Many patients are concerned about how to care for their incisions after bariatric surgery. Bariatric surgery, as you are probably aware, is all done laparoscopically. Laparoscopic surgery is a surgical technique in which the surgeon will make several small incisions, about 0.5 inches long, and use long, narrow instruments to perform the surgery. 

Typically we will make 5 to 6 incisions on the abdomen. None of these incisions are more than an inch in length. Most surgeons will close these incisions with absorbable sutures under the skin and will often apply skin glue over the incisions to seal the incision within an hour or two. 

In this blog, we will go over the best practices for handling your incisions to prevent wound infections or further complications. 

How to Care for Incisions after Bariatric Surgery

We get a lot of questions from our patients about when they can take a shower and when their incisions are healed. You should be allowed to take a shower the day after your bariatric procedure; however, recommendations might vary based on how the incision is closed.

A common problem with wound care is some patients try to get their incisions too clean. Avoid scrubbing the incision or removing scabs that form. You don't need to wash the incisions with alcohol or peroxide either. We recommend that you shower and wash your body as you usually would. Unless specifically instructed otherwise, a gentle wash with soap and water is more than adequate.

Some surgeons will use glue over the incisions (dermabod) or adhesive strips (Steri-strips) to reinforce the closure. If this is the case, do not pick at or remove the glue or strips. Similarly, we recommend not to submerge your incisions underwater or swim for about a week or two. 

Why You Should Pay Attention to Your Incisions after Bariatric Surgery

Even though we perform weight loss surgery using minimally invasive techniques, you will still have 5 to 7 small incisions. Sometimes the incisions will drain a little bit. Clear, reddish fluid is not uncommon and should just be covered with gauze. 

After your surgery, there will likely be some swelling, and bruising will probably become noticeable after about a week. As the body starts to break down the clotted blood, there might be some dark, bloody drainage at the corner of the incisions, which may require your surgeon to aspirate or even open the incision to get all the old blood out.

Although uncommon, you want to be aware of the risks of wound infections. Wound infections after weight loss surgery are infrequent, typically much less than a 1% risk. 

Early signs of wound infection are increasing pain at the site, redness, and swelling. Some drainage from the incision is to be expected (thin and usually transparent in color); however, drainage that is cloudy or has an odor is not normal and needs to be reported to your surgeon immediately.

Aside from infections, other potential wound problems include hematomas (blood in the incision). When this occurs, the patient will usually experience more pain at this site than the other areas of the incision point, yet the skin around the incision will look normal.

For the most part, the incisions are of minimal concern, and most people heal very well without any consequences. 

How your Incisions will Affect Your Physical Activity

Although you will begin walking around the same day as your bariatric procedure, we do not advise patients to lift any heavy objects until they are three to four weeks post-op. Lifting heavy objects can cause stress and tension on the incisions that could result in tearing. 

Certainly, if the activity is causing any pain at the incision site or the abdominal wall, you should avoid those types of exercises. But for the most part, after a week or two, everything is healed inside the body, so any activity an individual may be engaging in will not cause any problems with your surgery incisions. It may be uncomfortable or cause pain, which would be a reason to avoid that type of activity, but it will not cause any detriment to your overall recovery and health.