Laparoscopic bariatric surgery is a minimally invasive procedure that utilizes 3 to 6 tiny incisions to remove a portion of the stomach or reroute your intestines. Studies have shown that bariatrics is the most effective intervention for obese and morbidly obese individuals to reduce excess weight drastically and long-term.
As with any surgical procedure, healing is an essential part of recovery. Immediately after the bariatric operation the wound is closed using dissolvable sutures. The better you dress your wounds, can improve your chances of infection or serious side effects.
How long does it take incisions to heal?
In most cases, incisions should fully heal 2 to 4 weeks after the operation. Patients should cleanse the incisions and monitor for redness, swelling, discharge, and foul smell.
Remember to always avoid picking or scratching at incisions and allow the scabs to fall off on their own.
Note: Unlike the traditional laparoscopic sleeve gastrectomy, the single-incision gastric sleeve (SILS) uses only one minimally invasive port, saving multiple cuts. Undergoing SILS improves the healing time and minimizes scarring to look more aesthetically pleasing. The same incision care is required for all laparoscopic weight loss procedures.
There are a variety of different methods to care for your incision and heal after weight loss surgery – so here are a few that our doctors and patients recommend from their own experience.
Incision Post-Op Care
While some patients find that their cuts are covered with a gauze dressing, others may be left with them openly exposed. Every bariatric surgeon follows different methods, so it is important to follow your surgeon’s instructions first. Regardless, there are some standard practices for incision care that can be applied to improve curing, reduce scarring, and lower the chance of dangerous infection.
Tip: It is crucial that you keep your incisions clean and dry. It is commonly advised to avoid baths for approximately three weeks following surgery or until given clearance by your surgeon. Showering with soap and water and patting the incision dry provides adequate cleansing for the surgical site.
Make sure you wash your hands with soap and use disposable hand gloves.
6 Tips for Faster Incision Healing
Clear or pink drainage from the incision site and soreness are not abnormal. A gauze dressing may be used to promote comfort when wearing pants. Foul-smelling yellow, green, or white drainage can be a sign of infection, however.
An increased temperature (101 degrees Fahrenheit or above) or redness and warmth surrounding the incision site are also conditions that should be immediately reported to your bariatric surgeon near you or your primary care physician.
#1. Keep it Clean
Soap and water only. No peroxide/alcohol/iodine. Chemicals like peroxide kill bacteria, but they also kill healthy cells required for wound curing. This can delay healing and cause unsightly scars.
#2. Keep it Covered
Always keep your wounds covered. If your cuts are exposed, you are allowing deadly germs and infectious diseases to enter your body, leading to negative side effects, pain or discomfort, and even complications. Loose gauze and tape can also easily stop covering them when they are closed (scabbed over), and there is no drainage.
Some patients develop an allergic reaction to adhesives and get rashes. Use paper tapes instead of cloth band-aids to avoid skin irritation, such as blisters and burns.
#3. Keep it Dry
Despite what many people believe, keeping your wound dry is one of the most effective tools for fast healing. By drying out your wound the laparoscopic incisions will close quickly, scab, and heal. This also is helpful in reducing scarring.
#4. No Smoking
Cigarette smoking is bad for the skin and can cause poor healing and increased scarring. Nicotine slows down the curing process as it lowers the oxygen level delivered to your wound.
It takes at least three days of not smoking to eliminate all the carbon monoxide in the bloodstream. Smoking before surgery increases your risk for infection post-surgery.
#5. Get Enough Rest
Getting enough sleep promotes efficient wound healing. Resting “properly” is essential when recovering from any surgery such as bariatrics.
#6. Staying Active
Physical activity lowers the level of inflammation and accelerates healing. Less intense and simple exercises like walking around the block increase the blood flow to the wound.
Things You Should Avoid
Things that may delay cuts to get well,
- Antibiotic ointment (keeps the incision wet, no Neosporin® or equivalent)
- Waterproof bandages (keeps the incision wet moisture from sweat and fluids can’t escape).
- Removing Fibrin (a yellow substance produced by the body that is imperative in the wound)
- Closure; often confused by patients as “pus”
- Baths (quick shower is fine)
- Exposure to direct sun
- Pulling/cutting sutures that are “poking out” (once the internal portion dissolves, the external portion will fall off)
Wound Infection Post-Bariatric Surgery
Wound infections are a possible side effect that can occur up to 3 weeks post-op bariatric surgery. The indications can range from redness, warmth, pain to thick drainage (pus). Here is a list of the symptoms to look for,
- Pain and Discomfort
- Brown foul-smelling pus
- Inflammation of the infected area
- The increased temperature at the incision site
- Redness beyond the borders of the incision
Most Common Post-Op Concerns that are Oftentimes Harmless
Concern #1 – “I have pain under my left rib”
In most cases, this is a healing pain that resolves by 2 weeks; for some, it can last up to 6-8 weeks. Usually, medication for pain will be sufficient for this pain. If it is not reduced by medication or is accompanied by fever, follow up with a provider near you as soon as possible to identify the source of pain.
A study on the National Library of Medicine explained that a wound is considered infected if it “meets any of the Center for Disease Control (CDC) characterizations of pathogenic fluids or tissue exposed from the wound.”
- Contaminated drainage from the incision, with or without laboratory confirmation of infection
- Local signs and symptoms of infection such as inflammation, redness, and warmth
- Diagnosed by a bariatric surgeon confirming the infection
Concern #2 – “I’m just over a week post-op. When does the drain hole close?”
Gastric surgery drain, placed on the left side of the abdomen below the rib cage, is a common practice for bariatric surgery recovery and most often healthy. Red, pink, and clear drainage are common. Brown foul-smelling drainage (not common) is a sign of infection and should be looked at and treated by a local provider.
The area should be kept dry and quickly dressed to get well fast. You can expect some drain port pain – this is because it is in one of the most tender port sites of your body. Second, the drain is sutured to the skin so that it will not be accidentally pulled out, and if it is not taped so that pulling on the drain does not pull on the suture, a good deal of discomfort can result from normal activity.
Your incisions could take a few months to fully heal. Incision healing and wound recovery time will always vary for everyone differently. Do not be impatient or deviate from safety measures for proper healing. Follow your doctor’s guidance at all times.
- Learn more: Is removal of the drain painful?
Concern #3 – “I am extremely nauseous after having bariatric surgery. Is this normal.”
The new healing pouch can be sensitive to any pressure or pressure built up from things coming down the esophagus – often causing nausea after bariatric surgery. This symptom can typically be eliminated by taking less than 1-ounce fluid (or solid food when you get to that post-operative diet stage) at a time.
Wait 60 seconds before the next ounce of fluid (or solid). Using this trick, patients can get in 15-ounces of liquids into their bodies within as little as 15 minutes. Do that 5 times a day or more, and you will meet your liquid intake goal to avoid dehydration. Remember that liquids do not sit in the stomach to digest as solid foods do. Therefore it is NOT recommended to drink 30 minutes before or after you eat any solid foods or meals.
Liquids can push foods into the intestines faster, and then you may cause you to feel hungry quicker, and long-term may cause your pouch to stretch. If you still experience excessive nausea even after trying the “60-second trick”, follow up with a local medical provider to ensure you do not become dehydrated. IV rehydration may be necessary.
For more information on recovery after bariatric surgery, please read the following;