Your dressing is a multi layer dressing. After your skin is closed with the sutures, a layer of anti-bacterial glue is placed over the wound to seal the wound further. This does not create a fully water tight seal, but adds some additional protection against infections to the wound. On top of this, for a hip replacement, some steristrips are placed.
You will see a white strip of material – this is more of an indicator strip, and is designed to absorb a small amount of fluid or blood from your wound. It is normal to have a small amount of blood ooze from your wound over the first 2 weeks, but it may not be very visible, as the thin layer does a good job of absorbing small amounts.
Overlying the white strip is an orange edged dressing (Total hip replacements) or a green edged dressing (Total knee replacements) which seal in the operative site. The hip dressing (orange edged) is small and is designed to wick away a small amount of moisture – it is slightly permeable in one way, but does not allow fluid to come in from outside – this is designed this way as the hip area has slightly more skin moisture than around the knee. The knee dressing (green edged) is mostly impermeable both ways.
Can I get my dressing wet
Your dressing is a waterproof style dressing, but water can always get in underneath the dressing. Therefore it is recommended to not allow water to hit the dressing directly. For hip replacements, just angling your body away from the stream of water in the shower is enough – after your shower, just pat the dressing dry, to prevent it from being lifted off by the rubbing action of your towel on the skin. For knee replaceements, we recommend either a plastic bag or some glad wrap around the dressing for the first 2 weeks. This will allow minimal water to hit the dressing, and prevents it from lifting off prematurely. We are trying to avoid unnecessary external water from entering the wound during the first 2 weeks
Do my sutures need to be removed?
Unless discussed with you previously, it is usual for a fully dissolvable set of sutures to be used. These do not need to be removed. Sometimes the very tip of it can be visible, but can be left in. For the most superficial skin sutures, it can take 4-6 weeks to dissolve fully. Sometimes, you might notice a small amount of redness at the edges of your wound where the tiny knots are dissolving. If they aren’t too big, then you can leave them be and they will disappear without any treatment.
There is blood on the white strip of my dressing
This is normal. The white strip is designed to house a small amout of blood. If the blood is pooling underneath, or escaping past the white dressing and coming out from under your plastic part of the dressing then please get in touch with me by sending a photo to my mobile: 0448 898 898.
There are blisters forming under my dressing
The swelling of the leg and relative stretchiness of the dressing can sometimes result in some small blisters forming under the plastic. In general, we do not treat these blisters, and they heal with no intervention. We like to leave them intact and try not to pop them if possible as they will heal well without doing so. If you spot them, please leave them intact and they will subside without any treatment.
My wound is itchy
Itchyness is very normal. Your skin is not used to having an occlusive dressing on for 2 weeks. It is normal for the skin under the dressing to sometimes get a little sensitive after a while. You can leave this sort of dressing on for 4-6 weeks if necessary, but in general we try to remove and replace this dressing at the 2-3 week mark.
What happens to my dressing at the nurse appointment.
During your nurse appointment, we will inspect the skin, check the wound, and remove the dressing. Our nurse (Abbey or Jayde) will inspect your wound, and ensure it is healing satisfactorily. A white, non-waterproof dressing is then usually applied. This material is called Hypafix, and is designed to stay on for a while. This helps the wound edge to heal with a nice thin line, but also protects the wound during the next few days after your previous dressing is removed. Sometimes a tiny amount of blood seeps through the hypafix, which is fine. The hypafix dressing can be left on for as long as you like. It can stay up to 6 weeks post op, but as long as it last a few days after it is placed on, then it can be removed, if you are finding it irritating. When showering, you can get this dressing as wet as you would like – just pat this dry instead of rubbing it dry which will helpit to last the few days without being rubbed off.
What things might I need to worry about
The following would be things to monitored closely:
- Ongoing bleeding from the wound.
- Expanding redness past the plastic part of the dressing.
- An abnormal odor that is associated with increasing pain.
- Evidence of your wound splitting apart.
- A fall directly onto your wound.