Post-Surgery Wound Care

how to ensure proper healing after a procedure

Wound Care Instructions after Dermabrasion

 

The importance of post-operative care to your wound cannot be over stressed.

The care you take of yourself and your surgical wound is extremely important to the

success of the procedure and to your recovery and well-being.

There are several things that could happen following the procedure, such as:

  • Bleeding, bruising and swelling can occur, to reduce the severity of these things:

    • Limit activities for 2-3 days after the surgery and keep the pressure

dressing dry and in place for 2 days.

  • Keep the operative site elevated when possible.

    • Avoid stooping or bending.

    • Avoid straining or heavy lifting.

    • Sleep with your head elevated on extra pillows.

  • Apply ice pack for 10-20 minutes each hour during waking hours as needed to

reduce pain and swelling.  A towel may be placed around the ice pack to help keep

the bandage dry.  Wait until the numbing wears off before icing to prevent frostbite!

*Oozing may occur from the procedure site, especially during the first 24-48 hours.

If frank bleeding occurs, hold firm pressure over the wound with a clean washcloth

or gauze without looking for 15-20 minutes. If bleeding does not stop, call the

office (808) 621-1000 or, if after clinic hours, call Dr. Flament’s cell phone, (808) 798-2377.

 

Wound Care – 2 times each day after pressure dressing is removed after 2 days

  1. Wash your hands with soap and water.

  2. Apply Hydrogen Peroxide and/or soap and water to the suture line with a cotton ball or Q-tip to gently remove crusts from the wound.

  3. Dry wound thoroughly by blotting with a clean soft cloth or gauze.

  4. Apply a generous layer of ointment with a Q-tip.

  5. Cover with a clean, dry, nonstick dressing.

  6. Apply the bandage in slightly different directions to avoid tape irritation. Paper tape works very well for patients with very sensitive skin.

 

  •  Usually the site is mildly tender, especially in the first couple of days.  If you experience discomfort, take Tylenol (acetaminophen) as needed and according to the instructions on the bottle. Do not exceed more than 3 grams (3000 mg) of Tylenol in 24 hours.  If pain is experienced between doses of Tylenol, you may take ibuprofen per package directions for breakthrough pain.  Aspirin and ibuprofen type products can increase the chance of post-operative bleeding and bruising.  It is ok to continue medically prescribed blood thinner, such as daily aspirin, Coumadin and other prescription blood thinners. < >Infection seldom occurs if wound care instructions have been carefully followed.  To minimize the risk for infection, keep the wound covered while outdoors and overnight following the surgery.  Also, avoid swimming or soaking the wound in water until the skin surface is fully healed.  If you noticed any of the following signs of infection, please call our office (808) 621-1000 or, if after clinic hours, Dr. Flament’s cell phone.Increasing redness, warmth and swelling beyond the borders of the wound. Some redness at the border of the wound is normal.Signs of foul smelling, purulent (white or yellow pus) drainage.Increasing tenderness or soreness. < >Return for a wound check as directed, usually 2-3 weeks after the procedure. 

  • ** There will still be scarring and redness in and around the treatment area. This will decrease as healing progresses but may last several months. Everyone heals differently and the final scar appearance depends on the individual’s ability to heal. Because of the unpredictability in wound healing, the final appearance cannot be preoperatively ascertained; therefore, no guarantee can be implied or stated as to the final appearance of the scar.  For most people, dermabrasion smoothes the scar making it more subtle and better blended but it can take months for the redness to fade and the scar to reach it’s best appearance.  If you are unhappy with the appearance of your scar, please see Dr. Flament to discuss as there may be other options to improve scar appearance.

 

  • ** Wounds often darken or hyperpigment after surgery, especially if exposed to the sun.  To minimize this risk, use careful sun protection in the months following the procedure.  If the area is not covered by clothing, be sure to wear sunscreen (spf>30 at least) and make sure the sunscreen is reapplied at least every 2 hours while the area is exposed to the sun.  The sunscreens containing zinc or titanium in the ingredients work best.

 

Wound Care Instructions after Surgery -

Excisions or Mohs with Suture Closures

 

The importance of post-operative care to your surgical site cannot be over stressed. The care you take of yourself and your surgical wound is extremely important to the success of the procedure and to your recovery and well-being.

There are several things that could happen following the surgery, such as:

  • Bleeding, bruising and swelling can occur after the surgery, to reduce the severity of these things:

    • Limit activities for 2-3 days after the surgery and keep the pressure dressing dry and in place for 2 days.

    • Keep the operative site elevated when possible.

    • If surgery was on the face, head or neck:

      • Avoid stooping or bending.

      • Avoid straining or heavy lifting.

      • Sleep with your head elevated on extra pillows.

    • If the surgery was below the neck, avoid excessive activity or heavy lifting, pushing or pulling that involves the area and muscles around the surgery site for at least 2 weeks after surgery.  Please let us know if you need a letter for work or school.

    • Apply ice pack for 10-20 minutes each hour during waking hours.  A towel may be placed around the ice pack to help keep the bandage dry.  Wait until the numbing wears off before icing to prevent frostbite!

*Oozing may occur from the incision site, especially during the first 24-48 hours. If frank bleeding occurs, hold firm pressure over the wound with a clean washcloth or gauze without looking for 15-20 minutes. If bleeding does not stop, call the office (808) 621-1000 or, if after clinic hours, call Dr. Flament’s cell phone, (808) 798-2377.

 

Wound Care – 2 times each day after pressure dressing is removed after 2 days

  1. Wash your hands with soap and water.

  2. Apply Hydrogen Peroxide and/or soap and water to the suture line with a cotton ball or Q-tip to gently remove crusts from the wound.

  3. Dry wound thoroughly by blotting with a clean soft cloth or gauze.

  4. Apply a generous layer of ointment with a Q-tip.

  5. Cover with a clean, dry, nonstick dressing.

  6. Apply the bandage in slightly different directions to avoid tape irritation. Paper tape works very well for patients with very sensitive skin.

 

  • Usually the site is mildly tender; however, if you experience discomfort, take Tylenol (acetaminophen) as needed and according to the instructions on the bottle.  Do not exceed more than 3 grams (3000 mg) of Tylenol in 24 hours.  If pain is experienced between doses of Tylenol, ok to take ibuprofen per package directions for breakthrough pain.  Aspirin and ibuprofen type products can increase the chance of post-operative bleeding and bruising.  It is ok to continue medically prescribed blood thinner, such as daily aspirin, Coumadin and other prescription blood thinners. < >Infection seldom occurs if wound care instructions have been carefully followed.  To minimize the risk for infection, keep the wound covered while outdoors and overnight following the surgery.  Also, avoid swimming or soaking the wound in water until all surface sutures are removed and the skin surface is fully healed.  If you noticed any of the following signs of infection, please call our office (808) 621-1000 or, if after clinic hours, Dr. Flament’s cell phone. Increasing redness, warmth and swelling beyond the borders of the wound. Some redness at the border of the wound is normal. Signs of foul smelling, purulent (white or yellow pus) drainage. Increasing tenderness or soreness. < >Return for suture removal 5-7 days for external neck and facial stitches; 11-14 days for external stitches in other body parts of the body, or for a wound check as directed. 

  • There will be a scar and redness in and around the excision area after surgery. This will decrease as healing progresses but should be expected to last several months. Everyone heals differently and the final scar appearance depends on the individual’s ability to heal. Because of the unpredictability in wound healing, the final appearance cannot be preoperatively ascertained; therefore, no guarantee can be implied or stated as to the final appearance of the scar. The scar is often elevated or raised in the first several weeks after surgery.  This is done purposefully to give a more subtle permanent scar.  If the scar is still elevated or the skin is still tight after one month, you may start gentle massage to the area a few times daily to encourage flattening and softening of the scar.  If you are unhappy with the appearance of your scar, please see Dr. Flament to discuss as there are often options to improve scar appearance.

 

  • Wounds often darken or hyper-pigment after surgery, especially if exposed to the sun.  To minimize this risk, use careful sun protection in the months following surgery.  If the area is not covered by clothing, be sure to wear sunscreen (SPF>30 at least) and make sure the sunscreen is reapplied at least every 2 hours while the area is exposed to the sun.  The sunscreens containing zinc or titanium in the ingredients work best.

Wound Care Instructions For Biopsies -

Shaves & Punches

1. Remove present Band-Aid or dressing after 24 hours. Clean wound gently with soap and water.

2. After Cleaning the wound, apply an ointment:

  • Polysporin Ointment, Bacitracin Ointment, Neosporin Ointment or triple antibiotic ointment (If you have never had a reaction to them).

  • Mupirocin Ointment

  • Aquaphor Healing Ointment

  • Vaseline Ointment

 

3. The wound should be cleaned and the dressing changed 2 times a day for up to 2 weeks or until the wound has healed. Keep the wound covered with a dressing at all time. Studies show that wounds heal faster when covered. Do not allow the wound to “dry out” or develop a “scab”.

 

4. Patients who tend to heal slowly or for wounds on the lower legs may benefit from a Band-Aid product called Advanced Healing Band-Aids. These are bandages that can be applied to the wound and left on for 2-3 days at a time to encourage quicker healing.

 

  • Please call our office (808) 621-1000, if you see signs of infection such as:

  • Increasing redness and swelling beyond the borders of the wound. Some redness around the border or the wound is normal.

  • Signs of foul smelling or purulent (white or yellow pus) drainage.

  • Increasing tenderness or soreness.

     Oozing may occur from the site especially during the first 24-48 hours. If frank bleeding occurs, hold firm pressure over the wound with a clean washcloth without looking for 15 minutes. If it does not stop, call the office (808) 621-1000.

     Usually the site is mildly tender; however, if you experience discomfort, take Tylenol (acetaminophen) as needed and according to the instructions on the bottle. Do not exceed more than 3 grams (3000 mg) of Tylenol in 24 hours.  If pain is experienced between doses of Tylenol, ok to take ibuprofen per package directions for breakthrough pain.  Aspirin and ibuprofen type products can increase the chance of post-operative bleeding and bruising.  It is ok to continue medically prescribed blood thinner, such as daily aspirin, Coumadin and other prescription blood thinners.

     Remember to apply the bandage in slightly different directions over the wound with each dressing change to minimize tape irritation to the skin. Paper tape works well for very sensitive skin patients.

**Please be aware that although the doctor has submitted a biopsy for examination to the pathologist, our billing will only reflect the service of removing the necessary tissue for the biopsy. You will be billed separately by the pathologist for the actual study of the tissue specimen. Please address any billing concerns regarding the biopsy analysis directly to the pathologist and not to our office. **

 

Wound Care Instructions after Surgery with Skin Glue - 

Excisions or Mohs with Skin Glue Surface Closure

 

The importance of post-operative care to your surgical site cannot be over stressed. The care you take of yourself and your surgical wound is extremely important to the success of the procedure and to your recovery and well-being.

There are several things that could happen following the surgery, such as:

  • Bleeding, bruising and swelling can occur after the surgery, to reduce the severity of these things:

    • Limit activities for 2-3 days after the surgery and keep the pressure dressing dry and in place for 2 days.

    • Keep the operative site elevated when possible.

    • If surgery was on the face, head or neck:

      • Avoid stooping or bending.

      • Avoid straining or heavy lifting.

      • Sleep with your head elevated on extra pillows.

    • If the surgery was below the neck, avoid excessive activity or heavy lifting, pushing or pulling that involves the area and muscles around the surgery site for at least 2 weeks after surgery.  Please let us know if you need a letter for work or school.

    • Apply ice pack for 10-20 minutes each hour during waking hours.  A towel may be placed around the ice pack to help keep the bandage dry.  Wait until the numbing wears off before icing to prevent frostbite!

*Oozing may occur from the incision site, especially during the first 24-48 hours. If frank bleeding occurs, hold firm pressure over the wound with a clean washcloth or gauze without looking for 15-20 minutes. If bleeding does not stop, call the office (808) 621-1000 or, if after clinic hours, call Dr. Flament’s cell phone, (808) 798-2377.

 

Wound Care

  1. No special wound care is necessary.  When the pressure dressing is removed in 2 days, just let soap and water run over it in the shower.  Please do not scrub the area.

  2. There is no need for further dressings.  If desired, its ok to cover with a clean, dry, nonstick dressing.  Do not apply any ointment, just a dry dressing.  Make sure the tape of the dressing (sticky part) does NOT contact the glue or it can pull it off.  This may be continued until the skin glue has come off on its own and the incision appears fully sealed.

  3. Apply the bandage in slightly different directions to avoid tape irritation. Paper tape works very well for patients with very sensitive skin.

  4. Do NOT pick at or remove the skin glue until at least 2 weeks have passed.  This could pull open your wound.  If it flakes off before then on its own, this is ok, but do not attempt to remove the glue.

 

  • Usually the site is mildly tender; however, if you experience discomfort, take Tylenol (acetaminophen) as needed and according to the instructions on the bottle.  Do not exceed more than 3 grams (3000 mg) of Tylenol in 24 hours.  If pain is experienced between doses of Tylenol, ok to take ibuprofen per package directions for breakthrough pain.  Aspirin and ibuprofen type products can increase the chance of post-operative bleeding and bruising.  It is ok to continue medically prescribed blood thinner, such as daily aspirin, Coumadin and other prescription blood thinners. < >Infection seldom occurs if wound care instructions have been carefully followed.  To minimize the risk for infection, keep the wound covered while outdoors and overnight following the surgery.  Also, avoid swimming or soaking the wound in water until all surface sutures are removed and the skin surface is fully healed.  If you noticed any of the following signs of infection, please call our office (808) 621-1000 or, if after clinic hours, Dr. Flament’s cell phone.Increasing redness, warmth and swelling beyond the borders of the wound. Some redness at the border of the wound is normal.Signs of foul smelling, purulent (white or yellow pus) drainage.Increasing tenderness or soreness. < >Return for a wound check as directed (usually 2-3 weeks). 

  • There will be a scar and redness in and around the excision area after surgery. This will decrease as healing progresses but should be expected to last several months. Everyone heals differently and the final scar appearance depends on the individual’s ability to heal. Because of the unpredictability in wound healing, the final appearance cannot be preoperatively ascertained; therefore, no guarantee can be implied or stated as to the final appearance of the scar. The scar is often elevated or raised in the first several weeks after surgery.  This is done purposefully to give a more subtle permanent scar.  If the scar is still elevated or the skin is still tight after one month, you may start gentle massage to the area a few times daily to encourage flattening and softening of the scar.  If you are unhappy with the appearance of your scar, please see Dr. Flament to discuss as there are often options to improve scar appearance.

 

  • Wounds often darken or hyperpigment after surgery, especially if exposed to the sun.  To minimize this risk, use careful sun protection in the months following surgery.  If the area is not covered by clothing, be sure to wear sunscreen (spf>30 at least) and make sure the sunscreen is reapplied at least every 2 hours while the area is exposed to the sun.  The sunscreens containing zinc or titanium in the ingredients work best.

 
 
Taping a shoulder wound

General Dermatology Procedures

Excisions and Mohs Surgery

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skin-biopsy-stitches.webp
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Illustrations courtesy of the American Academy of Dermatology Association and Ethicon

Mohs Surgery > Wound Care