ACL Post Surgery Wound Care

ACL Post Surgery Wound Care

Post-ACL Surgery Wound Care: What You Need to Know

Proper wound care following ACL surgery is a vital part of recovery and plays a key role in preventing complications such as infection, delayed healing, or skin irritation. While everyone’s surgical experience can vary slightly, particularly depending on the type of graft used, understanding general wound care principles can help ensure a smoother recovery.

Just to be clear, and not to be an alarmist, poor wound care can lead to truly tragic results. Infection can lead to complications from additional required surgeries to death. You must pay attention to this. Post surgical wound sites are not simple cuts and scrapes. They are usually somewhat deep wounds and need appropriate care.

Managing Wound Sites

ACL reconstruction typically involves several incisions around the knee area, and additional sites may be present if your graft came from your own tissue (autograft), such as the hamstring or patellar tendon.

Each of these wounds will likely be dressed and bandaged immediately after surgery:

• Dressing refers to the sterile material applied directly to the wound to protect it and promote healing.
• Bandage refers to the outer layer that secures the dressing in place and helps control swelling.

It’s common for patients to confuse these terms or think only of branded adhesive strips like Band-Aids, but understanding this difference can help when changing or checking your wound coverings. In some cases, surgeons may also use Steri-Strip™ closures or medical glue to help keep incisions closed. There’s actually a lot of dressing options these days, that aren’t typically things you see on the shelf at the drugstore. There are dressings called Hydrofiber and Hydrocolloid for absorption and maintaining moistness, Foam dressings, and more.

Regardless of what’s used, when you leave your surgical facility, your wounds will have been properly dressed and this was done under sterile conditions by people who know what they’re doing and were probably using sterile gloves as well as using sterile materials.

Always follow your surgeon’s specific wound care instructions. Some protocols may include not removing or disturbing the dressing for several days, while others may allow for gentle cleaning or re-wrapping.

If you do need to re-dress your wound(s), (especially if you are experiencing a lot of bleeding), you should consult with your doctor’s office as to what to use you if you have a choice. It’s likely that using “non-adherent gauze” would be better. Non-adherent gauze is a type of wound dressing designed specifically not to stick to the wound bed. “Regular” gauze is still widely used because it’s versatile, absorbent and cost-effective, and maybe is what was initially used, but probably not the best to re-do for wounds that could be sensitive. And if you do need to re-dress your wound, consider going back to your surgeon or doctor’s office if you need to. They can check for any issues and take care of it. If you do it yourself, make sure to wash your hands, use sterile medical gloves if you have them, take care with how you open wrappings on any dressings and bandages. Your goal is a sterile re-dressing of your wound.

Note that if you do feel compelled to re-dress a wound, (perhaps original dressings were pulled off for whatever reasons), if you can you should consider taking a picture of the wound sites. This way, you can share with doctor’s office without having to remove dressings again. This may allow them to see if there were any new issues such as torn stitches, infection and so on.

What to Watch For

Staying alert for any unusual signs can help catch potential problems early. If you think there is any question of infection, advocate for yourself and seek assistance. If you’re wrong, you’ve inconvenienced yourself and others. (Not a great big deal.) If you’re right, you may save yourself from some serious consequences. (A very big deal.) No one wants to be the problem patient or waste time with non-issues, but if you have any unease with a potential wound care issue, it’s worth seeking advice just in case, given consequences can be serious.

Don’t Rush to Physical Therapy

Many people want to aggressively start a healing process. That’s maybe ok, but taken to an extreme can quickly lead to setbacks. There’s reasons surgeons want you to get some rest first, though they might not always make the reasons clear.

Here’s at least some of the reasons:

1. Wound healing and incision closure

• Early motion can stress the incision site or cause it to reopen.
• If the wound isn’t sealed yet, it’s vulnerable, not because of sweat specifically, but because any disturbance can impair healing or introduce bacteria.

2. Control of swelling and inflammation

• Starting PT too soon can increase swelling, slow healing, or disrupt the graft.
• Most surgeons want swelling and inflammation significantly reduced before aggressive movement begins.

3. Protection of the graft

• For ACL surgery in particular, early rehab must be carefully controlled to avoid stretching or damaging the new graft before it integrates.

4. Risk of infection from activity

• Surgeons may advise against PT or activity if there’s any concern about the incision not being clean or closed, but again, the concern is more about open wounds than sweating specifically.

What about sweat?

• Sweat is typically a minor or non-factor in choosing when it’s ok to start therapy, but is a reason to not immediately start serious workouts early before wounds have even started to heal. Sweat might not be bad itself, but it can easily move across skin and pick up bacteria. When sweat runs into an open wound, it can carry those bacteria directly into the tissue, increasing the risk of infection.
• Sweat can weaken adhesives like steri-strips or bandages, exposing the wound.
• It can also irritate healing tissue, potentially reopening a fragile incision.
• If a wound is closed and sealed properly, sweat isn’t a big threat.
• But if a patient is doing PT while the incision is still open or fragile, and they’re sweating heavily, then yes, that increases risk.

Signs of Infection

Infection is rare but serious and must be treated immediately. This is an area where waiting can have significant consequences for severity. Monitor wounds and your condition for:

• Redness or spreading discoloration not related to typical bruising
• Excessive swelling or fluid leakage (especially yellow, green, or foul-smelling discharge)
• Pain that worsens rather than improves
• Heat coming from the wound area
• Fever

If any of these symptoms appear, call your healthcare provider, especially warmth and abnormal discoloration. If it’s not during office hours, don’t wait until morning. Get on telehealth, go to a clinic, go to the emergency room. Something. Be sure to ask your doctor in advance what warning signs require urgent action.

Allergic Reaction

A serious allergic reaction, (medically called anaphylaxis), may be rare, but would be a true emergency. If you have any trouble breathing, or feel things like hives developing in critical areas, (such as your throat), that’s reason to seek immediate emergency care.

Less seriously, but still uncomfortable, some patients may experience irritation around the surgical sites. If so, you should contact your caregiver as soon as you can to make sure it’s nothing serious. Usually it won’t be. Some issues may include:

• Hives or itchy rashes near the bandages
• Red, blotchy skin unrelated to the surgical incisions
• Discomfort that spreads beyond the incision area

Such reactions may be caused by surgical preparation solutions, adhesives, or latex in the dressings. They are usually minor but should still be reported to your doctor. It’s often easy to switch materials or apply topical treatments to relieve symptoms, but get medical guidance if you have issues. Also, consider if you’re using anything new that may be a problem. If you just bought some kind of new clothing to use post-surgery, there could be an issue with that material.

If you do develop something significant, like widespread contact dermatitis, you’ll likely want to get some kind of medicine or over-the-counter anti-itch solution to relieve the discomfort and possibly pain. It’s also possible a fuller length leg cold sleeve could help. Though ideally, this type of problem won’t last too long, various types of skin irritation may take days or even weeks to clear up.

Final Reminders

• Keep your wound sites dry (unless told otherwise): Moisture can increase infection risk. Some doctors say keep it dry, and patients will use coverings for showers, other doctors say bathe at will. And some doctors recommend moist wound care of some sort. The protocol will depend on patient risk factors, wound types, would closure types, dressing types, and surgeon preference. Follow your doctor’s office instructions. Others may have different suggestions, which may seem inconsistent. But there are multiple ways to care for wounds. Just remember, you have been given a personalized program thought to be best for you.
• Don’t pick or peel: Let steri-strips or glue come off naturally unless your doctor says otherwise.
• Follow-up appointments matter: Your care team will check your healing progress and spot issues early.
• Don’t hesitate to ask: If something looks or feels off, reach out. Peace of mind is part of recovery too.

With the right attention and care, most wounds from ACL surgery heal well and without complications. Take care of your body, follow instructions closely, and you’ll set yourself up for a strong recovery. As always, contact your care professionals if something seems wrong and you can’t clearly identify and deal with the issue.