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Advice following Dermatology Skin Excision

The surgery you have had today involves cutting into the skin – an excision. Wounds require time to begin to heal and to stop bleeding. Please follow these instructions to help avoid complications.

The first 24-48 hours after surgery:

  • If there is a plaster leave it in place and keep it dry.  If it comes loose please re-tape it.  If there is an additional ‘pressure bandage’ this can usually be removed within  48 hours.
  • There may be signs of bleeding on the bandage this is normal.  If the bleeding continues please:
  • In the case of a limb, elevate it as much as possible.
  • Apply firm pressure with a gauze swab over the wound for 15 minutes.  If still bleeding apply an ice-pack for 15 minutes to the bandage (frozen peas in a plastic bag are affective and avoid wetting the bandage)

If bleeding still continues either:

  • Call the Dermatology Secretaries during office hours (9-5pm)  – 0203 315 4007.
  • Ask your own GP or Nurse for advice
  • Attend the nearest Accident & Emergency or Minor Injuries Treatment Unit.

Post -operative pain is usually mild.  You may take Paracetamol and  avoid Aspirin (unless you are already  taking it) as this may promote bleeding.

48 hours after surgery:

  • Carefully remove the plaster. If it is very sticky try soaking it in the shower.
  • Pulling the plaster off may start bleeding.
  • After the plaster is off you may gently clean the area but avoid scrubbing or powerful shower jets.
  • If there are steri-strips across the wound do not remove them let them fall off , when you start getting the area  wet the steri-strips will fall off.  A non-stick plaster can be used to protect the wound ensuring that it is large enough not to stick to the wound.

 Steri-strips and other special dressing:

  • If your incision is in a place where it might stretch as it heals you will be advised to apply steri-strips across the wound.  These adhesive strips are designed to take the tension away from the wound.  As they become loose they need to be replaced.  For best wound care the strips must be used for about two months after surgery.  It is during this time that the skin is most likely to stretch and leave a large, red scar instead of a fine line.  The strips need to be applied to dry skin.  Supplies can be purchased from your chemist.
  • Keloid Scars:  Some people develop these lumpy raised scars whenever their skin is cut, others only in certain areas (eg.  Chest and shoulder ) and others never at all.  If you have had keloid scars in the past you  can minimise the recurrence by applying a silicone dressing.  This can be purchased from a chemist and continued for  4 months.

What is normal:

  • The first couple of days your wound may be tender and may bleed slightly when you clean it.
  • There may be swelling and bruising around the wound, especially if near the eyes.
  • The area around the wound may be numb for many months.
  • You may experience episodic sharp pains as the wound heals.
  • The scar will look dark pink at first and the edges reddened.  This will change and blend in with your skin in months to years.
  • With dissolving stitches under the skin you may be able to see and feel small bumps under the wound for several months where the knots are located.  These will gradually go.  If a bump forms a small blister see your practice nurse – they should be able to remove the stitch remnant.

 Seek medical help if:

  • You have bleeding which will not stop after applying pressure and ice.
  • You have excessive (or increasing) pain.
  • You have signs of an infection such as a raised temperature, redness, swelling or a foul-smelling discharge from the wound.

Wound Surveillance: 

We like to be kept informed if you have problems with your wound

In office hours please phone the Dermatology Secretaries on 0203 315 4007. Otherwise speak to your GP/Practice Nurse or attend the nearest A&E or Minor Injuries Treatment unit.

Follow up:  You will be informed about any necessary follow-up by either a telephone call or by letter if you do not already have an appointment.

Please note that we do not routinely give results over the telephone.

 

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