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The epithelialization phase of wound healing is completed 48 hours after an operation—if the wound edges are adapted in the correct manner. Postoperative wound infections are caused by pathogens that penetrate into the deep tissue during the procedure; such pathogens do not reach deep tissues by any secondary route. This means that showering is feasible as early as 48 hours after surgery.

The incidence of blistering owing to wound dressings is 15–35%. This prompts the question of whether dressings after surgery should not be omitted altogether, while covering the wound loosely with a gauze pad/gauze strip. This makes clinical monitoring easier as far as infections or postoperative hemorrhage is concerned.

What follows is based on clinical experience in obstetric medicine at two university hospitals over 35 years: birth-related injuries and tears in the vulval and vaginal area are located close to the anus. If the anal sphincter is damaged, the content of the colon will penetrate into the tears. The conditions around the wounds will make optimal adaptation of the wound edges difficult. After often long-term wound care, it is not possible to cover this area because of its anatomical location. In spite of all this, such wounds usually heal without any problem—even in the absence of antibiotic treatment.

Local wound care consists of irrigation using lukewarm tap water from the public water supply. The latter is well-controlled in Germany, which obviates having to boil the water first.

After cesarean section—which today is the delivery mode in one in every three women—the incision edges can be optimally adapted and the abdominal wall can be optimally disinfected before the procedure—in women who as a rule are young and healthy. In this setting, it is usually sufficient to loosely cover the wound with a gauze pad, which covers the entire wound area, for 24 and 48 hours. Discharge from hospital follows three days later.

In conclusion: the above approach is patient oriented and cost effective. By contrast, commercial wound care concepts/products are expensive. Comparative studies are needed.

DOI: 10.3238/arztebl.2018.0427b

Prof. Dr. med. J. Matthias Wenderlein

Universität Ulm

wenderlein@gmx.de

Conflict of interest statement

The author declares that no conflict of interest exists.

1.
Bredow J, Hoffmann K, Oppermann J, Hellmich M, Eysel P, Zarghooni K: Evaluation of absorbent versus conventional wound dressing—
a randomized controlled study in orthopedic surgery. Dtsch Arztebl Int 2018; 115: 213–9 VOLLTEXT
1.Bredow J, Hoffmann K, Oppermann J, Hellmich M, Eysel P, Zarghooni K: Evaluation of absorbent versus conventional wound dressing—
a randomized controlled study in orthopedic surgery. Dtsch Arztebl Int 2018; 115: 213–9 VOLLTEXT

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