Can Stitches Get Wet?
Yes, surgical wounds closed with sutures can safely get wet within the first 24-48 hours after surgery without increasing the risk of infection. 1, 2, 3
Evidence-Based Wound Care After Suturing
Early Water Exposure is Safe
Wounds can be uncovered and wetted starting 24-48 hours after closure without increasing infection rates. A prospective randomized controlled trial of 857 patients found that allowing wounds to be uncovered and wet in the first 48 hours showed equivalent infection rates (8.4%) compared to keeping wounds dry and covered (8.9%). 3
Active washing with soap and water twice daily starting the morning after surgery does not cause wound infections or dehiscence. A study of 100 consecutive patients undergoing soft-tissue excisions with monofilament nylon sutures demonstrated that all wounds healed without infection or disruption when patients washed wounds with soap and water twice daily beginning the day after surgery. 1
Standard instructions to keep wounds covered and dry are not evidence-based. Patients are traditionally instructed to keep wounds covered and dry after suturing, but they can safely get wet within 24-48 hours without increasing infection risk. 2
Dressing Management
Dressings can be removed early without adverse effects. Very low certainty evidence suggests that early dressing removal (within 48 hours) has no detrimental effect on surgical site infection rates compared to delayed removal, and may result in shorter hospital stays and reduced costs. 4
There is no clear evidence that any particular dressing type prevents surgical site infections better than others. Multiple comparisons of film dressings, hydrocolloid dressings, and silver-containing dressings versus basic wound contact dressings showed uncertain effects on infection rates. 5
Special Considerations for Central Venous Catheters
While standard sutured wounds can get wet, central venous access devices should NOT be submerged unprotected in water. 6
- Showering may be allowed if the catheter and connecting device are protected with an impermeable waterproof cover. 6
- Swimming requires water-resistant dressings covering the entire catheter, with exit site cleaning and disinfection required after water exposure. 6
- Catheter dressings must be protected against wet and dirty environments, particularly when the exit site is not fully healed. 6
Tympanostomy Tubes Exception
Routine water precautions are NOT recommended for children with tympanostomy tubes. 6
- Randomized controlled trials found no clinically significant reduction in ear drainage (otorrhea) with routine water precautions including ear plugs during bathing or swimming. 6
- Water avoidance creates unnecessary social inconvenience and may prevent development of water safety skills in young children. 6
- Water precautions may be considered only for children with recurrent/persistent infections, immunodeficiency, or exposure to highly contaminated water. 6
Practical Clinical Approach
For Standard Sutured Wounds:
- Patients can shower and wash wounds with soap and water starting 24-48 hours after closure. 1, 2, 3
- No evidence supports keeping simple sutured wounds dry beyond 48 hours. 4, 3
- Irrigation with sterile saline or tap water is equally effective—antiseptic irrigation offers no additional benefit. 2
Common Pitfall to Avoid:
Do not unnecessarily restrict patient activity by mandating prolonged periods of keeping wounds dry, as this is not supported by evidence and may reduce patient quality of life without providing benefit. 6, 3