Neurosurgery Incision Cares

What is an incision? 

An incision is made when the surgeon cuts the skin to get to the area of surgery (brain, spine, etc).  They can range in size and location. 

Incisions are usually closed with sutures under the skin that you cannot see to hold the dura (lining around the brain and spine) and muscle together.  There will be sutures and/or staples on the skin that you can see.  After the incision is closed, a sterile dressing (bandage) is placed in the operating room and is removed 2 days after surgery or before going home. 

How are incisions closed? 

Incisions are closed with either sutures, staples, steri-strips, or tissue glue (Dermabond®).  Sutures can be dissolvable or non-dissolvable. Dissolvable sutures are clear and non-dissolvable sutures are black or blue. 

Suture and staple removal: 

Dissolvable sutures typically fall out on their own 2-6 weeks after surgery (post-op).  Sutures that are non-dissolvable will need to be removed in clinic 2-3 weeks post-op.  Staples are also removed in clinic 2-3 weeks post-op.  Suture and staple removal is usually done in the neurosurgery clinic though may be done with the primary care provider.  This will be discussed prior to being discharged from the hospital from surgery. 

Steri-strips and tissue glue will fall off on their own as the incision heals, usually 7-14 days.  Do not allow your child not to pick at or remove the steri-strips or glue on their own.  

What do I need to know to take care of my incision at home? 

Frequent hand hygiene or washing is the most important way to prevent the spread of germs. Always wash hands well with soap and water for at least 15 seconds, or use an alcohol hand sanitizer, such as Purell®.  Do not continually touch the incision.  Do not scratch the incision.  It is normal for the incision to itch as it heals. 

Washing: 

Unless otherwise instructed by your provider, it is ok to wash your incision 48 hours after surgery.  Do not scrub your incision until at least 2 weeks after surgery or until healed.  It is ok to take a bath and soak/submerge your incision 2 weeks after surgery.  Use gentle soap or shampoo that is fragrance free as this can irritate a healing incision.  Pat the incision dry. 

Dressings: 

Incisions heal best when they are uncovered and left open to air.  You may be asked to place a dressing over the incision, most commonly a lower back incision, to protect from poop or diaper rubbing while the incision is healing.  Your neurosurgery provider will discuss what kind of dressing may be needed prior to discharge from the hospital. 

Lotion and Ointments: 

Do not put lotion or ointment, including Bacitracin, on incisions for the first few weeks as the incision heals.  Lotion and ointment can soften the skin edges and cause the wound to not heal well.  Washing the incision with warm soapy water should be enough to keep the incision clean.  If the incision is itchy while healing, it is ok to put lotion around the area but not directly on the incision. 

Other things to know: 

• Be careful wearing hats shortly after surgery if you have a head incision.  Wear loose fitting hats for the first few weeks after surgery to prevent any rubbing on the incision while it is healing. 
• It may be tempting to pick at scabs but it is important to leave them alone.  A scab indicates the skin underneath is still healing. 

• If your child wears a cranial modeling helmet or any kind of brace or orthotic that will cover the incision, speak with your neurosurgery provider for further instruction. 
• Your incision skin is more susceptible to burning for the first 12 months after surgery. Before the incision is fully healed, cover it with clothing or a hat when outside. Once fully healed, you may apply sunscreen to the incision. 

When should I call the clinic? 

Call the clinic if: 

• Temperature higher than 101.5º F (38.6º C). 
• Changes in the incision (redness, swelling, tenderness, drainage, or opening of the incision) 
• Increasing pain, warmth, or hardness around the incision 
• Vomiting 
• Worsening headache 
• Chills or clamminess 

Questions? 

This information is not specific to your child but provides general information. If you have any questions, call our clinic at 651-220-5230. There is always a provider on call during the day, evening, and night. 

Reviewed 9/2023

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