Two dressings, not one
Following an anatomic or reverse shoulder replacement, two dressings are placed over the incision in theatre. The first goes directly onto the incision and is a Prineo dressing. The second, usually a honeycomb dressing, goes over the top of it. They are deliberately positioned as separate layers so that the top dressing can be removed without disturbing the Prineo underneath.
Removing the top dressing
Dr Cutbush suggests removing the top honeycomb dressing at approximately 7 days after your operation. The Prineo layer beneath it stays where it is.
Leaving the Prineo alone
The Prineo is left in place until it begins to fall off of its own accord, at which point it can be removed. There is no need to take it off at a set time.
Showering
Both dressings are waterproof. You may shower with the honeycomb dressing on, and you may continue to shower with the Prineo on once the honeycomb has been removed. Both are designed to get wet.
Why the wound is closed this way
The incision is closed with subcuticular Monocryl sutures, which sit beneath the skin surface, with the Prineo applied over the skin incision on top. The Prineo is occlusive, meaning it seals the incision against bacteria from outside, and published work on this type of closure reports that it adds strength to the wound closure compared with sutures alone. Individual results vary.
No sutures need to be removed. Monocryl is absorbable and dissolves on its own.
The honeycomb dressing used is Opsite, made by Smith & Nephew. It is low allergenic and, usefully, allows the wound to be seen so that it can be assessed without being uncovered. Prineo is made by Johnson & Johnson.
Bruising is expected
Extensive bruising down the arm after a shoulder replacement is common and is not a sign that something has gone wrong. It happens because blood from the surgical site tracks downwards through the subcutaneous tissue under gravity. It typically resolves within a few weeks without any treatment.
When to make contact
Bruising and some discomfort are expected. Increasing rather than settling pain, fever, feeling unwell, or a wound that becomes red and spreading, hot or discharging are reasons to contact the rooms rather than wait.
Related information
Our anatomic total shoulder replacement and reverse total shoulder replacement pages explain the operations themselves, and we have written separately about preventing infection in shoulder replacement surgery. If you had an arthroscopic procedure instead, see how to take your dressings off. The surgery FAQs cover the practical questions.