Wound Care After Orthopaedic Surgery: What to Expect at Home
- Mar 24
- 5 min read
Updated: Apr 13
Orthopaedic Surgery Recovery Guide | Dr Thomas Hilton
Recovery after orthopaedic surgery continues long after you leave the hospital.
While the procedure itself is carefully performed in theatre, wound healing takes place gradually over the weeks that follow. Knowing what is expected - and understanding how to interpret changes - can significantly reduce anxiety during recovery.
This guide explains how surgical wounds heal, how to interpret fluid on your dressing, how to care for your incision, and how surgical site infections typically develop.
Understanding the Surgical Wound Healing Timeline
Surgical incisions heal in stages. Although individual recovery varies depending on the type of orthopaedic procedure performed, most wounds follow a predictable pattern of inflammation, repair, and remodelling.
It is normal for an incision to look more noticeable in the early weeks. Firmness, tightness, and temporary colour changes are part of how the body rebuilds tissue strength. Bruising around the incision is also normal and may spread away from the wound site - this happens because gravity causes blood to track through the tissue, sometimes appearing at a distance from the incision itself.
Scar maturation continues quietly beneath the surface for several months. The key indicator of healthy healing is steady progress over time rather than perfection at any one point.
If the overall trend appears to be worsening rather than stabilising or improving, the wound should be assessed.
Understanding Fluid on Your Surgical Dressing
Seeing fluid on a surgical dressing is one of the most common reasons patients become concerned.
After orthopaedic surgery, the body naturally produces fluid as part of the healing response. In the early phase, this can mix with small amounts of blood from the incision. This is not automatically a cause for alarm.
What matters more than the presence of fluid is:
The amount
Whether it is increasing or decreasing
How long it persists
Whether it is accompanied by other symptoms e.g. red, hot, swollen skin under and around the dressing
Drainage that gradually reduces is reassuring. Drainage that becomes heavier, changes in consistency, or persists longer than expected should be reviewed.
What is a Haemotoma?
In some cases, a haematoma can develop after surgery. A haematoma is a pocket of blood that collects in the space left behind after surgery - for example, where tissue has been removed or disturbed during the procedure. It may feel like a firm, tender swelling beneath the skin, look bruised, and feel warmer than the surrounding area.
Although every effort is made during surgery to prevent this, some degree of haematoma formation is almost inevitable, particularly after oncology or revision surgery.
Over time, a haematoma gradually changes. The blood separates and a softer, more fluid-filled pocket (called a seroma) may remain. A seroma can occasionally discharge from the wound, which can look alarming but is usually manageable.
If this happens, contact the practice. If it is after hours and you don't have antiseptic ointment and spare dressings at home, please go to the hospital's emergency room. In most cases, the discharge settles with a few dressing changes. Occasionally a VAC (vacuum) dressing may need to be applied, and we can arrange a wound care nurse to assist if needed.
How to Care for Your Surgical Wound at Home
Appropriate wound care after orthopaedic surgery plays an important role in preventing complications.
Keep the Wound Protected
Unless instructed otherwise:
Leave the original dressing undisturbed
Avoid unnecessary exposure of the incision
Keep the area dry
If showering is permitted, protect the dressing and dry the surrounding skin gently afterwards. Avoid soaking the wound until cleared by your surgical team. The dressing that you will have on after discharge will be water resistant but not waterproof and so soaking or long showers should be avoided and take care not to rub the edges of the dressing up.
Dressing Changes (If Required)
Some patients are advised to change their dressing at home.
If so:
Wash hands thoroughly before and after
Use sterile materials only
Avoid applying any topical products unless specifically prescribed
Excessive cleaning or repeated dressing changes can irritate healing tissue. When in doubt, contact the practice for clarification.
Managing Swelling After Orthopaedic Surgery
Some swelling after orthopaedic surgery is completely normal.
Your body's natural response to surgery causes fluid to build up around the affected area - and because gravity pulls fluid downward, swelling tends to settle in the lower parts of the body. If you've had a leg or knee procedure, don't be surprised if your feet, ankles, and calves swell too.
A few things that help:
Elevate the limb. Keeping your arm or leg raised above heart level as much as possible encourages fluid to drain away from the swollen area and eases discomfort.
Use ice and compression. Both are effective for reducing swelling and managing pain. The practice rents ice and compression garments at an additional cost if needed.
Wear your compression stockings. These help reduce swelling and prevent it from returning. Take care not to slip while wearing them, and avoid any tight or restrictive bands around the limb - these can press into the skin and cause pressure sores.
Swelling that gets significantly worse, feels very tense, or comes with other concerning changes should be assessed promptly - don't hesitate to contact the practice.
Understanding Surgical Site Infection
Infection does not usually appear suddenly without warning. It tends to follow a pattern.
In the early days after surgery, mild redness, warmth, and discomfort close to the incision are common. Infection becomes more likely when:
Symptoms intensify rather than settle
Pain increases after a period of improvement
The surrounding skin becomes progressively inflamed
Drainage changes in character and does not reduce
Systemic symptoms such as fever develop
Surgical site infection represents an ongoing inflammatory process rather than a single isolated change. It is the combination and progression of symptoms that is significant.
If there is uncertainty, early assessment is preferable to waiting.
When to Contact Our Practice
Please contact our rooms if:
The wound appears to be deteriorating rather than improving.
Bleeding persists.
Drainage increases unexpectedly.
Pain becomes more severe.
You feel generally unwell.
There is a foul smell coming from the wound or dressing
Early communication allows concerns to be addressed promptly and safely.
Final Reassurance
Most wounds heal without complication.
Temporary swelling, light staining, and visible scarring are normal aspects of recovery after orthopaedic surgery.
Understanding how wounds heal - and recognising patterns rather than reacting to isolated changes - can make the recovery period far more predictable.
If you are ever uncertain, it is appropriate to seek advice. Your recovery is an essential part of achieving the best possible outcome after surgery.
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