Gynaecology wound care: aftercare advice

With any surgery, there can be a risk of infection. However, most surgical wounds heal quickly without complications. This leaflet explains:

• how to care for your surgical wound at home

• what symptoms to look out for if you have a suspected infection, and

• what do if you have any concerns.

If after reading this leaflet you have any further questions, please contact one of the Gynaecology Assessment Units or your GP.

What are surgical wound infections?

Many germs live in and on our bodies and also in our environment. Most of these germs are harmless, and some are even useful. For example, the germs in our gut (intestines) help with digestion and help to protect us from other harmful germs.

Our bodies have natural defences against the germs that can cause harm. For example, our skin is normally a barrier preventing germs from entering our bodies. A surgical wound infection may happen when germs enter the incision (cut) that your surgeon makes through your skin during an operation.

What are the signs and symptoms of a wound infection?

You may have an infection if you develop one or more of the following symptoms.

• Swelling and redness (discolouration)

  Swelling is a normal stage of wound healing. However, it may be a sign that your wound is infected if as well as swelling, you also have:

  • redness and soreness around your wound site, and / or

  • your wound site is hot to touch.

• Abnormal oozing from your incision (cut) site

  Your wound may spot a bit of blood or clear fluid in the first two to three days after your operation, which is normal. If you have an infection, this discharge will be thick, and often green or yellow in colour, with a bad smell.

• Vaginal discharge

  Depending on the type of procedure you have had, it is normal to have a small amount of spotting of blood for a few weeks after your surgery. You may have an infection if the discharge is abnormal, for example, heavy, smelly, or itchy.

• Fever

  You may feel generally unwell or have a temperature.

What do I do if I think I have an infection or have any concerns about my wound?

You will need to call one of our Gynaecology Assessment Units (GAU) on:

• GAU, Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
  Telephone: 01843 235009 (Open 24 hours a day; 7 days a week)

• GAU, William Harvey Hospital (WHH), Ashford
  Telephone: 01233 633331 extension 723-4257 (Open Monday to Friday 8am to 6pm)

Please ring the GAU at the hospital where you received treatment. You will speak to one of the nurses, who will offer you the most appropriate advice.

The GAU is an assessment unit within the ward, led by a clinical nurse specialist. It is a service for all our gynaecology patients with concerns following their surgery. It operates by self-referral, on an appointment only basis. This means that you will have to call first to make an appointment with the GAU, do not just turn up.

For out of hours concerns, please ring either:

• Birchington Ward, QEQM, Margate
  Telephone: 01843 234201 (Open 24 hours a day; 7 days a week)

• Women’s Health Suite, WHH, Ashford
  Telephone: 01233 651987 (Open 24 hours a day; 7 days a week)

What happens if I have a wound infection?

If you have a suspected wound infection the nurse will take some wound or vaginal swabs. They will send these to Pathology for testing. The results normally take between three to seven days.

The nurse will also collect some blood tests to check your infection markers. Your results from these blood tests will be available later the same day.

In the meantime, you might be started on some antibiotics. Depending on how serious your infection is, these will either be given intravenously (IV) (through a cannula), or taken orally (in tablet form).

You will also have observations, including checking your blood pressure and temperature. A doctor would assess you and make a decision whether to:

• send you home with oral antibiotics, or

• admit you onto the ward for further treatment and observation.

If you are sent home with antibiotics, we may ask you to return to the GAU in a few days. This is to recheck your bloods to see if the antibiotics are working.

How do I look after my wound dressing?

Your wound dressing should remain in place for 48 hours after your procedure. After this time you can remove your dressing. Keeping the dressing on for too long creates unnecessary moisture, which can delay wound healing. Unless your wound is oozing, keep it uncovered to help it heal quicker.

Before you remove your dressing, you must wash your hands with soap and water. Once your hands are clean, you can carefully take the dressing off. Your nurse may give you spare dressings before you leave hospital.

When will my stitches be removed?

A wound can be closed with a range of different materials.

• Dissolvable stitches will usually start to disappear on their own after seven to 10 days. Although it may be a few weeks before they disappear completely.

  Your nurse will tell you if you have removable stitches. They will make arrangements for their removal, which is usually seven days after your surgery. This can either be by your GP practice nurse or in one of our GAUs.

• Surgical clips are usually left for 5 to 10 days before they are removed. Arrangements will be made for you to have them removed either by your GP practice nurse or in one of our GAUs.

• Your cut may have been closed using special medical glue. This glue must stay in place until your cut has healed, which will take about 5 to 6 days. The glue forms part of the scab. It will come off gradually by itself, do not pick at it.

• Steri-strips are small strips applied to the skin to help pull the edges of the wound together. This helps to stop any bleeding from the wound. Your nurse will tell you about how long they will need to stay on for. To remove steri-strips you need to soak them in water; you can do this in a shower. Once the steri-strips are wet, the adhesive will come unstuck.

  If the steri-strips do not fall off by themselves, gently pull them to remove them. Do not get your steri-strips wet until they are due to come off.

How can I help my wound to heal?

• Cleaning. Do not use any detergents such as soap directly on your wound site, particularly before your skin has sealed together. And, do not touch the area unnecessarily, to reduce the risks of an infection.

• Bathing. Do not soak your wound in a bath, as that may introduce bacteria to the site. Have a shower for the first few weeks instead.

• Food and drink. Keep yourself well hydrated, by drinking plenty of water. Eat a protein rich diet (such as eggs, milk, beans, sweetcorn, and apricots). Doing this can help your wounds heal quicker. Drinking plenty of water will also help you to have regular bowel movements and reduce the risks of developing blood clots.

• Sex. The length of time before you can have sex again will depend upon the type of surgery you have had. Generally, we advise you to wait until 6 weeks after major surgery before having sex again.

• Housework / avoid heavy lifting. Before you are sent home, your nurse will tell you how long you will need to do this for. It will depend on the type of surgery you have had. Usually it will be between 2 to 6 weeks.

• Driving. When you can start driving again will depend on the type of surgery you have had. Please discuss this with your nurse before you leave hospital. Check with your insurance company before you drive again, to make sure that you are covered.

• Exercise. Keep moving and do light activities to help good blood flow around your wound. Do not do any high impact exercise for at least 6 weeks after your surgery.

What if I have any further questions or concerns?

If you have any questions, please contact one of the GAUs or wards listed above. Or, visit your GP surgery as they might be able to help too.