Post Operative Day
How Postoperative Wounds are Managed
Once it has been determined that your skin cancer has been completely removed, we will decide how best to manage your wound. In most instances, the wound will be repaired with stitches. Dr Collier’s goal is to leave the least visible scar. If the wound is especially large, it may require a skin graft or flap. Sometimes, the wound can be allowed to heal by itself, this is called “healing by granulation.” The decision will depend on the size and location of your wounds. If a repair is needed, this usually can be done the same day, or in special cases, the next day by a plastic surgeon.
If your wound is sutured, you will need daily bandage changes for a week to 10 days. If the wound is left to heal by itself, you will need daily bandage changes for three to six weeks. You will be given verbal and written instructions that describe how to change your bandages.
What to Expect After Surgery
Pain. Most patients do not have severe pain, but may experience slight discomfort. If this occurs, we suggest you take two tablets of Tylenol every six hours. Pain medications stronger than Tylenol will occasionally be needed.
Bleeding. Occasionally, bleeding follows surgery. If this happens, do not become alarmed. Lie down and place steady, firm pressure over the wound as close as possible to the bleeding area. Apply the pressure continuously for 20 minutes (timed). Do not lift the bandage to check on the bleeding. If bleeding persists after 20 minutes of steady pressure, apply pressure for an additional 20 minutes. If bleeding still continues, call our office, or go to the nearest hospital emergency room.
Swelling. Swelling is very common following surgery, particularly when it is performed near the eye. All wounds swell a little. Usually this is not a problem, and the swelling diminishes as the wound heals. Ice packs may help to reduce the swelling.
Drainage. All wounds will drain to some extent during the first week or two. This is why frequent dressing changes are necessary.
Infection. Infection of the wound is unusual. However, if you see thick, foul-smelling fluid coming from the wound, call our office immediately. An antibiotic may be necessary.
Redness. All wounds will develop a halo of redness, which disappears gradually. If the area becomes extremely red and itchy you may be allergic to either the ointment or tape. Call our office if this condition develops.
Scarring. All surgeries leave a scar, and we do our best to minimize the scar. However, with excellent wound care, your scar will improve and become less noticeable as time passes.
Stitches and skin grafts. If we close the wound with sutures (stitches) or place a skin graft, you should keep the area clean and bandaged until the next visit.
What to Expect After the Wound Has Healed
You may experience some tightness, or drawing, as the wound heals. This is normal and usually lessens with time. Patients also commonly experience some itching after their wounds have healed. Rubbing a small amount of plain petroleum jelly on the scar often relieves this. Frequently, tumors involve nerves, and it may take up to a year, or even two years, before normal feeling return to an area. Sometimes the area remains numb permanently. Only time will tell.
The scar tissue that grows over the wound contains many more blood vessels than the skin that was removed. This results in a red scar that may be sensitive to temperature changes. This sensitivity improves with time and the redness gradually fades. Sometimes, the scar is unacceptable to the patient and the patient’s family. If this is the case, surgical scar revision may be considered. However, we usually advise patients to wait 12 months before having the scar revision performed. This is because the scar continues to improve in appearance and becomes less conspicuous up to one year after surgery.