Caring for the Wound After Knee Replacement Surgery
Correct wound care after knee replacement helps protect the healing incision and allows possible problems to be recognised early. The incision may be closed with sutures, clips, surgical glue, adhesive strips or a combination of methods.
The dressing and wound instructions should be followed exactly because closure methods and dressing materials differ. Early home recovery guidance is available on First Week After Knee Replacement.
Main Principles of Wound Care
Keep the dressing clean, secure and protected from unnecessary moisture according to discharge instructions.
Avoid repeated touching, unnecessary opening of the dressing and application of unprescribed products.
Observe whether redness, swelling, drainage, wound gap or pain is increasing rather than settling.
What a Healing Incision May Look Like
A healing wound may have mild redness close to the incision, local tenderness, swelling, bruising, early blood staining, mild warmth, numbness or altered sensation and a firm scar line. These changes should stabilise and gradually improve. A changing or worsening pattern is more important than one isolated observation.
Understanding the Surgical Dressing
The original dressing may be waterproof, semi-waterproof, absorbent or specialised depending on the hospital and wound closure method. Some dressings are intended to stay on for several days. Others may need scheduled changes. Patients should follow the specific discharge instruction rather than assuming all knee-replacement wounds are dressed the same way.
When Should the Dressing Be Changed?
A dressing is changed according to the surgical plan or earlier if it becomes loose, wet, damaged, excessively stained, leaking beyond the edge, irritating the skin or no longer protecting the wound. Repeated unnecessary changes can irritate skin and contaminate the incision.
Blood Staining and Fluid Under the Dressing
A small amount of early blood or blood-stained fluid can occur after surgery. The team should be contacted when the stain is increasing, fluid reaches the dressing edge, the dressing repeatedly becomes wet, leakage continues after a change or the wound had become dry and then begins draining again.
Drainage Patterns That Need Review
Increasing drainage, repeated soaking, leakage after a dry period or persistent wetness.
Cloudy, yellow, green, thick, foul-smelling or pus-like fluid.
Drainage associated with increasing redness, pain, swelling, warmth, wound opening or feeling unwell.
Showering After Knee Replacement
Showering depends on the dressing type and the wound instruction. Some dressings allow brief showering; others must be kept dry. When showering is allowed, avoid scrubbing the incision, avoid soaking, avoid slipping and check whether water has entered beneath the dressing.
Bathing, Swimming and Soaking the Wound
Bathtub immersion, swimming pools, spas and open water should wait until the wound is completely closed and cleared by the treating team. Soaking a wound too early may soften the skin edges, loosen dressings and increase contamination risk.
What Not to Apply on the Wound
Avoid antiseptic liquids, alcohol, hydrogen peroxide, antibiotic cream, oils, powders, herbal products and home remedies unless prescribed.
Do not scrub the incision or remove glue, strips, clips or scabs by force.
Do not massage an open, draining, red or painful wound.
Stitches, Clips, Glue and Adhesive Strips
The closure method determines what happens next. Some sutures dissolve under the skin. Some clips or sutures are removed at a scheduled review. Surgical glue and adhesive strips should not be picked or pulled. The patient should ask what closure method was used if discharge instructions are unclear.
Wound Care During Physiotherapy
Exercises should not repeatedly stress the wound. Excessive forced bending early may increase tightness, dressing tension or drainage. The dressing should be checked after physiotherapy if the knee feels unusually tight or if fresh staining appears. Read Physiotherapy After Knee Replacement Surgery.
Clothing and Friction Around the Incision
Loose clothing is usually more comfortable early. Tight garments, rough fabric, repeated rubbing, kneeling and direct pressure on the incision can irritate the wound or scar area. Footwear should also be secure because falls can damage the wound and implant area.
Bruising Around the Wound
Bruising may appear around the knee, thigh, calf, ankle or foot. It may change colour and move downward because of gravity. Bruising is often more noticeable in patients taking blood-thinning medicines. Rapidly increasing swelling or fresh bleeding requires review.
Swelling and Wound Healing
Swelling can increase wound tension and make the knee feel tight. Activity pacing, elevation and appropriate rehabilitation may support comfort during early healing. A wound that becomes more painful, red, tense or draining as swelling increases should be reviewed. Read Swelling After Knee Replacement.
Possible Signs of Wound Infection
Increasing redness, warmth, swelling or pain around the incision.
Drainage, wound separation, unpleasant odour or a dressing that repeatedly becomes wet.
A previously improving knee that becomes more painful, stiff, swollen or less functional.
Why Infection Around an Implant Is Important
A knee replacement implant is a foreign material, and infection around an implant can be difficult to treat if not recognised. This is why persistent drainage, worsening redness, increasing pain or a declining recovery pattern should not be ignored. Evaluation may require clinical assessment, blood tests, imaging or joint-fluid testing depending on the situation.
What Can Delay Wound Healing?
Healing may be affected by diabetes, smoking, poor nutrition, anaemia, obesity, poor circulation, immune-suppressing medicines, long-term steroid use, previous scars, infection, persistent swelling, repeated friction and poor wound protection. Patients with these factors may need closer monitoring and clearer wound instructions.
Scar Care After the Incision Has Closed
Scar care should begin only after the incision is completely closed, dry and free from scabs or drainage. Once permitted, scar care may include gentle moisturising, gradual scar massage, desensitisation, sun protection and silicone-based products in selected patients. Do not start scar massage on an open or draining wound.
Wound Care After Partial, Total, Robotic or Revision Surgery
Basic wound principles are similar, but complexity differs. Revision surgery, bilateral surgery, previous scars, infection surgery, diabetes or high swelling may require different dressing plans and follow-up. Robotic assistance does not remove the need for careful wound protection and monitoring.
When to Contact the Treating Team
Contact the treating team if drainage increases, the dressing becomes repeatedly wet, redness spreads, the wound appears to open, pus-like fluid appears, wound pain worsens, swelling is rapidly increasing or the knee becomes less functional after initially improving. Severe systemic symptoms should be handled through urgent medical care.
Frequently Asked Questions About Wound Care
How long should the dressing stay on?
It depends on dressing type and closure method. Follow the written instructions given at discharge.
Can I shower after knee replacement?
Only when allowed by the dressing and wound instructions. Some waterproof dressings allow brief showering, while others must remain dry.
Is a little blood staining normal?
A small early stain may occur. Increasing, spreading or persistent leakage should be reviewed.
Can I apply antiseptic or ointment?
Not routinely. Use only products prescribed or specifically recommended by the treating team.
When can I start scar massage?
Only after the wound is fully closed, dry and cleared for scar care by the treating team.
About the Author
Dr. Mayur Rabhadiya is an Orthopedic & Joint Replacement Surgeon in Mumbai with clinical focus in knee replacement recovery, wound care, prosthetic joint infection assessment, pain and swelling after knee replacement, total and partial knee replacement, robotic-assisted knee replacement and revision knee replacement. Written and medically reviewed by Dr. Mayur Rabhadiya. Last medically reviewed: June 2026.
Book a Wound Review After Knee Replacement
Consultation may be useful if the dressing is soaked, drainage is increasing, redness is spreading, the wound appears to be opening, feverish symptoms develop or the knee becomes more painful or stiff. Book an orthopedic consultation with Dr. Mayur Rabhadiya in Ghatkopar, Mumbai. Call or WhatsApp: +91 84249 03913 / +91 96113 30063.
Medical References
American Academy of Orthopaedic Surgeons: Total Knee Replacement Recovery
American Association of Hip and Knee Surgeons: Patient Education Resources
NHS: Knee Replacement Wound and Recovery Guidance
Medical Disclaimer
This information is intended for general patient education and does not replace personalised surgical or wound-care advice. Dressing type, showering, stitch removal, wound review and scar treatment vary according to closure method, procedure, medical condition and surgeon protocol.
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