Wound Care After Surgery: What to Expect in the First 5 Days
A patient guide from Dr Devesh Kaushal — Specialist General Surgeon, Campbelltown
General information only: This article provides general patient education about wound care after surgery. It does not replace the specific post-operative instructions provided at discharge. If you have concerns about your wound at any point, contact the rooms on (02) 7906 8312. |
The First 5 Days After Surgery — Day by Day
The first five days after surgery are the most important period for wound care. This is when the wound is at its most vulnerable — the skin edges are held together by the initial repair, the dressing is protecting the wound from the outside environment, and the body is beginning the process of healing from the inside.
Dr Kaushal applies a waterproof wound dressing in the operating theatre at the end of every procedure. This dressing stays in place for five days, protects the wound, and allows patients to shower without getting the wound wet. Dissolvable stitches are used under the skin — there are no visible stitch ends and no stitches to remove at a separate appointment.
The following outlines what to expect — and what to do — each day in the first five days after surgery.
DAY 0 Day of Surgery | You will be discharged home with the waterproof dressing already in place. You may feel groggy from the anaesthetic — rest at home. Do not drive. A responsible adult must be with you. Some pain and discomfort at the wound site is expected — take prescribed pain relief as directed. Keep the wound dry today. |
DAY 1 Day After Surgery | You may shower today — the waterproof dressing allows this. Let water run gently over the dressing, then pat dry carefully. Do not rub or soak. Some swelling, bruising and redness immediately around the wound is normal. A small amount of pale pink or clear fluid visible under the dressing is expected. Take pain relief as needed. |
DAY 2 Two Days After | Discomfort usually beginning to ease. Continue showering with the dressing in place as on day 1. Gentle walking is encouraged — it helps circulation and recovery. Avoid lifting, bending or straining. The redness and swelling around the wound should not be spreading or getting worse — if it is, contact the rooms. |
DAY 3 Three Days After | For most patients, pain is manageable with paracetamol alone by day 3. Continue to keep the dressing in place and dry. Check the wound through the transparent dressing — the edges should be coming together. If you notice increasing redness spreading beyond the wound, increasing warmth, yellow or green discharge, or fever, contact the rooms or see your GP. |
DAY 4 Four Days After | The wound is progressively healing. The dressing should still be intact and in place. Continue to avoid heavy lifting or strenuous activity. Check the wound daily through the dressing. If the dressing has lifted or fallen off — check the wound beneath. If it looks clean with closed edges, leave it uncovered. Contact the rooms if unsure. |
DAY 5 Remove the Dressing | Remove the waterproof dressing today. Peel it off gently — warm water in the shower can help loosen the adhesive edges. The wound beneath should look clean with the edges together. After dressing removal, leave the wound open to air — no further dressing is required in most cases. You can continue to shower directly over the wound, letting clean water run over it and patting dry. |
What Is Normal in the First 5 Days?
Many patients worry about what they see and feel at the wound site in the first days after surgery. The following are normal and expected:
- Mild to moderate pain and discomfort — managed with prescribed analgesia
- Swelling, puffiness and bruising around the wound and nearby tissue
- Redness immediately around the wound edges — a narrow rim of pink or red
- A small amount of clear or pale pink fluid under the dressing in the first day or two
- Itching around the wound from day 3 onwards — a sign of healing
- Shoulder tip pain after laparoscopic surgery — from residual gas, settles in 24–48 hours
- Feeling tired and flat — general anaesthesia and surgery are physically demanding
What is NOT normal — contact the rooms or see your GP:
- Redness spreading outward beyond the wound edges — and getting worse over time
- Increasing warmth, swelling or pain after day 3 — symptoms should be improving, not worsening
- Yellow, green or cloudy discharge from the wound — or a foul smell
- Fever above 38°C in the first two weeks
- The wound edges separating or the wound opening
- A new lump developing under or around the wound
Pain Management in the First 5 Days
Pain after surgery is expected and manageable. Dr Kaushal prescribes appropriate pain relief at discharge — take it as directed rather than waiting until the pain is severe.
- Paracetamol: Take regularly as prescribed — every 4 to 6 hours. Effective for mild to moderate post-operative pain and has fewer side effects than stronger analgesics.
- Anti-inflammatory medication (e.g. ibuprofen, diclofenac): Prescribed for most patients — reduces inflammation and swelling. Take with food. Do not take anti-inflammatories if you have had gastric bypass or gastric sleeve surgery, or if your discharge instructions advise against them.
- Stronger pain relief: If prescribed, take as directed and only as needed. Do not drive or operate machinery while taking opioid pain relief.
Contact the rooms if: Your pain is not controlled by the prescribed medication, or if pain is getting significantly worse after day 2 rather than gradually improving. Worsening pain after initial improvement can be a sign of a wound complication. |
Activity in the First 5 Days
- Rest at home on the day of surgery
- Gentle walking from day 1 — short walks around the house, gradually increasing
- Light activities of daily living — cooking, dressing, moving around the house
- No driving on the day of surgery or while taking opioid pain relief
- No lifting anything heavier than a kettle of water
- No strenuous exercise, gym, running or sport
- No heavy housework — vacuuming, mopping, gardening
- No bending repetitively or straining to open bowels — use a stool softener if constipated
Driving after surgery: You may drive when you can perform an emergency stop without discomfort and are not taking opioid pain relief — typically 5 to 7 days after most laparoscopic procedures. Check with the rooms if you are unsure. |
Frequently Asked Questions
My dressing fell off on day 2 — what do I do?
Check the wound beneath. If the wound edges are together, the skin looks clean and there is no discharge, simply leave it uncovered — no further dressing needed. Do not apply antiseptic solutions or home remedies. If the wound is open, weeping or you are unsure, contact the rooms on (02) 7906 8312.
I can see something under the dressing — is that normal?
A small amount of pale pink or clear fluid under the dressing in the first 24 to 48 hours is normal. The wound may also look slightly raised or puffy. If the fluid appears yellow or green, or the volume is increasing, contact the rooms for advice.
Can I take paracetamol and anti-inflammatories together?
Yes — paracetamol and anti-inflammatory medications (such as ibuprofen) work in different ways and can be taken together safely in most patients. This combination provides better pain relief than either alone. Take each as directed on the label and with food. If you have been specifically advised not to take anti-inflammatories — for example after bariatric surgery — follow that instruction.
When can I go back to work?
This depends on the nature of your work and the procedure you had. Desk-based or sedentary work is typically possible from 1 to 2 weeks after most laparoscopic procedures. Manual work involving lifting, bending or physical labour requires a longer period — usually 4 to 6 weeks. Dr Kaushal provides specific return-to-work advice at your post-operative appointment and can provide a medical certificate if required.
Specialist General Surgeon | Upper GI and Bariatric Surgery 4 Hyde Parade, Campbelltown NSW 2560 Phone: (02) 7906 8312 Email: [email protected] | drdeveshkaushal.com.au Office Hours: Monday – Friday, 9:00 AM – 5:00 PM Current hospital appointments and accreditations include: Sydney Southwest Private Hospital Liverpool | Campbelltown Public Hospital | Campbelltown Private Hospital | The George Hospital Medicare rebates and private health insurance benefits may apply depending on the service, referral and individual policy. Please contact the rooms and your insurer regarding fees and potential out-of-pocket costs. |
General information only: This article provides general patient education about wound care. It does not replace specific discharge instructions. Contact the rooms on (02) 7906 8312 with any wound concerns. Read about more Iron Deficiency After Bariatric Surgery: Causes, Symptoms and Treatment |