Wound Care After Knee Replacement

Wound care after knee replacement protects the healing incision and helps identify problems before they become more difficult to treat. The wound may be closed with dissolving or removable sutures, metal clips, surgical glue, adhesive strips or a combination. The dressing may be waterproof, absorbent or designed to remain in place for several days. Instructions therefore vary between patients.

The safest principle is to follow the written discharge instructions for the exact closure and dressing used. Do not copy another patient’s schedule for dressing removal, showering or stitch removal. Early recovery guidance is available in First Week After Knee Replacement.

Quick Answer: How Should the Wound Be Cared For?

Keep the dressing clean, secure and protected according to the surgical instructions. Wash or sanitise hands before touching the dressing, avoid unnecessary opening, do not apply unprescribed antiseptics or creams, and observe whether staining, drainage, redness, swelling, pain or wound separation is increasing. Contact the treating team when the wound pattern is worsening rather than settling.

What a Normally Healing Incision May Look Like

A healing incision can have mild redness immediately beside the cut, tenderness, swelling, bruising, warmth, a small early blood stain, a firm ridge beneath the scar, itching, numbness or altered sensation. Bruising may extend to the thigh, calf, ankle or foot. These findings should stabilise and gradually improve. A progressive pattern is more concerning than one isolated appearance.

Understanding the Dressing

Some modern dressings are designed to remain undisturbed for several days and may permit brief showering. Others must remain dry or need scheduled changes. The dressing should cover the incision completely, remain attached around the edges and avoid folds that create pressure or leakage channels. A loose or damaged dressing no longer provides reliable protection.

When Should the Dressing Be Changed?

Change the dressing according to the scheduled plan or earlier when it becomes loose, wet, damaged, heavily stained, leaking beyond the edge, irritating the skin or no longer covering the wound. Repeated unnecessary changes can irritate skin and introduce contamination. When a change is required, use the method and supplies advised by the treating team.

Blood Staining and Drainage

A small amount of early blood or blood-stained fluid may occur, depending on the closure and dressing. Marking the edge of a stain with the date and time can help show whether it is stable or spreading, but this should not delay contacting the team when leakage is substantial.

Review is needed when fluid reaches the dressing edge, repeatedly soaks through, remains persistently wet, increases after each exercise session, becomes cloudy or foul-smelling, or restarts after the wound had become dry. Persistent drainage is important because it may increase the risk of deeper infection and may require changes in wound management or rehabilitation.

Drainage Patterns That Need Prompt Assessment

Contact the treating team for increasing drainage, repeated soaking, yellow, green, thick or pus-like fluid, unpleasant odour, wound opening, increasing redness or warmth, increasing pain, fever, chills or a knee that becomes less mobile after initially improving. Do not start leftover antibiotics independently because antibiotics can reduce the accuracy of cultures if infection testing is required.

Showering After Knee Replacement

Showering depends on the dressing and wound instructions. A waterproof dressing may permit a brief shower, but waterproof does not mean suitable for soaking. Avoid direct high-pressure water, scrubbing and slipping. After showering, check that water has not entered beneath the dressing and that the edges remain sealed.

Baths, Swimming Pools and Soaking

Do not immerse the incision in a bathtub, swimming pool, spa or open water until the wound is completely closed, dry and cleared by the treating team. Early soaking can soften the wound edges, loosen dressings and expose the incision to microorganisms. A visually closed surface may still require additional healing before immersion is safe.

What Should Not Be Applied to the Incision?

Do not apply alcohol, hydrogen peroxide, povidone-iodine, antibiotic cream, powder, oil, turmeric, herbal paste, moisturiser or another home remedy unless specifically prescribed. These products may irritate tissue, damage adhesive, trap moisture or alter the wound appearance. Do not scrub the incision or pull off glue, adhesive strips or scabs.

Sutures, Clips, Glue and Adhesive Strips

Dissolving sutures may not require removal. Removable sutures or clips are taken out at a scheduled review when the incision is sufficiently healed. Surgical glue and adhesive strips should loosen naturally or be removed according to instructions. Do not attempt home removal unless the treating team has explicitly arranged it.

Wound Care During Physiotherapy

Exercises should not repeatedly create fresh staining, wound gaping or substantial skin tension. Some tightness during bending is expected, but forceful flexion through severe pain can increase swelling and drainage. If fresh fluid appears after therapy, reduce the provoking activity and contact the treating team rather than covering the problem with repeated dressing changes.

Read Physiotherapy After Knee Replacement.

Clothing, Friction and Pressure

Loose, clean clothing is generally more comfortable. Tight garments, rough seams, repeated rubbing, kneeling and direct pressure can irritate the dressing or incision. Secure footwear and clear walking paths reduce the risk of a fall that could split the wound or cause bleeding around the replacement.

Redness, Warmth and Swelling Around the Wound

Mild local warmth and a narrow area of redness can occur early. Concern increases when redness spreads, becomes more intense, is associated with increasing pain or drainage, or appears after a period of improvement. Swelling can place tension on the incision; activity pacing, elevation and appropriate cold therapy may help, but a tense painful wound needs review.

Read Swelling After Knee Replacement.

Possible Signs of Surgical-Site or Prosthetic-Joint Infection

Possible signs include increasing pain, spreading redness, increasing warmth or swelling, persistent drainage, pus-like fluid, wound separation, fever, chills, fatigue, progressive stiffness or loss of previously gained function. Not every implant infection causes high fever or obvious pus. A knee that was improving and then deteriorates deserves assessment.

Evaluation may include examination, blood inflammatory markers, imaging and joint-fluid aspiration. The treatment depends on timing, organism, implant stability, tissue condition and medical health. Read Infection After Knee Replacement.

What Can Delay Wound Healing?

Healing can be affected by uncontrolled diabetes, smoking, poor nutrition, anaemia, obesity, poor circulation, kidney disease, immune-suppressing medicines, long-term steroids, previous scars, skin disease, infection, persistent swelling and repeated friction. These factors do not guarantee a complication, but they may require closer monitoring and medical optimisation.

Scar Care After the Incision Has Closed

Scar care begins only after the incision is fully closed, dry, free from drainage and cleared by the treating team. Later measures may include moisturising, gentle massage, desensitisation, silicone products and sun protection. Do not massage a wound that is open, draining, red or increasingly painful. Numbness beside the scar may improve slowly and can persist in a small area.

Partial, Total, Robotic and Revision Surgery

Basic wound principles apply after all knee replacements. Partial replacement may use a smaller exposure, but the incision still requires protection. Robotic assistance does not prevent drainage or infection. Revision, bilateral and previous-scar surgery can involve more extensive tissue work and may require a different dressing or follow-up schedule. The mini-subvastus approach concerns surgical access; it does not remove the need for wound monitoring.

When to Contact the Treating Team

Seek prompt review for increasing or recurrent drainage, repeated dressing soak-through, spreading redness, wound separation, pus-like fluid, increasing wound pain, rapidly increasing swelling, fever, chills or declining knee function. Emergency care is appropriate for severe breathlessness, chest pain, fainting, uncontrolled bleeding or a cold pale foot.

Questions Patients Commonly Ask

How long should the dressing remain in place?

It depends on the dressing and closure. Follow the written schedule and change it earlier only for a clinical reason or as instructed.

Is a small blood stain normal?

A small stable early stain may occur. A spreading, recurrent or soaking stain requires review.

Can I shower with a waterproof dressing?

Only when the surgical instructions permit it. Keep the shower brief and check the dressing seal afterwards.

When can I swim?

After the incision is fully closed and the treating team confirms that immersion is safe.

Can I apply antiseptic or antibiotic ointment?

Not routinely. Use only a product specifically prescribed for the wound.

When are clips or stitches removed?

At the scheduled review once healing is satisfactory. Dissolving sutures may not require removal.

Is numbness beside the scar normal?

A patch of numbness is common because small skin nerves are affected. It may improve gradually but can persist.

Can exercises open the wound?

Appropriate exercises should not. Fresh drainage, gaping or substantial skin tension after exercise requires reassessment of the programme and wound.

Is redness always infection?

No. Mild local redness can occur, but spreading or increasing redness with pain, drainage or systemic symptoms needs review.

Can an infection occur without fever?

Yes. Persistent drainage, increasing pain, swelling or stiffness may be the main warning signs.

Should I start antibiotics for drainage?

Contact the treating team first. Unplanned antibiotics can interfere with culture results and may not address the underlying problem.

When can scar massage begin?

Only after the incision is completely closed, dry and cleared for scar care.

Clinical References and Further Reading

CDC: Surgical Site Infection Basics and Prevention

AAOS OrthoInfo: Total Knee Replacement Recovery

NHS: Recovering From a Knee Replacement

About Dr. Mayur Rabhadiya

Dr. Mayur Rabhadiya is an Orthopedic and Joint Replacement Surgeon in Mumbai. His focused knee practice includes total and partial replacement, minimally invasive mini-subvastus robotic knee replacement, wound and infection assessment, painful implant evaluation and revision planning. His qualifications are MBBS, D’Ortho, DNB (Orthopedics), MNAMS (Orthopedics) and FIJR (Robotic & Navigation).

Last medically reviewed: 24 July 2026. Medical reviewer: Dr. Mayur Rabhadiya.

Book a Wound Review After Knee Replacement

Patients concerned about dressing soak-through, drainage, redness, wound separation, increasing pain or delayed healing can consult Dr. Mayur Rabhadiya in Ghatkopar East or Ghatkopar West, Mumbai. Call or WhatsApp +91 84249 03913 or +91 96113 30063, or use the orthopedic appointment page.

Medical Disclaimer

This guide provides general education and does not replace personalised wound assessment. Dressing type, showering, closure removal and scar care vary by operation, closure method, medical health and surgeon protocol.