Wound care after surgery
When you’re back home after Mohs, it’s important to make sure your surgical site doesn’t get infected. Below are simple steps you can take to heal your wound. Note: our Answering Service is available for calls after hours and over the weekend. Please call the office at 402.484.9009 and follow prompts.
General wound care
Take it easy!
- No exercising, lifting, bending, stretching, or straining for 48 hours.
- Do not exercise heavily or lift over 10lbs until after the sutures are removed. If the surgery site is on an arm or leg, this restriction might be extended. Ask your provider.
To decrease swelling...
- If your surgical site is on your face, we recommend sleeping with your head elevated by a couple of pillows for the first few nights to decrease swelling. Do not be alarmed if you experience a black eye or eyelid swelling. Eyelid swelling usually peaks at 48-72 hours. Using an ice pack (or frozen vegetables) over the dressing for the first 24 hours is helpful to decrease swelling. Apply for 5-10 minutes on every hour until you go to bed.
- Take Extra Strength Tylenol® (acetaminophen 500mg) every 4-6 hours. Do not take more than 6 pills in 24 hours. Depending on location and size of surgical site, a stronger medication might be prescribed. If given Tylenol with Codeine you should not take any extra over-the-counter Tylenol or drive while taking this medication. After 24 hours you may take ibuprofen.
If you bleed...
- Do not be surprised if you see a small amount of blood-tinged drainage. If your dressing becomes saturated with bright red blood then remove the dressing. Use clean gauze to apply gentle but firm pressure for 10 minutes (check a clock). If the bleeding hasn’t stopped, apply pressure for another 10 minutes. Once the bleeding stops, clean and redress the surgical site as directed previously.
Cleaning + dressing Surgical site
- Keep our bandage on for 24 or 48 hours, the site should not be exposed to water during this period.
- Wash your hands before you remove and change your dressings.
- Use plain water and mild soap to gently wash the area. You can gently remove any dried blood with a Q-tip® or clean gauze.
- After our bandage is removed, you may get your wound wet in the shower. Do not soak your wound and do not allow direct water pressure to hit the wound. It is ok for soap lather and water to run over the wound. Pat the area dry.
- After cleaning, apply a coat of Vaseline® or Aquaphor® onto a new bandage (Band-Aid or non-stick gauze and paper tape). The bandage only has to be large enough to cover the stitches.
- Repeat the above steps daily until the sutures are removed.
- In the instance you have dissolving sutures on the top layer, repeat the steps above for 7 days after surgery. Do not use rubbing alcohol or hydrogen peroxide on the surgical site unless directed. After one week, if sutures or knots remain you may use an alcohol swab to help dissolve them.
When to call a doctor
- If you have bright red bleeding from your wound that does not stop after applying pressure for 20 minutes, please call the office.
- If you have any concerns for infection (increased drainage from the wound, increased pain, redness that is spreading). Infection usually occurs 5 days after surgery.
- If you have a large, swollen, tender, purple area around the surgery site (hematoma).
Send us a photo of your surgical site/wound for review via email@example.com. Note: this method is not HIPAA compliant
Please call our office and let us know you sent photos. The physician will be notified and will review. A staff member from the surgical team will then contact you.
Scars after surgery
Scars are inevitable when the skin barrier has been breached, such as with an excision of a tumor, sample of a suspicious lesion, or biopsy of a rash. Everyone scars differently and the long-term appearance of a scar often cannot be predicted. Scar outcomes can differ depending on location of the procedure, skin type of the patient, and if the healing process is eventful (infection, bleeding, opening of the wound). The appearance of a scar changes over the first year and sometimes over many years.
General Scar care
- Once the wound has healed, you do not need to do anything special to clean it.
- Sun protection – scars can darken irregularly in the sun or become red. We recommend using SPF 30 sunscreen or greater on your scar daily.
- Massage – After the stitches are removed, you can massage your scar twice a day for 5 minutes to try to improve or prevent thickening of the scar.
- Makeup – Once the stitches are removed and the area has healed over, you can apply makeup.
Additional Scar treatments
Sometimes additional treatments are needed to help address the appearance of a scar. If you have any concerns about the appearance of your scar, please come see us so that we can discuss treatment options with you. If you are concerned about your scar, a simple thing that you can do is use topical silicone.
Silicone has been shown to improve scar redness, texture, and appearance. This can be used in a gel or a sheet. Silicone should be used for at least 12 weeks to see results. Silicone sheets are often used on the trunk or extremities and silicone gels are often used on the face.
Silagen 100% silicone scar sheets and gel are available for purchase from Sutton Dermatology or available for purchase at Walgreens:
How long will the redness last?
Redness can last anywhere from 2 weeks to 4 months. If after a few weeks/month if the redness still remains, please return to the clinic for evaluation.
Will the bumpiness go down?
Over time bumpiness will diminish. If it persists, please return to the clinic for evaluation.
Can I massage the site?
Yes, you can massage the site several times a day. Scar massage helps the scar lay flat and soften/mobilizes the scar tissue. Scar massage is gentle pressure in a circular pattern direction over the scar. You can use Vaseline to assist with scar massage.
Do I need to put anything else on it?
Once the scar has healed over (no crusts or open areas) you do not need to apply anything special besides daily sunscreen. If you would like to apply a topical to improve scar appearance, we recommend silicone-based scar products such as Silagen Silicone scar gel.
Should I watch for anything?
Once the stitches are removed and the wound has healed over, the risk of infection and bleeding go down.
Scars never fully regain the strength of normal skin. This means even after the stitches are removed, the scar is still weaker than normal skin and can spread or open. Because of this we recommend avoiding activities that increase the tension on the scar for a few weeks/months after the procedure.
When can I start using scar creams/sheets? How long should I use them for?
You can start using scar creams once the stitches have been removed and the scar has healed over completely. Best results are seen after 12 weeks of consistent use of a silicone sheet or silicone gel. Most gels require twice daily application. A little bit of the silicone gel goes a long way. A pinhead amount covers a 1 inch scar.
Schedule your Appointment
Ready to schedule an appointment with our team of aesthetic experts? Call our office at 402.484.9009 or fill out our Contact Us form and we would be happy to get you scheduled.