Direct closures

Will I be in pain?

During the surgery you will have had local anaesthetic injected into your wound so that it is numb will the operation takes place. This will also help reduce the pain fro a short time after the operation. Once the local anaesthetic wears off it is expected that you will feel sore. You should take simple pain relief such as paracetamol before the effects of the local anaesthetic wear off. If you find that the pain is not managed by taking regular paracetamol you should speak to your GP or a pharmacist for advice on additional pain tablets.

Do I need to have the dressing(s) changed?

It is common for the dressing to be left in place for up to a week. The frequency of your dressing changes will be determined by your surgeon and the location of your wound and or the presence of infection.

Do I need to come back to the burns unit to have the dressing(s) changed?

Some direct closures can be managed appropriately by your local practice nurse. You will be advised to make an appointment with your practice nurse if it is deemed safe to do so. Otherwise you will be given a follow up appointment for the Burns Dressing Clinic to have you dressing changed.

Do I need to have the stitches removed?

This will depend on what stitches were used during your operation. If you have dissolvable stitches they do not usually need to be removed. Dissolvable stitches take approximately 6-8 weeks to fully dissolve. Occasionally the stitches on the surface of the wound do not dissolve and do have to be removed. If you have dissolvable stitches and they have not dissolved in two weeks you can arrange and appointment with your GP practice to have them removed. If you have non-dissolvable stitches or staples, these will have to be removed.

Who removes the stitches?

The surgeon will advise you about when the stitches need to be removed. This will range from 5-21 days depending on the area.

After the operation what do I need to look out for?

Complications are not common but the ones to look out for are:

Bleeding

after 48hours you may notice some bleeding on your dressing. This is completely normal straight after your surgery. However if the wound continues to bleed or leak fluid, an appointment will need to be made for a registered nurse to review the wound. You can do either of the following:

• Make an appointment with your practice nurse at your local GP
• Make an appointment with the nurses at the Burns Dressing Clinic

If bleeding is continuous you should seek medical attention via an emergency department immediately.

Pain

If your wound is causing you significant discomfort and an the pain is increasing, this could indicate the following:

• putting too much strain on the wound, you need to rest the area to allow the damaged skin to heal.
• a sign of infection

If pain is continuous you should seek medical attention via your GP or an ED

Infection

It is important to look out for signs of infection. If you develop any of the following symptoms, please seek medical advice straight away:

• Redness and heat surrounding the wound
• An increase in pain
• Discharge from the wound
• Generally feeling unwell in yourself
• Nausea or vomiting
• Fever (temperature anove 38C)

If any of the above symptoms occur, please seek medical attention immediately. You can contact the nurses in the Burns Dressing Clinic first as they may have a space to see you. However, if this is not possible we recommend that you arrange an appointment with your GP or attend an ED

How will it look after the scar is healed?

A scar will be left once the wound has healed. How visible the scar is differs from person to person and will continue to change over time.

After all dressings, and any stitches or staples have been removed or have dissolved from your wound, the scar will begin to remodel to look more like the surrounding skin and get stronger. It will always be more fragile than it was before the operation so needs protection.

Scarred skin can become thick, lumpy, dry and itchy. To combat this, scar massage and moisturising can be started as soon as the wound is healed. It is recommended that you massage the scar 2-3 times a day for 5-10 minutes each time to help soften it, to prevent skin breakdown and improve appearance. Consider wearing sun protection (>spf30) at all times. 

When can I return to normal activities?

This will differ between individual circumstances, the type of operation, and your level of pain. Most wounds take a minimum of two weeks to begin to heal and get stronger so you are advised to avoid activities that could put strain on your wound. However, some areas need further restrictions. For example, if you have had surgery on a limb it is advised that you elevate to reduce any swelling, do not drive, avoid exercise and avoid heavy lifting. The type and size of your wound and the extent of your injury will determine how long these restrictions should be followed. The Burns Dressing Clinic Nurse of Therapists will discuss this with you.