and soils the dressing, apply firm, steady pressure over the dressing with gauze for 20 minutes.  If bleeding continues, repeat pressure for an additional  20 minutes.  If bleeding persists, call the doctor or go to the nearest Emergency Room while continuing to hold pressure on the wound.

PAIN:  

Post-operative pain is usually minimal.  Plain Tylenol, Extra Strength Tylenol, or Advil usually relieves any pain you may have (please take these according to package directions or as directed by your primary care physician).  To minimize pain, swelling, and bruising apply an ice pack (or bag of frozen vegetables) over the dressing, you may do this for 15-20 minutes every hour as needed for symptoms.

DO NOT TAKE  MEDICATIONS CONTAINING ASPIRIN OR DRINK ANY ALCOHOL 3 DAYS AFTER SURGERY (unless otherwise instructed).  Continue to take all other prescribed medication.

APPEARANCE:  

The wound edge usually becomes bright pink to purple as it heals and may feel firm and swollen.  Centrally, the wound may be covered by an “exudates” which is yellow, white or gray material stuck to the base.  This yellowish film is not pus and is not a sign of infection.  Try to gently clean off this film with a Q-tip dipped in dilute peroxide with each dressing change.  If it does not come off easily, it is okay to leave it.  Below the exudates, you may notice healthy, pink tissue growing over the wound.  This is granulation tissue and is necessary for healing.  New pink skin will grow from the edge to the center of the wound, over this granulation tissue.  The whole process may take 3-5 weeks depending on the size and depth of the wound.

The area may remain numb for several weeks or even months.  You may also experience periodic sharp pains near the wound as it heals.  If you notice increasing pain, swelling, redness, heat or pus-like drainage from the site, these are signs of infection.  Please call our office immediately.

NOTES:  

  1. Never place a used applicator back into the hydrogen peroxide.
  2. Make sure your hands are cleaned with soap and water and your scissors are cleaned with alcohol before each dressing change.
  3. Change the dressing twice daily for 2 weeks and then once daily until the wound is completely healed.
  4. If the wound is near the eye, saline eyewash (example – Dacriose solution) may be used on an applicator to clean the corner of the eye and eyelids.
  5. Do not wet the pressure dressing for 24 hours.  After that, you may shower as usual.  The dressing will most likely get wet but will act as protection during your shower.  Do not let the forceful stream of the shower directly hit the wound.  Apply a new clean dressing immediately after each shower.
  6. You may have a low-grade fever (99-100F) for which Tylenol may be used.
  7. You may have some clear drainage from the wound.  This will stop after a few days.  If not, please call the office.
  8. It is a myth that wounds heal better with a scab or left open to the air.  If a scab begins to form, soak the wound with diluted hydrogen peroxide and gauze for 15 minutes and gently rub it away with a Q-tip.

IF THERE ARE ANY QUESTIONS, PLEASE CALL OUR OFFICE AT (828) 274-4880 MONDAY THROUGH FRIDAY (8 AM – 5 PM).

ON WEEKENDS OR EVENING HOURS, CALL (828) 259-5008.