Brain surgery wound care

What is a wound?

During your brain operation an incision (cut) is made in your skin to access the brain in your skull. After the operation to your brain the skin covering the skull is repaired by sutures (stitches) or staples (clips) and covered with a dressing to keep it clean and dry. The method chosen will be the most appropriate for you.

How should I keep my wound healthy?

• Avoid touching your wound or wound dressing as much as possible
• If you do need to touch the wound or dressing for any reason, make sure that you wash your hands thoroughly with soap and water before doing so
• If anyone else needs to touch your dressing or wound, make sure that they wash their hands thoroughly with soap and water before doing anything with the wound
• Avoid getting the dressing wet; do not submerge the dressing and wound in water
• Avoid changing the dressing. Surgical wounds and dressings should only be changed if they get wet, if the wound starts oozing, or if it produces an unpleasant odour
• Do not scratch the wound or the skin around the wound and dressing. It is normal to experience some itchiness as the wound heals
• A number of weeks (even months) after brain surgery, you may experience “odd” sensations sporadically. This may very well be the final stages of nerve recovery/wound healing. If this concerns you, please contact your GP
• We do not recommend that you shave the remainder of your hair as this may cause infection around the wound area.

If there are no problems with the wound the dressing should be left in place. Dressings are routinely and safely left in place from when you leave the hospital until it is time for your stitches/clips to be removed.

Different types of skin closure

The skin layer may be closed using:

• Subcuticular Stitch – A dissolvable suture that is not visible.
• Mattress Stitch – Individual sutures in a line that do not dissolve and will need to be removed.
• Running stitch – A continuous suture that does not dissolve and will need to be removed.
• Surgical Clips – Small metal ‘staples’ that will need to be removed.
• Surgical Glue – Applied to the edges of the wound, not removable. Will peel off in 5-7 days.

When should my stitches/clips be removed?

This varies depending on the type of brain surgery you have undergone. This information will be specific to you as instructed by your surgical team.

• Brain tumour CNS: 020 3448 8830
• Hydrocephalus CNS: 020 3448 4174
• Neurovascular CNS: 020 3448 3523
• Pituitary Tumour CNS: 075 3820 6413

If you consider it is urgent and out of hours, please attend your local Emergency Department (ED). If you are undergoing chemotherapy/radiotherapy, please attend the closest A&E in a hospital which provides cancer services. The Acute Oncology team on site will be able to triage your wound and advise accordingly.

If there is a concern with your wound, please do not return unannounced to your discharging ward as we do not have a walk-in service. Your GP/Emergency Department can contact your Neurosurgical Team.

Yes, but only if you can avoid submerging the wound in water. The wound should have a waterproof dressing and avoid getting water or shampoo on the wound. You will be discharged from hospital with a waterproof dressing. If your surgeon does not want you to wash your hair this will be discussed with you before you are discharged.

Yes, as long as you can avoid submerging the wound in water. Once your stitches have been removed, it should be fine to bathe. Please remember that there may be other reasons for patients to avoid baths, please discuss this with your neurosurgical team, nursing team or therapy team.

No, it would be impossible to avoid submerging your wound in a swimming pool. Once your stitches have been removed, it should be fine to go swimming. Please remember that there may be other reasons not to swim (for example - safety concerns climbing in and out of the pool).

The dressing needs to be replaced as soon as possible. Thoroughly wash your hands with soap and water (or the person who is going to apply a new dressing). Carefully, avoiding touching the side of the dressing that touches your wound, reapply the new dressing.

The dressing needs to be replaced as soon as possible. Thoroughly wash your hands with soap and water (or the person who is going to apply a new dressing). Carefully, avoiding touching the side of the dressing that touches your wound, reapply the new dressing.

You may find the following websites helpful:

• www.brainandspine.org.uk
• www.uclh.nhs.uk/nhnn
• www.patient.co.uk

UCLH cannot accept responsibility for information provided by other organisations.

The National Hospital for Neurology and Neurosurgery
Queen Square
London
WC1N 3BG
Switchboard: 0845 155 5000 / 020 3456 7890