Post Surgery Instructions
Please read carefully after your surgery
- Apply an ice pack over the bandage for 15 – 20 minutes before the anesthesia wears off. Then again 2 separate times for the first 24 hours after your surgery. This will decrease pain, swelling and bleeding.
- Keep the area dry, still, and elevated (above the level of the heart) as much as possible for the first 48 hours. After 48 hours, you may shower. Apply a new bandage immediately afterwards (see # 3 below). Do not submerge the area in a bathtub, swimming pool, hot tub, or any bodies of water until after your sutures are removed or dissolved (usually 7-14 days).
- Dress the wound once daily as directed below unless the doctor specifies otherwise. Follow these important steps to promote optimal healing with minimal discomfort and to prevent infection and crust formation:
- After the pressure bandage from the Mohs surgery has been in place for 48 hours, remove the bandage, and then gently cleanse the area with soap and water.
- You may have steri-strips in place. Steristrips are sterile pieces of medical tape used to close wounds and help the edges grow back together. Steristrips keep the wound clean and protected while it heals. Leave these on. They will fall off on their own.
- Apply a thin layer of plain petrolatum / Vaseline and a non-stick bandage.
- Repeat and rebandage daily for 7 – 10 days (remove bandage, cleanse, apply petrolatum, apply a non-stick bandage).
- Continue this routine until you return for your suture removal appointment (or until sutures are dissolved, usually 7-14 days).
- Do not shave near the site because the sutures may be cut.
- It is normal after surgery to experience some discomfort, swelling and bleeding. If pain occurs, take Tylenol Extra Strength 500mg (acetaminophen) 1-2 tabs every 6 hours and Ibuprofen 200-400mg every 6 hours.[IN THE SETTING OF NORMAL LIVER AND KIDNEY FUNCTION]. If you notice any unusual fever, swelling, bruising, reddening, or discharge, please call the office at 941.907.0222.
- After the pressure bandage from the Mohs surgery has been in place for 48 hours, remove the bandage, and then gently cleanse the area with soap and water.
- It is normal to see small spotting of blood on the first bandage. If there is active bleeding, apply an ice pack over the bandage with constant pressure for 20 minutes to encourage clotting. If the bleeding persists, alert our office immediately at 941.907.0222.
- The following is a list of things you should AVOID:
- Avoid aspirin 2 days after surgery. Both promote bleeding.
- Avoid alcoholic beverages 48 hours after surgery. It promotes bleeding.
- Avoid stretching, bending or physical activity which could strain the wound. Such actions slow the healing process and increase the risk of bleeding.
- Avoid swimming in the pool or any bodies of water, hot tub, using a spa, taking tub bath while the sutures are in place.
- Scar tissue is pink 3 – 6 months, then usually fades to white. Sunlight exposure may cause skin to darken. The appearance of a surgery scar usually continues to improve for 6 – 12 months as the scar “matures”. The tissue around a surgical site may remain either firm or puffy for several months.
Wound Care Instructions
Instructions for naturally healing wounds
- After 24hrs, remove the bandage and begin cleansing & bandaging as follows twice daily:
- Remove the dressing
- Clean with gentle soap and water, pat try
- Apply Vaseline, Polysporin, or Bacitracin. Do NOT use Neosporin.
- Cover the wound with a band-aid or non-stick gauze + tape.
- If you are allergic to band-aids, use a non-stick pad + paper tape or hypoallergenic bandages like Band-aid Sensitive Skin. OTC Hydrocortisone 1% cream can help with itching due to allergic reaction to bandages.
- Repeat twice daily until the wound has healed (approximately 4-8 weeks for the scalp or 8-12 weeks for the lower legs)
- If you are having discomfort, take Tylenol Extra Strength 500mg (acetaminophen) 1-2 tabs every 6 hours and Ibuprofen 200-400mg every 6 hours.
- It is OK to shower, exercise, swim, and wet the wound in clean water. Do not swim or submerge in soiled or ocean water.
- Do NOT let the wound dry, scab, or crust. The wound will heal faster and with a better cosmetic result if kept clean, moist, and covered.
- NORMAL: Reddish or clear discharge from the wound is NORMAL, and can occur for up to 6-8wks. A yellow to white base of the wound is NORMAL, this is called ‘granulation tissue’.
- Bleeding: Following surgery bleeding is always possible. If bleeding occurs, do not remove the bandage. Apply additional gauze with tape and apply firm continuous pressure on the bandage with ice for 20 minutes. If bleeding does not stop, we want to know immediately.
- Scar: All surgical sites will heal by forming a scar and the scar with mature over time. The wound will transition to a pink, red or purple circle. The coloration will fade to white or skin tone over the course of several months.
- If you notice increasing redness, pain, or warmth of the wound, please contact the office immediately.
- In case of emergency, call the office emergency line: 941.907.0222
Instructions for skin grafts
- Do not remove or wet the bandage for 1 week. We will remove the bandage for you at your suture removal. The bolster bandage is sewed on, so do not attempt to remove or pull off the bandage. If the bandage falls off, gets wet, or is soiled, apply a temporary bandage over the original bandage with nonstick gauze & tape, and contact the office for a bandage change.
- Take it easy – no exercise, exertion, lifting over 10lbs, bending, or straining for 1 week.
- For pain, take Tylenol Extra Strength 500mg (acetaminophen) 1-2 tabs every 6 hours and Ibuprofen 200-400mg every 4-6 hours. You can use an icepack, but do not wet the bandage.
- Do not drink alcohol for 24 hours.
- Do not sleep on the surgical site.
- Take your antibiotic pill as instructed if prescribed by your provider.
Special instructions for facial wounds
- While sleeping, keep your head elevated for the first two nights. Do not sleep on the surgical site.
- Do not bend over with your head lower than your heart level. Bend at the knees to stoop down. Do not lift anything heavy or do anything that may cause strain or tension on the sutures.
- It is normal to have bruising, discoloration, and swelling around the surgery sites, especially if the wound is in the eye area. Your eyes may swell shut. Do not be alarmed by this, it will fade and return to normal color.
- Bleeding: Following surgery bleeding is always possible. If bleeding occurs, do not remove the bandage. Apply additional gauze with tape and apply firm continuous pressure on the bandage with ice for 20 minutes. If bleeding does not stop, we want to know immediately.
- Graft appearance: The graft appearance at your 1 week follow up will not look like normal skin; it may be pale, pink, purple, or lumpy appearing. The graft will continue to heal and appear more normal flesh tone and texture over 4-12 weeks.
- Scar: All surgical sites will heal by forming a scar and the scar with mature over time. The incision will be thick and pink/red for about 6 weeks, then over the next few months the scar will soften, and redness will fade. You will continue to see improvement in the appearance of your incision for up to 1 year.
- In case of emergency, call the office emergency line: 941.907.0222
Scar gel recommendations
- Starting 2-4 weeks after surgery, apply a silicone-based scar gel at night. In the morning, apply mineral based sunscreen SPF 30+ or a silicone-based scar gel with SPF 30+.
- Scar gel should not be applied to open or crusted wounds.
- Available at your pharmacy:
- Available to purchase in office or order online:
