Is it normal to experience pain in the surgical wound after surgery?

Postoperative wound pain is mostly normal, but normal doesn't mean you have to endure it, nor does it mean all pain is nothing to worry about. Surgery involves cutting the skin, subcutaneous tissue, muscles, and fascia; severing nerve endings; releasing local inflammatory mediators; tissue swelling; and suture tension all cause pain. After the anesthesia wears off, pain usually begins to become noticeable six to twelve hours post-surgery, peaks at twenty-four to forty-eight hours, and then gradually decreases as inflammation subsides and tissues repair. The degree of pain varies greatly among different surgeries; abdominal, thoracic, orthopedic, and joint surgeries are generally more painful than minor superficial surgeries, but the overall trend should be gradual relief, not increasing pain.

When is it considered normal to experience pain? 

Normal postoperative pain has several characteristics. The pain is often dull, aching, or pulling, and worsens with activity, coughing, or turning over, but is relieved by rest and timely medication. The pain is generally confined to the area around the incision and does not spread rapidly to distant areas. The pain is most pronounced within the first three days after surgery, then gradually decreases, and significantly lessens within one to two weeks. If the pain follows this timeline, the wound appears stable, and there is no fever or abnormal drainage, it is mostly part of the normal recovery process. The goal of postoperative analgesia is not complete painlessness, but rather to control the pain to a level that is tolerable, allowing for sleep, coughing, and activity. Enduring pain restricts breathing and movement, which can increase the risk of lung infection and blood clots.

How do you distinguish between normal pain and abnormal pain?

Abnormal pain often involves changes in its nature and accompanying symptoms. If pain persists and worsens after three days post-surgery, or if it changes from a dull ache to a persistent throbbing pain, it suggests possible fluid accumulation, pus accumulation, or deep infection within the incision. Pain accompanied by expanding redness and swelling around the incision, increased skin temperature, purulent exudate, foul odor, or fever significantly increases the likelihood of infection. Sudden, severe pain accompanied by wound opening, blood-soaked dressings, or rapidly increasing local swelling should raise suspicion of wound dehiscence or hematoma. Numbness, weakness, coldness, or discoloration of the limbs may involve nerve or vascular injury. Swelling and pain in the lower leg, chest pain, and difficulty breathing require ruling out deep vein thrombosis and pulmonary embolism. These are not normal postoperative pains and require immediate medical attention.

If the pain is severe, can I add more medication myself?

Do not increase the dosage or change medication on your own. Postoperative pain management typically employs a multimodal approach, including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and short-term opioids. The doctor will choose the combination based on the type of surgery, the patient's age, liver and kidney function, and bleeding risk. Taking medication on time is more effective than waiting until the pain reaches its peak, as it takes time for the medication to take effect once the pain reaches its peak. NSAIDs should be used with caution in patients with stomach ulcers, renal insufficiency, or bleeding risk. Opioids may cause nausea, constipation, and respiratory depression, all of which require medical guidance. Apply cold compresses locally for 15 to 20 minutes within 48 hours post-surgery, using a towel as a buffer, to reduce swelling and pain. Elevate the affected limb, press a pillow against the incision when coughing, and use your hands for support when turning over or getting up to reduce traction on the incision. Do not apply heat to the early wound, and do not apply alcohol or folk remedies to the incision.

How can I monitor changes in pain at home?

Record your pain score daily; zero indicates no pain, and ten indicates the most severe pain. Record whether the pain is worsening or lessening, what actions trigger it, and what postures provide relief. Monitor your temperature at least once a day. Check the incision dressing for bleeding, oozing, or odor, and for any enlarged redness or swelling around the wound. If the pain gradually decreases, your temperature returns to normal, and the wound is clean, you can care for it at home as prescribed by your doctor. If the pain score remains above seven and cannot be relieved, or if you experience fever, abnormal wound oozing, enlarged redness and swelling, bleeding, numbness or weakness in the limbs, chest pain, or shortness of breath, seek medical attention immediately. 

What causes chronic pain after surgery?

In a small number of patients, postoperative pain persists for more than three months, termed chronic postoperative pain. This may be related to nerve damage, scar compression, long-term local inflammation, or central sensitization. This type of pain often manifests as burning, electric shock-like, or needle-like pain, and common analgesics have limited effectiveness. Specialist pain management is required, and neuropathic pain medications, local treatments, or interventional procedures may be used. The key to postoperative pain management is distinguishing between normal recovery pain and abnormal warning pain, administering analgesia on time, close observation, and seeking medical attention promptly if any abnormalities are detected. Neither endure the pain nor ignore it. For more information on Innomed® Hydrogel Dressing, refer to the Previous Articles. If you have customized needs, you are welcome to contact us; You Wholeheartedly. At longterm medical, we transform this data by innovating and developing products that make life easier for those who need loving care.

Editor: kiki Jia