How to Dress a Sutured Wound
For primarily closed sutured wounds in healthy adults, use a simple standard dressing (sterile gauze or basic adhesive dressing), keep it undisturbed for a minimum of 48 hours unless leakage occurs, then remove it permanently—advanced dressings offer no additional benefit for infection prevention or healing outcomes. 1
Initial Wound Preparation
Before applying any dressing, thoroughly clean and irrigate the sutured wound until no obvious debris or foreign matter remains, using running tap water or sterile saline solution—avoid antiseptic agents like povidone-iodine as they provide no benefit over saline or tap water and may impair healing. 2, 3
Dressing Selection
Use standard dressings only (simple sterile gauze, basic adhesive dressings, or breathable non-adhesive dressings) for primarily closed sutured wounds. 1
Do not use advanced dressings (hydrocolloids, hydrogels, foam dressings, silver-impregnated dressings, or other specialty products) as they do not reduce surgical site infection rates compared to standard dressings and are not cost-effective for this indication. 1
The choice between standard dressing options can be based on cost and patient preference, as no particular standard dressing type has proven superior for preventing surgical site infections or improving outcomes. 1
Application Technique
Apply the dressing to act as a physical barrier protecting the wound from external contamination until skin continuity is restored (approximately 48 hours). 1
Use a sterile dressing that does not shed fibers, ensuring it covers the entire wound with adequate margins. 1
Avoid applying the dressing too tightly, especially on limbs, to prevent a tourniquet effect that could compromise circulation. 2
Ensure the wound area is completely dry before applying the dressing to prevent maceration of surrounding tissue. 4
Dressing Maintenance Period
Keep the dressing undisturbed for a minimum of 48 hours after surgery unless leakage, bleeding, or signs of infection occur. 1, 3
There is no evidence that extending dressing time beyond 48 hours reduces surgical site infections. 1
After 48 hours, the dressing can be removed permanently as the wound becomes impermeable to microorganisms once skin continuity is restored. 1, 5
When to Remove Dressing Early (Before 48 Hours)
Remove and inspect the wound before 48 hours only if:
- Excessive leakage or bleeding saturates the dressing 1
- Signs of infection develop (increased pain, erythema, purulent drainage, fever, or warmth) 2, 4
- The dressing becomes damp, loosened, or soiled 4
Post-Dressing Removal Care
After removing the dressing at 48 hours, the wound can be left open to air or covered with a simple plaster based on patient preference and wound location. 4, 5
The wound can be cleansed with soap and water of drinking quality for routine hygiene. 4
Monitor for signs of infection during follow-up visits, but routine re-dressing is unnecessary for clean, healing sutured wounds. 2
Critical Contraindications to Standard Approach
Do not use occlusive or moist dressings if:
- Signs of infection are present, as occlusive dressings may promote bacterial growth 2, 3
- The wound is contaminated with saliva or caused by animal/human bites 3
- There is excessive exudate without proper absorption capacity, leading to tissue maceration 3, 6
Common Pitfalls to Avoid
Avoid using antimicrobial dressings routinely—they have not demonstrated benefit for improving wound healing or preventing secondary infection in clean sutured wounds. 2
Do not apply occlusive dressings to primarily closed surgical wounds, as the moist environment they create offers no advantage and may increase infection risk if contamination occurs. 2, 3
Do not change dressings before 48 hours unless clinically indicated, as unnecessary dressing changes can traumatize the healing wound and increase infection risk. 1, 7
Do not use povidone-iodine or other antiseptics for wound cleansing, as they provide no benefit over sterile saline or tap water. 2