Monday Myths: Getting an Incision Wet
August 9th, 2010
Monday Myths: Getting a surgical wound wet is bad
Washing an incision after surgery is not bad. It is important that only clean running water (showers only) and soap are used. Baths must be avoided, as sitting in the water can contaminate it and lead to bacterial contamination. The same is true for washing dishes when there is an incision on the hand, as there can be considerable oral bacteria contamination on eating utensils.
I believe that gently washing incisions in the shower within 24 hours after surgery does two things. First, it reduces the normal bacterial growth on the skin around the incision. Secondly, the normal debris and blood that can contaminate the surrounding skin following surgery are very easily washed away in the shower, significantly eliminating risk of infection. Bacteria love to live in this stuff, especially the bacteria which most commonly cause infections (Staph and Strep). Once the incision is washed, it is important to allow the wound to air-dry completely. Bacteria hate dry environments. Keeping the incision dry is also very important, so avoid getting perspiration onto the incision. This is particularly true when the incision is in the groin or armpit area.
I find that after my patients have a shower, it actually makes them better, too. It is a great first step in getting back into your daily routine. It is important to follow the after-care instructions regarding activity, but the sooner you resume your normal life, the sooner you will recover and interestingly, patients report that they have less pain.
MORE MONDAY MYTHS: Stitches ALWAYS Need to be Removed
August 2nd, 2010
Is it true that all stitches need to be removed?
For years, skin sutures (stitches) or skin staple closures needed to be removed after cosmetic surgery. Some surgeons still use removable skin sutures or skin staples to shorten the duration of surgery by quickly closing incisions using these older techniques. With the advent of modern absorbable stitches and surgical skin glue, which are FDA approved, the combination makes removing stitches a thing of the past in my office.
Absorbable stitches are simply absorbed by the tissue. Surgical glue is similar to “Superglue” and is now being used to close small skin cuts, lacerations (tears in skin) and surgical incisions.
How does surgical glue work? It is applied by an applicator to the skin. Once it comes into contact with the skin, the glue hardens rapidly and holds the edges of skin together so the skin can heal.
I prefer to use surgical glue and absorbable stitches for several reasons. I have found that patients really dread the removal of any skin closure device. It is just stressful to remain still while someone picks at a tender incision to remove sutures or staples. I also believe that surgical glue most often provides the least visible scare after healing. And finally, skin glue seals the incision. The adhesive material in specialty surgical glue forms a strong microbial shield to protect wounds while they heal. Some believe this actually reduces the risk of infection and yields a better overall scar, as well. The surgical glue also does away with the need for most of the bulky dressings of the past, making recovery easier for the patient to manage. The glue just washes off in the shower within about two weeks.
Surprisingly, many of my patients are unaware of these new methods and I’ve never had anybody come to the office and ask about glue having replaced stitches. However, certainly no one has missed out on the stress of having stitches or staples taken out.
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