The initial bulky bandage placed on your knee during surgery is typically removed two days after the procedure. After that, a lighter dressing covers the incision and gets changed every one to two days until your staples come out, usually around two weeks post-surgery. Your surgical team may give you slightly different timing depending on the type of dressing they use, but this two-day mark for the first big bandage is the standard starting point.
The First Bandage Comes Off on Day Two
Right after surgery, your knee is wrapped in a large, padded bandage that serves double duty: protecting the fresh incision and applying gentle compression to limit swelling. This isn’t meant to stay on long. University of Utah orthopedic guidelines instruct patients to remove this operative dressing on post-op day two, which means two calendar days after your surgery date.
In most cases, a nurse removes this bandage before you leave the hospital. If you’re discharged on post-op day one (which is increasingly common), you may need to remove it yourself at home. Your discharge paperwork will specify the exact day. Underneath the bulky wrap, you’ll find a smaller adhesive dressing sitting directly over the incision. That one stays put for now.
What Happens After the First Bandage Is Off
Once the large bandage is gone, wound care shifts to keeping the incision clean and lightly covered. What comes next depends on which type of dressing your surgeon used on the incision itself.
Many surgeons now use silver-impregnated waterproof dressings that stick directly to the skin around the incision. These are designed to stay in place for about seven days without being changed. Washington University’s wound care protocol instructs patients to leave the silver strip on for a full seven days, then peel it off. These dressings are a significant improvement over older methods. Studies on waterproof occlusive dressings show they reduce the average number of dressing changes to less than one during the entire hospital stay, compared to two or more changes with older bandage types.
If your surgeon used traditional gauze and tape instead, you’ll need to change the dressing more frequently. Massachusetts General Hospital’s guidelines call for daily dressing changes with dry gauze, or you can leave the incision uncovered if the staples aren’t catching on your clothing. Either way, keep changing dressings every one to two days until 24 hours after your staples are removed.
When Staples Come Out
Staples or sutures are typically removed at your first post-operative office visit, which falls somewhere between 10 and 14 days after surgery. Once the staples are out, you’ll apply one final clean dressing for 24 hours. After that, most surgeons allow you to leave the incision open to air, which actually promotes healing at that stage.
Until staple removal, keep changing your dressing on schedule. If gauze sticks to the incision when you try to change it, dampen it with a little clean water rather than pulling it off dry. When applying a fresh dressing, hold a sterile gauze pad by its corner, place it over the incision, and secure it with a few strips of medical tape.
Showering With Your Dressing
Most surgical teams allow showers starting around post-op day four, but the incision needs to stay dry until your surgeon gives the green light. If you have a waterproof dressing, it will repel water on its own during a quick shower. For extra protection, or if you have a standard gauze dressing, wrap the knee area with plastic kitchen wrap or press-on food wrap (like Glad Press and Seal) before stepping in. Avoid soaking in a bath, pool, or hot tub until the incision is fully closed and your surgeon approves, which is typically three to four weeks out.
Managing Swelling With Compression
Compression wraps like ACE bandages serve a different purpose than the wound dressing. After the initial bulky bandage comes off on day two, you can use an elastic wrap around the knee to help control swelling. This is optional and separate from your incision dressing.
Ice or cold therapy devices are more important than compression for the first few days. Use cold therapy as often as possible during the first three to four days, then as needed for pain relief. If you’re using a cold therapy unit with a compression setting, start with no compression and move to low compression after a couple of days as your comfort allows.
Normal Drainage vs. Signs of Trouble
Some fluid leaking through the dressing is completely normal in the first few days. Healthy surgical drainage is thin, watery, and slightly pink or pale yellow. This is a mix of plasma and a small amount of blood, and it typically decreases steadily over the first week. You might also see a few small blood streaks or tiny clots on the gauze early on.
What’s not normal is a change in the character of that drainage. Watch for these specific warning signs during the first 30 days after surgery:
- Thick, cloudy, or milky discharge that looks white, green, yellow, brown, or gray. This suggests pus, which signals infection.
- Foul smell coming from the dressing or incision site.
- Increasing redness that spreads outward from the incision edges rather than fading over time.
- New or worsening pain at the incision site, distinct from the general soreness of recovery.
- Warmth and swelling concentrated around the incision rather than the joint in general.
- Fever above 100.4°F (38°C) that develops days after surgery rather than improving.
- Heavy red bleeding that soaks through the dressing, which could indicate a deeper issue.
Superficial wound infections after knee replacement can develop anytime within the first 30 days, while deeper infections around the implant can appear up to 90 days out. The earlier an infection is caught, the simpler it is to treat. If your drainage changes color, develops an odor, or you spike a fever, contact your surgeon’s office that day rather than waiting for your next scheduled visit.
Quick Reference Timeline
- Day 0 (surgery day): Large padded bandage applied in the operating room.
- Day 2: Bulky outer bandage removed. Smaller wound dressing stays on.
- Days 2 through 7: Silver or waterproof dressing remains in place. Gauze dressings are changed daily or every other day.
- Day 4: Showering typically allowed with the incision kept dry.
- Day 7: Waterproof/silver dressing removed and replaced with light gauze if staples are still in.
- Days 10 to 14: Staples or sutures removed at your post-op visit.
- Day 15 onward: Incision can usually be left uncovered and open to air.