You now have a surgical wound that needs some care following your skin surgery procedure. The following advice will describe what you need to know and what to expect post operatively.

Some items for your information following your skin surgery that was carried out by your skin cancer doctor

• Leave your dressing on for the assigned number of days
• follow up appointment are scheduled, make sure you attend as instructed by your doctor
• Rest the area as much as possible – one of the sayings I like is that scars are like fractures, they heal best when they are still
• Signs of a problems are excessive pain, swelling, redness, bleeding
• Contact your treating doctor if you have any concerns

Dressings

Your dressing will cover your surgical site, it must remain in place for the first 48 hours post-surgery and please keep the site dry.

Discomfort

You may feel some discomfort after the anaesthetic has worn off. Taking paracetamol is recommended (if not allergic to it). Please do not take either Aspirin, or ibuprofen, as they will cause the wound to bleed.

Bleeding

Small amounts of clear fluid or blood may come through the wound dressing, this is quite normal but if it does not stop, apply firm pressure to the wound site for ten minutes to stop the bleeding. If bleeding continues, please contact your GP or after-hours service.

Signs of Infection

Post-surgery infection signs usually appear 48 hours after surgery.
Please contact your GP or after-hours service if you experience any of the following signs;

• Increased redness at the wound.
• Pain at the site, even after taking pain killers
• Heat and throbbing
• Leaking, oozing or bleeding
• Feel unwell or lethargy

Physical Activity

You must refrain from intense physical activity, this may require taking some days off work, depending on the physicality of your occupation. This will also depend on the type of surgery.

No swimming, full body bathing, running, contact sports, bending or straining, no lifting weights or heavy objects. Try to relax following your surgery and not do anything overly strenuous.

Bathing

You must keep the wound and dressing dry for 48 hours. After this time, you can carefully remove the dressing. You can then bathe as normal but not place the wound under direct running water of the shower. Daily bathing is acceptable but do not rub or actively wash the wound site, just rinse gently and pat dry first, before drying the rest of your body.

Removal of Wound Closure Material

Your stitches or surgical clips require removal by a health care professional. Depending on your wound closure material a follow-up appointment will be scheduled for removal. If you have Steri-strips applied they must remain in place until the stitches are removed.

Post-Surgery

After surgery your skin will need time to heal and this process is facilitated by several stages.

Your platelets will attend to the wound and form a blood clot, this stops bleeding, protects the wound from germs and infection. Your wound will be closed using sutures, staples or surgical glue.

Red blood cells and other protective cells attend the wound help it heal. White blood cells remove bacteria and other debris from the wound. All this increased metabolic activity may be experienced as heat, redness, pain and swelling – typically called inflammation. Inflammation is a normal phase of wound healing and should only last a few days after your surgery.

Your skin cells start repairing the wound twenty-four hours after surgery, your skin cells start to cover wound with new cells and repair is underway.

If a drain was placed, it will remain for several days to help remove fluid from the wound site.

The wound will be covered either with a bandage or a dressing to help protect the skin and help it to heal. Healing will continue underneath the wound for approximately three to seven days.

After fourteen days your skin will have regained up to half of its tensile strength and when it is fully healed it will only regain eighty percent tensile strength.

Surgical wound sites heal quickly when protected from infection and cared for appropriately.

Materials to Close the Wound
Before a dressing is placed to cover the wound, you will see the material the surgeon has used to close the wound margins and approximate the wound edges to support the incision site while it heals. Dissolvable stitches will be used by your surgeon to close the deeper layers of your skin, and either, sutures, staples, glue or tapes will be used in the top of your wound.

Sutures/Stiches

Dissolvable sutures; If your wound is closed with dissolvable sutures you don’t have to do anything as they will dissolve over time. They may be seen in your skin as plastic sutures but they will eventually just dissolve on their own without the need for removal.

Non-Dissolvable sutures; If your skin is closed with non-dissolvable sutures, dark threads will be visible on the incision line and require removal by a healthcare professional approximately two weeks after surgery.

Surgical Clips

Surgical clips, are visible on the surface of your skin as thin metal bars running along the incision line and removal should be done by a healthcare professional approximately ten days after surgery.

Glue/Skin Adhesive

If surgical glue is used to close your wound. Ensure you don’t soak the wound in water, avoid picking or rubbing at the site. After ten days wash the wound site to remove the surgical glue residue.

Tapes

Steristrips or surgical tapes are used to bring the wound edges together. It’s important to not get the tapes wet as they won’t hold on the skin. The tapes can be removed after seven days.

Removal of Wound Closure Material

Your stitches or surgical clips require removal by a health care professional. Depending on your wound closure material a follow-up appointment will be scheduled for removal. If you have Steri-strips applied they must remain in place until the stitches are removed.

Results

Please be aware it can take up to six weeks to receive your results, once received we will recall you for a clinical appointment to discuss your results or your results will be sent to you and your GP.

References:

Alam, M. (2019). Evidence-based procedural dermatology (2nd ed.). Springer.
HAYES, M. (2014). Practical skin cancer surgery. Elsevier Health Sciences.

Rosendahl, C. (2018, June). Course Textbook [Chapter 9]. The University of Queensland.

Usatine, R., Pfenninger, J. L., & Stulberg, D. L. (2011). Dermatologic and cosmetic procedures in office practice. Elsevier Health Sciences.