Wound Care after Plastic Surgery
Important information:
Most plastic surgery procedures involve an incision in the skin that is closed with sutures. Your surgeon will determine the length and shape of the closure, and they will also decide what kind of sutures to use. While individual surgeons may vary in their choice of suture material and in their specific wound care instructions, general guidelines are listed below.
After the operation, your child will go to the peri-anesthesia care unit (PACU). The PACU staff will tell you when you may join your child in the PACU and when they are ready to go home. The nurse will explain your post-op instructions to you, including the type of dressing your child has and how to care for the incision.
Instructions for caring for your child’s incision:
Absorbable sutures and Dermabond™
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Dermabond is liquid glue applied to a closed incision at the end of the operation. It is waterproof and holds the wound edges together.
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Dermabond will gradually loosen over 5-10 days.
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In most cases, your surgeon will also use absorbable sutures underneath the skin to provide additional strength to the wound closure.
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Avoid scratching, rubbing, or picking at the incision, as it may loosen the Dermabond before the incision has healed.
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Do not apply antibiotic ointment or Vaseline® to Dermabond as it may loosen or dissolve the glue.
Steri-Strip™ Wound Closure (paper tape reinforced with thread)
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Steri-Strips will stick to the incision for about 7-14 days before loosening.
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Do not pull them off before they loosen on their own.
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Steri-Strips may get wet but avoid scrubbing over them.
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Do not apply lotion or ointment to the incision while the strips are in place.
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If a rash or blisters develop, your child may be sensitive to an adhesive (benzoin, Mastisol®, or Dermabond) that was applied to the skin before placing the Steri-Strips. These adhesives help Steri-Strips to stick better. If this occurs, call our office at 215-590-2208 for advice. We may suggest using an adhesive remover to relieve the rash.
Gauze dressings
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The surgeon may allow you to remove the dressing on the day after the operation.
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Your child may be allowed to bathe or shower 24-48 hours after the procedure, when the dressing has been removed.
Sutures
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If you can see your child’s sutures, you may be asked to apply antibiotic ointment lightly to the incision, once or twice a day, to reduce crusting and make suture removal easier.
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Your surgeon will decide when you need an appointment for suture removal. They may allow you to remove the sutures at home.
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Sometimes the buried absorbable sutures may work themselves through the skin and become visible. They may look like white sewing thread and there may be some drainage around the suture (suture abscess). Call the office for advice, or use tweezers and small scissors to remove the suture, which will usually solve the problem.
Additional wound healing concerns
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It is normal to have some swelling and some bruising at the operative site for at least 2 weeks.
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Your child may have some pain or act fussy after surgery. Tylenol can be given up to every 4 hours for mild to moderate discomfort. Follow the directions on the label. Your surgeon may prescribe a stronger pain medicine for moderate to severe pain.
Scar care
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Avoid excessive sun exposure and use SPF 30 and above after the incision has healed.
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The scar will change over the course of a year. Many pediatric scars will become pink and raised over the first 2 months, then gradually lighten, soften, and flatten.
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Your surgeon may discuss other options for improving the appearance of scars such as massage, silicone rubber sheeting or gel, steroid injections, laser photocoagulation, pressure garments, or long-term use of Steri-Strips or tape.
Instructions for follow up:
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Your surgeon will tell you when to return to the office for follow up.
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Please call 215-590-2208 to schedule the appointment.
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Your surgeon may tell you to return only on an "as needed" basis. For simple straight-forward procedures, follow up may not be necessary unless you have questions or concerns. You may call 215-590-2208 to speak with one of our nurses if problems arise.
Contact your surgical team with questions, concerns or if:
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The wound edges open or separate, or if your child falls and disrupts the closure
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Your child has signs of infection such as:
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Increasing redness, swelling or pain at the surgical site
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Fever greater than 101ºF (38.3° C) under the arm or 102ºF (38.8° C) by mouth or rectally
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Drainage from the incision
Monday through Friday, 8 AM -5 PM
215-590-2208
Evenings, weekends, and holiday, call 215-590-1000 and ask to speak with the plastic surgery resident or fellow on call
Reviewed December 2023 by Kelsey Reilly, CRNP