How long to keep a pacemaker incision covered?

September 28, 2025 •

4 min read

Following a pacemaker implantation, proper incision care is crucial for preventing infection and ensuring a smooth recovery. Knowing how long to keep a pacemaker incision covered is a critical part of this process, as instructions can vary based on the specific type of dressing used and your doctor's recommendations. This guide will walk you through the standard recovery process and key factors influencing wound care.

Quick Summary

The duration to keep a pacemaker incision covered depends on the dressing type, typically ranging from 48 hours to one week, as per your surgeon's specific instructions. Some waterproof dressings may be left on longer, while adhesive strips should remain until they fall off naturally.

Key Points

Initial Covering: Keep the initial sterile dressing on for 48 hours to one week, as instructed by your surgeon, to protect the fresh incision from infection.
Steri-Strips Care: If you have white steri-strips, leave them in place until they fall off on their own, which usually takes about 7 to 10 days.
Water Exposure: Keep the incision completely dry during the initial healing phase; avoid baths, swimming, and hot tubs for several weeks to prevent contamination.
Showering Safely: You can often shower with precautions after the initial dressing is removed, such as using a waterproof barrier or gently letting water run over the site and patting it dry.
Monitoring for Infection: Watch for signs of infection like increased redness, swelling, drainage, warmth, or fever, and contact your doctor immediately if they appear.
Follow Doctor’s Orders: Always follow the precise wound care and activity instructions given by your healthcare provider, as protocols can differ.

Understanding Pacemaker Incision Care

For patients who have undergone a pacemaker implantation, proper care of the incision site is one of the most important aspects of recovery. Following your doctor's specific instructions is key to preventing complications like infection and ensuring the wound heals properly. While generalized guidelines exist, the exact timeline for removing dressings can vary. The type of dressing used, the surgical method, and your body's own healing rate all play a role in determining how long your incision needs to be covered.

The Initial Dressing

Immediately following your procedure, a sterile dressing will be applied to the incision site to protect the wound from bacteria. This initial covering is a critical barrier for the first stage of healing. You must keep this initial dressing clean and dry. In most cases, patients are instructed to avoid showering and getting the incision wet for at least 48 hours to a full week. Your surgical team will provide a precise timeline for when this first dressing can be removed.

Timeline for Dressing Removal

48 Hours to 1 Week: Many protocols advise removing the initial dressing after 48 hours, at which point the incision is usually sealed enough to prevent infection from external contaminants during a shower. Other clinics may recommend keeping a waterproof or specific type of bandage on for up to 7 days.
Steri-Strips and Adhesive: If your surgeon used steri-strips (small white paper tapes) or surgical glue, these typically do not need a separate bandage over them after the initial hospital dressing is removed. Do not pick at these; they are designed to fall off on their own over the course of 1 to 2 weeks.
Long-Term Coverage: After the initial dressing is removed, the general consensus is to leave the incision open to the air, so long as it is kept clean and dry. You should not re-cover the incision with new bandages unless specifically instructed by your healthcare provider. A moist, warm environment created by a new dressing can actually promote bacterial growth.

Signs of a Healing Incision

A healing incision will typically show the following signs:

Slight swelling and bruising, which gradually subside over several weeks.
Pinkish or reddish coloration that slowly fades.
Itching around the incision site, which is a common part of the healing process.

Signs of Infection

While uncommon, infection is a risk with any surgical procedure. It is crucial to monitor your incision for any signs of infection and contact your doctor immediately if you notice any of the following:

Increased redness, swelling, or warmth around the incision site.
Drainage of pus or other fluid from the incision.
Increased pain or tenderness at the site.
Fever or a general feeling of being unwell.

Comparison of Incision Care with Different Dressings


Feature	Sterile Bandage/Gauze	Steri-Strips (White Tapes)	Surgical Glue/Dermabond
Initial Removal	Typically removed by patient or clinic after 48 hours to 1 week.	Remain in place until they fall off naturally, usually 7-10 days.	Peels off on its own over several weeks; do not pick at it.
Shower Instructions	May require covering with plastic wrap for 1 week.	Keep dry for 1 week; can let water run over it after this period.	May shower the day after surgery; avoid rubbing.
Submersion	Avoid for at least 2 weeks, or as directed by your doctor.	Avoid for at least 4 weeks.	Avoid for at least 2 weeks.
Re-covering	Not typically necessary after removal.	No, leave open to air.	No, leave open to air.

Post-Procedure Activity and Hygiene

Keeping your incision dry is a priority, especially during the initial recovery period. For the first week, you may be instructed to take sponge baths instead of showers to avoid getting the wound wet. If showering is permitted earlier, you will need to cover the area with a waterproof seal. For example, the Arizona Heart Arrhythmia Associates suggest using plastic wrap to protect steri-strips during a shower.

Beyond keeping the incision dry, you should avoid submerging the wound in water. This means no baths, swimming pools, hot tubs, lakes, or oceans for a period of several weeks, as advised by your doctor.

Restricting arm movement on the side of the implant is also essential to prevent stress on the incision and the new pacemaker leads. Avoid raising your arm above shoulder level for a few weeks, and refrain from heavy lifting or strenuous activities.

The Importance of Follow-Up

Your first post-op visit is vital for ensuring a good recovery. This appointment usually takes place about one week after the surgery. At this time, your doctor or a nurse will inspect the incision to make sure it is healing correctly and address any concerns you may have. They will also provide further guidance on when you can resume normal activities.

Conclusion

While the general rule of thumb is to keep a pacemaker incision covered for the first few days to a week, the specific instructions hinge on the type of dressing and your surgeon's protocol. The most important actions you can take are to keep the incision dry, monitor for any signs of infection, and follow your doctor’s precise instructions for care. Do not remove any surgical tapes or glue yourself, and always attend your follow-up appointments to ensure optimal healing.

For more information on living with a pacemaker, consult the American Heart Association at https://www.heart.org/.

Frequently Asked Questions

The duration varies depending on your doctor's instructions and the type of dressing used. It is typically kept covered for 48 hours to a week. Follow your specific discharge instructions from the hospital or clinic.

Your doctor will tell you exactly when to remove the initial bandage. This is often done at a follow-up appointment about a week after surgery, but some protocols allow for removal after 48 hours.

Do not pull or pick at steri-strips. They are meant to fall off on their own. If they are still in place after 10 days or at your follow-up visit, your doctor can remove them.

After the initial dressing is removed (and with your doctor's approval), you can usually shower. Use a waterproof cover for the first week if advised, and let water gently run over the incision rather than scrubbing it.

You should avoid submerging the incision in water, such as in baths, hot tubs, or pools, for several weeks. Follow your doctor's guidance, which is often a period of 2 to 6 weeks, to prevent infection.

Watch for signs like increased redness, swelling, or warmth around the wound. Other signs include pus or fluid drainage, fever, or increased pain. If you notice any of these, contact your doctor immediately.

You should not apply any lotions, creams, powders, or ointments to the incision unless specifically instructed by your healthcare provider. These can interfere with healing and increase the risk of infection.