Post skin surgery wound care instructions

Day of the surgery: Immediately after surgery a dressing will be placed on the wound. Leave the dressing in place and avoid contact with the treated area for 24 hours. Do not get the wound wet during this period of time. If bleeding occurs, apply 20 minutes of firm constant pressure with the palm of your hand. If the situation persists, call our office.

When to change the dressing? Start dressing changes 24 hours following your surgery. The wound can be washed gently following the 24 hour mark. Dressing changes should be performed twice a day, every morning and evening, until your follow up visit. If the dressing becomes wet from blood or any other liquid for any reason, it must be changed.

How to remove the bandage? Do not pull off the bandage. Release the sticky parts of the bandage first and then take it off of the skin gently.

How to place a bandaid on incisions? You want to keep the surgical site under minimal tension while it is healing. It is best to place bandages perpendicular to the wound to help decrease tension.

How to clean the wound? At the time of dressing changes, cleanse the wound with soap and warm water. Do not allow a scab or crust to form over the wound. If you have stitches, it is okay to use a Q-tip to gently wipe away any debris or crust by stroking the wet Q-tip parallel to the incision line. Hydrogen peroxide can be used as well if necessary to remove crust. Do not rub, scrub, or soak the wound. Pat dry the wound with a clean gauze or cloth.

A moist environment is crucial for wound healing: Following cleansing of the wound, reapply a non-antibiotic ointment (vaseline/aquaphor) using a Q-tip. Do not use topical antibiotics unless it is recommended by your provider. Allergic reactions to topical antibiotics are common. Healing ointments (vaseline/aquaphor) prevent the wound from drying out and forming a scab. Dry wounds develop scabs which delays wound healing and increases the risk of scarring. After cleaning the wound and applying healing ointment, cover the skin with a bandage. If you have skin that is sensitive to adhesives, use a non-adhesive gauze pad with paper tape.

When you can make the wound wet (ie shower): Keep the wound dry, covered with ointment for 24 hours after surgery. You may take a shower with the bandage on the second day after surgery. After the shower you may remove the bandage and follow the dressing change instructions above.

Things to avoid after your surgery:

• Strenuous exercise, activity or sweating for 1-2 weeks
• Avoid taking any type of blood thinner within 48 hours after your skin surgery (unless instructed by your doctor differently). Following are commonly used medications or supplements that thin the blood: Advil, Aleve, Motrin, and Ibuprofen, fish oil, omega-3 fatty acids, DHA/EPA and more. Blood thinner may promote bleeding at the site of surgery which may increase the chance of scarring.
• Avoid trauma and any type of irritation at the site of skin surgery while it is healing
• Lying or sleeping on the side the surgery was performed

For pain/discomfort: Pain after most of our skin surgeries is not expected. If you need to take any pain meds for other reasons or minor discomfort then take tylenol (aka acetaminophen; can take up to 3000 mg per 24 hours if not contraindicated for other reasons).

Things to expect after your surgery: Local swelling and drainage of clear or blood-tinged fluid may be present for less than 24 hours following surgery. Swelling or bruising around the eyes is rare but possible if surgery was performed on the forehead or around the eyes. Itching can be present at the site of skin surgery due to an allergic reaction to the type of bandage and healing ointment you used. Another common cause of itching is dryness. Keep the treated area moist and clean all the time while healing.

Location specific wound instructions:

• Around lips or cheeks – minimize activity for 1-2 weeks; avoid excessive facial expressions, eating hard or large foods
• On the lower legs – elevate the leg as often as possible. This can be performed by placing pillows beneath your feet. Minimize activity and weight bearing activity.
• On the head or neck – elevate your head and neck using pillows while sleeping to avoid excessive swelling/bruising

When are sutures removed? After skin surgeries, sutures will be removed anywhere between 5 to 21 days after procedure depending on the anatomic location, depth and length of the incision. You will be informed about the date of suture removal by your provider.

Guidelines for when sutures should be removed:

• On the face: 5-7 days
• On the neck: 7 days
• On the scalp: 10 days
• On the trunk and upper extremities: 10-14 days
• On the lower extremities: 10-21 days

Post suture removal care: After suture removal, continue to reapply healing ointment to the site for another week until the wound has completely healed. In certain cases we place steristrips after sutures are removed. Steristrips can stay on the site of surgery for up to 10 days. In such a case you can remove or replace the steristips as instructed individually.

How to contact us for questions and concerns: If you have any questions and concerns during office hours please call us. For after hours questions and concerns you may text your dermatologist at (949) 426-7744.