Good wound healing is helped by many factors. None is more important than the patients time in the operating theatre. From a surgeons perspective; it’s handling tissue gently, appropriate control of bleeding, minimal use of foreign material and perfect wound closure i.e basic principles of wound care that are most important. Other factors are: maintainance of sterile surgical technique, proper instrument and equipment sterilisation, proper air handling and avoiding excessive traffic in the operating theatres.
There will still remain certain patient specific factors like diabetes, blood flow limitation in areas of the wounds and use of excessively high doses of potent drugs (used as life savers in critical patients).
Most wounds become impervious to foreign material by protein sealing within 48 hours. All the science points towards lack of benefit if antibiotics are continued for more than 48 hours
So “48 hours” is important. That’s the time when a patient is being looked after some of the best trained professionals in the world. Have that faith. Regardless of the timing of the swelling, pain, redness and discharge which might take days to weeks to develop; if a wound has to get infected it is decided during these “48 hours”.
A good surgical wound is a thin line without any swelling, bunching, tethering or balckening of the margins. If the wound is as nice as that, then 5 days after surgery it needs no more care than regular bathing and gentle rubbing with damp towels. I prefer to expose the wound to sunlight for a few minutes.
A wound that is red, hot, swollen and tender is a bad wound, it needs to be looked at by the surgeon, and whether it requires drug or surgical treatments can only be decided by the surgeon.
Observation: Children never allow wound scabs to peel off naturally, they keep scraping scabs. Children’s wounds strangely never get infected despite that.