Incision Care after Liver Transplantation

Important information:

Liver transplant surgery involves an incision that is usually closed with surgical staples. The surgeon will decide the size and shape of the incision and what materials to use for closure.

After surgery, the incision will be covered with a dressing, which is removed the day after surgery for an ultrasound. A new dressing is not needed after this unless directed by the healthcare team. The incision heals best when left open to air.

Patient instructions: Caring for the incision 

Surgical staples: are most often used to close the incision and remain in place for about 2–3 weeks.

• Some children go home with staples and have them removed at a clinic visit.

  • They may be removed in two stages, with half taken out at one visit and the rest a week later.

• Your child may shower or bathe while staples are in place.

  • Do not let the incision soak in water until the staples are removed and scabs have fallen off.

  • Gently rinse the incision with mild soap and water. Do not scrub.

• Do not apply lotion or ointment unless instructed by the healthcare team.

• Staples may turn or loosen as the incision heals. Do not pick at them or try to remove them. Call the transplant team if concerned.

• After the staples are removed, small adhesive strips (Steri-Strips™) are applied.

Steri-Strips (thin adhesive strips reinforced with thread) help keep the incision closed after staples are removed.

• They will loosen and fall off on their own. Do not pull them off early.

• They typically stay in place for about a week but may fall off sooner.

• They may get wet but should not be scrubbed. Wash the incision gently with mild soap and water.

• Do not apply lotion or ointment unless instructed by the healthcare team.

Dermabond® (a medical-grade skin adhesive) holds the incision closed. It is often used for liver resection incisions.

• It will loosen and peel off on its own in 5–10 days.

• It is waterproof. Your child may bathe, letting water run over the incision. Do not scrub the incision.

• Do not scratch, rub, or pick at the glue. This can cause it to come off too soon.

• Do not apply ointment or lotion unless instructed by the healthcare team. This may dissolve the glue before healing is complete.

Absorbable stitches (sutures) are placed under the skin to close deeper layers. These stitches dissolve over several months.

• These stitches are usually blue and firm. Sometimes, a stitch may push through the skin and look like a small bump or a piece of thread.

• Do not pull or pick at the stitch.

• You do not need to do anything if a stitch appears. It will be absorbed over time.

• If the stitch is long or uncomfortable, you may trim it with clean nail clippers or cuticle scissors.

• Contact the transplant team if the area around the stitch shows signs of infection:

  • Redness or pain

  • Yellow or green drainage (pus)

  • Clear drainage is normal and may occur

Call your CHOP liver transplant team with questions, concerns or if your child has:

• A fever of 101.5°F (38.6°C) or higher

• Pain at the incision site

• Redness or swelling of the incision

• Drainage from the incision

• Separation of the incision edges

Mild itching around the incision is common during healing. If itching occurs all over the body, contact the healthcare team.

Liver Transplant Program

• Monday to Friday, 8 a.m.–4 p.m.: Call 215-590-4281. Leave a message if needed; voicemails are checked often.

• Evenings and weekends: Call 215-590-1000 and ask for the GI fellow on call.

• MyCHOP messages: You can send messages and include pictures of the incision, but do not use MyCHOP for urgent questions.

Reviewed February 2025 by Kathleen Anderer, MSN, CRNP