Looking after your wound following skin surgery Exceptional healthcare, personally delivered
Introduction You have just undergone an operation, under local anaesthetic, for the removal of a skin lesion. The following guidelines are to help you look after your wound according to the type of surgery you have received. if you have any questions, please ask a nurse. Date of operation. Curettage and Cautery. You have been treated, using a scraping technique called curettage. After curettage, the raw area has been treated with Cautery (heat), electrodessication (electric current only) or a chemical to stop the bleeding. There are no stitches because this treatment is designed to allow healing with minimal scarring. The wound will be a black area like a deep graze, which may take two to three weeks to heal. Once healed the scar may be red and slightly raised. After several months it should settle to a more flesh coloured, flat scar. Once the local anaesthetic has worn off, you may need to take a simple pain relieving drug. Leave the dressing that has been applied in place for 24 hours, unless you have been advised otherwise. Remove the dressing and wash the area under the shower, soak it or pour warm water over it. This will help to remove any loose debris under which infection can occur. Pat the area dry with a seperate clean towel or tissue and cover with a thin smear of vaseline or an ointment that the Doctor has given you. A dry dressing may be applied, but it is not essential. Use a breathable, not waterproof, type of dressing. Repeat every 24 hours until the wound has healed. Do not apply makeup until the wound has healed. 2 Looking after your wound following skin surgery
Shave Excision A shave excision involves shaving the skin lesion off. It will leave a small wound, which may take 1-2 weeks to heal over. Once healed, the scar may be red and slightly raised. After several months, it should settle to a more flesh coloured, flat scar. Because the technique only removes the part of the legion that protrudes above the skin, the appearance may remain abnormal. Wound care following surgery, if the wound continues to ooze or bleed, press firmly on the area for 20 minutes with a clean dressing and the bleeding should stop. If the bleeding continues contact your GP or Accident and Emergency Department Please follow instructions above for Curettage and Cautery Incision/Biopsy Your rash or skin lesion has had a small piece removed (an incisional or punch biopsy) to help reach a diagnosis.. Excision/Biopsy Your skin lesion has been completely removed. If you have stitches, please book an appointment with your GP surgery as soon as possible to have them removed on a recommended date. You have.stitch(es) to stay in place for days Avoid bumping or stretching the wound after the stitches have been removed, the area will be weak for some time. The initial dressing should be left in place for 24-48 hours, unless you have been advised otherwise. Looking after your wound following skin surgery 3
(If a pressure dressing has also been applied, this should be carefully removed after 24 hours, unless advised otherwise, taking care not to disturb the dressing underneath) You should then wash the area under the shower, soak it, or pour warm water over it. This will then help to remove any loose debris under which infection can occur. A cotton bud may be used to gently remove adherent crust. Use mild shampoo to clean the scalp Pat the area dry and cover with a thin smear of fresh Vaseline or an ointment that the doctor has given you. A dry dressing may be applied, but it is not essential. Do not apply make up over the wound until it has healed. REMEMBER: If the wound is painful after the anaesthetic has worn off, you can take a mild painkiller. If the wound continues to ooze or bleed, press firmly on the area for 20 minutes with a clean dressing and the bleeding should stop. Do not dab or keep looking at the wound. If on the leg, raise the limb. If the bleeding continues, contact your GP or accident and emergency department. DO: If the wound is on the face, use extra pillows to sleep more upright, which helps clear swelling and bruising. Change a dressing if it gets wet or dirty. A wet dressing will promote infection. If the wound is on your leg, keep your leg up whenever possible and avoid prolonged periods of standing, long walks, or sports until the scab has come off leaving a healed wound. 4 Looking after your wound following skin surgery
If you are given tubigrip it must be taken off at night because it can cause swelling. Reapply tubigrip the next morning. DON T: Undertake too much activity or dirty work too soon. An infected or stretched wound will take longer to heal and may give you a larger scar. If the wound is on the face, don t stoop or strain (including on the toilet) whilst it is still tender. If the wound takes more than three weeks to heal, becomes increasingly red and tender or leaks pus, contact your GP or Practice nurse. You will be contacted about any further appointment References and Further Information NHS Constitution. Information on your rights and responsibilities. Available at www.nhs.uk/aboutnhs/ constitution [Last Accessed March 2010] Looking after your wound following skin surgery 5
How to contact us: www.nbt.nhs.uk/dermatology H If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice. North Bristol NHS Trust. First Published February 2011 NBT002436