Showering After Knee Surgery

After undergoing knee surgery, whether it's a total knee replacement, a partial knee replacement, or a minimally-invasive partial knee replacement, there are important considerations to keep in mind when it comes to post-surgery showering. This is an essential part of the recovery process and, when done correctly, can contribute to the overall healing and well-being of the patient.

Importance of Post-Surgery Showering

The act of showering after a surgical procedure serves multiple purposes. It provides a sense of normalcy, which can be crucial for mental well-being during the recovery period. Moreover, showering helps keep the body clean, reducing the risk of infection. However, there is currently no conclusive evidence available from randomised controlled trials regarding the benefits or harms of early versus delayed post‐operative showering or bathing for the prevention of wound complications.

Considerations for Showering

While showering post-surgery is important, it comes with unique considerations. For instance, many orthopaedic surgeons do not allow knee and hip replacement patients to get their incisions wet until after sutures or staples are removed, typically around two weeks after surgery. Early washing of the surgical wound may have an adverse effect on healing, for example by irritating or macerating the wound, and disturbing the healing environment [1].

Furthermore, individuals must keep in mind that they will need to rely on assistive walking devices such as a front-wheel walker or crutches in the early stages of recovery, which may present challenges in a wet and potentially slippery environment, such as a shower [3].

Understanding the nuances of how to shower after knee surgery can contribute to a smoother, more comfortable recovery process. With the right knowledge and precautions, individuals can navigate this aspect of post-operative care with confidence.

Timing and Precautions

Understanding when and how to shower after knee surgery can be a daunting task for many patients. The timing of the first shower and precautions to avoid complications form a crucial part of the recovery process.

Early vs. Delayed Showering

The timing of the first shower post-surgery has been a topic of discussion. There is currently no conclusive evidence available from randomised controlled trials regarding the benefits or harms of early versus delayed post‐operative showering or bathing for the prevention of wound complications.

Early bathing may encourage early mobilisation of the patient, which is beneficial after most types of operations. On the other hand, avoiding post‐operative bathing or showering for two to three days may result in the accumulation of sweat and dirt on the body. However, early washing of the surgical wound may have an adverse effect on healing, for instance, by irritating or macerating the wound, and disturbing the healing environment.

Despite the diverging views, many orthopaedic surgeons do not allow knee and hip replacement patients to get their incisions wet until after sutures or staples are removed, typically around two weeks after surgery. This poses an inconvenience, as patients must find alternative ways to bathe their bodies while keeping their incisions dry.

Preventing Complications

Given the lack of specific guidance about when the wound can be made wet by post‐operative bathing or showering, adopting precautions to prevent complications becomes even more significant. Patients should ensure that the surgical wound is kept clean and dry until the sutures or staples are removed.

In the absence of evidence to support either early post‐operative bathing or showering, or delayed post‐operative bathing or showering, it is impossible to rule out a clinically significant increase or decrease in surgical site infection by early post‐operative bathing.

Therefore, patients should follow their surgeon's instructions and use common sense when showering after surgery. Care should be taken to avoid direct water pressure on the surgical wound, and to dry the area thoroughly after showering. Using a waterproof dressing can also help protect the wound while showering.

The lack of definitive guidance underscores the need for further research on this topic, particularly through randomised controlled trials that compare early versus delayed post‐operative showering or bathing. Until then, patients should adhere to their surgeon's advice on how to shower after knee surgery, and take necessary precautions to prevent complications.

Guidelines and Recommendations

Mastering the art of showering after knee surgery requires understanding the instructions and necessary precautions. These guidelines ensure that your incision heals properly and you minimize the risk of complications.

Showering Instructions

Following knee surgery, showering can be a challenging task due to mobility restrictions. Patients typically need to use assistive walking devices such as a front-wheel walker or crutches [3].

There is currently no conclusive guidance on when patients can start showering post-surgery. Some physicians allow patients to shower two days after surgery, while others suggest waiting for 10 to 14 days. The timing may depend on the type of surgery, be it total knee replacement, partial knee replacement, or minimally-invasive partial knee replacement.

Patients should follow these general instructions when showering:

  1. Use a slip-resistant mat in the shower to prevent falls.
  2. Avoid direct water pressure on the surgical site.
  3. Keep the incision area dry by using waterproof bandages or plastic wrap.
  4. Sit on a shower chair if standing is difficult.

Precautions for Incision Care

Proper incision care is crucial to prevent infection and promote healing. Here are some key precautions:

  1. Do not scrub or rub the incision area.
  2. Avoid using soaps, lotions, or creams on the incision until fully healed.
  3. Pat the area dry with a clean towel after showering.

Despite these general guidelines, there is no consensus on the best practices for showering post-surgery. There is a need for further studies to establish evidence-based guidance.

Patients should follow their surgeon's specific instructions for post-operative care. It's important to communicate any concerns or questions to your healthcare provider to ensure a safe and smooth recovery.

Patient Experiences and Preferences

Understanding patient experiences and preferences can offer valuable insights into the process of showering after knee surgery. This section will focus on patient feedback on this subject and their preferences for the timing of their first post-surgery shower.

Patient Feedback on Showering

A study featured on ScienceDaily included 32 knee replacement patients treated for bone-on-bone arthritis. Half of those patients were allowed to shower two days after surgery, while the other half had to wait 10 to 14 days before showering. The feedback from patients in the early-shower group indicated that early showering was important to them and they would have preferred to do so if given the choice.

This feedback is crucial as it highlights the importance of comfort and personal hygiene during the recovery process. However, it's also important to note that the study highlighted a need for larger-scale research to further evaluate the effect of early versus delayed wound cleaning on the risk of infection after knee replacement surgery.

Patient Preferences for Shower Timing

In terms of timing, the same ScienceDaily study suggested that patients who have had knee replacement surgery may not need to wait up to two weeks before showering. No differences were found between patients who showered two days after surgery and those who waited 10 to 14 days. Patients overwhelmingly preferred early showering.

Interestingly, many orthopaedic surgeons do not allow knee and hip replacement patients to get their incisions wet until after sutures or staples are removed, typically around two weeks after surgery. This poses an inconvenience, as patients must find alternative ways to bathe their bodies while keeping their incisions dry.

The patient's preferences and feedback underscore the need for flexible showering protocols that are sensitive to the patient's comfort and hygiene needs, without compromising the success of their recovery and the integrity of the surgical site. This is an area that requires further research and evidence-based guidance.

Future Research Needs

In the realm of post-surgery care and specifically on the topic of how to shower after knee surgery, there are significant gaps in evidence-based guidance and conclusive research. These deficiencies have led to a reliance on anecdotal evidence and surgeon preferences, underscoring the crucial need for further investigation.

Lack of Evidence-Based Guidance

Currently, guidance on when a patient can wet the surgical wound through post-operative bathing or showering is noticeably absent PubMed. The benefits and potential harms of early versus delayed post-operative showering or bathing have not been definitively determined, with no conclusive evidence available from randomized controlled trials.

These gaps in knowledge have significant implications for patient care. Early bathing may encourage patient mobility post-operation, a generally beneficial practice following most types of surgery. However, avoiding bathing or showering for two to three days post-operation could result in dirt and sweat accumulation on the body. Conversely, early washing of the surgical wound could negatively impact healing by irritating the wound or disturbing the healing environment PubMed.

In orthopaedic surgery, many surgeons advise knee and hip replacement patients to keep their incisions dry until sutures or staples are removed, typically around two weeks post-surgery. This requirement often presents an inconvenience as patients must devise alternative methods to bathe while keeping their incisions dry ScienceDaily.

Call for Further Studies

The lack of evidence-based guidance on post-operative wound care regimens, particularly in the orthopaedic field, has led to a call for further research ScienceDaily. There is a significant need for larger-scale studies to evaluate the effect of early versus delayed wound cleaning on the risk of surgical site infection, particularly for procedures like total knee arthroplasty (knee replacement surgery) ScienceDaily.

Further randomized controlled trials are recommended to compare early versus delayed post-operative showering or bathing PubMed. Such trials would help establish evidence-based guidelines, enabling healthcare providers to offer patients informed advice on safe and effective post-operative hygiene practices.

In conclusion, there is a crucial need for further research in the field of post-operative showering. By bridging the current knowledge gap, healthcare providers can ensure patients receive the best care following knee surgery.

Showering After ACL Surgery

Anterior Cruciate Ligament (ACL) surgery, a type of knee surgery, requires specific showering protocols and a certain timeline to ensure proper wound healing and to avoid complications.

Showering Protocols

After ACL surgery, patients are generally permitted to shower right away or within a few days post-surgery. However, it's crucial to keep the dressing and incision dry. To do this, patients are advised to use a plastic cover or waterproof sheet over the knee before showering, providing an extra layer of protection.

During showering, warm water flowing over the top of the plastic cover on the knee should be avoided as it can lead to swelling and dilation of blood vessels around the knee. To minimize swelling, patients are advised to reposition the knee away from the shower water [5].

For those experiencing difficulty standing in the shower post-ACL surgery due to pain and swelling, using a chair or handrail is recommended. Alternatively, patients could consider sponge cleaning until confidence and balance improve. This advice is particularly relevant in the early recovery phases when knee functionality is compromised [5].

Recovery Timeline for Showering

During the initial 10 to 14 days after ACL surgery, preventing saturation of the knee is critical. This means no baths or swimming until the wound is fully sealed and clean. This period is crucial prior to the removal of stitches.

Full immersion in water, including swimming exercises, is typically feasible around 3 weeks post-ACL surgery. This, of course, assumes proper healing of the surgical incision and the absence of complications. Swimming exercises are considered highly effective for ACL surgery recovery [5].

In conclusion, understanding how to shower after knee surgery, particularly ACL surgery, is essential in the recovery process. It's always advisable to follow the directions provided by the healthcare provider and to reach out if any complications occur.

References

[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092546/

[2]: https://www.sciencedaily.com/releases/2016/05/160512085350.htm

[3]: https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/after-surgery/discharge-equipment

[4]: https://orthop.washington.edu/patient-care/articles/knee/total-knee-replacement-a-patients-guide.html

[5]: https://aclinjuryrecovery.com/can-shower-after-acl-surgery/