Aftercare: Surgical Care

THE  SKIN CENTER:   PRE & AFTERCARE INSTRUCTIONS:                           www.aderm.us   

 

PRE-CARE (reduce staph & skin infections)                                                  TSCFRM  revised 1/28/11, 12-24-06

1.      CLEANSE*: Wash your body with Hibiclens cleanser starting 2 days before your procedure appointment. Do not get in eyes or mouth.

2.      NOSE*: Neosporin twice daily to your nostrils for 2 days before for face biopsies & all surgeries

3.      For all surgeries, ask about antibiotic prevention:

Keflex take 2 capsules 1 hour before surgery, 2 capsules 6 hours after surgery, and 2 capsules the next AM.

Cipro take 1 caplet  hour before surgery, 1 @6 hours after surgery, and 1 @ the next AM.

Doxycycline or Adoxa take 1 pill 1  hour before surgery, 1 @6 hours after surgery, and 1 @ the next AM.

BIOPSY1. Please keep area bandaged, clean & dry until tomorrow AM.  You may shower tomorrow.

 2.CLEANSE*: After the Band-Aid is removed, clean the site 1-2 times a day with hydrogen peroxide, Hibiclens,  or soap and water.

 3.MOISTEN*: Apply Vaseline or an antibiotic cream like Neosporin 2-4 times daily, after each cleaning.

4.FOLLOW UP*: 2 weeks for wound check and  test results with doctor.

FREEZING /BURNING OFF”

Shower, bathe & use your normal make-up to the treated areas.   Often the treated areas look WORSE before getting better ( blister, scab, turn pink/dark).   Blisters may develop, some may be blood blisters.  If these are very uncomfortable you may take a small needle (cleaned with alcohol) and puncture the blister. 

*Cleanse, Moisten, and follow up as above.

 SURGERY: (STITCHES)

1.      Keep site dry for 24 hours. Remove bulky dressing after 24 hours.  You may shower tomorrow.  

2.      Leave butterfly tape strips (called steri- strips) on skin. No other wound care is needed while butterfly tapes are intact. If butterflies fall off before your next appointment, you may start to cleanse* and moisten the area as above.

3. RETURN FOR WOUND CHECK & SUTURE REMOVAL in average 11-14 DAYS.      

BLEEDING: Reduce bleeding & swelling risks by limiting activities for 24-48 hours.  If bleeding occurs, apply firm & constant pressure over the bandage for 10-15 minutes without peeking.  For face, consider applying ice bag or frozen peas, for 5-10 minutes 4-6 times daily. May also sleep elevated on several pillows.  

INFECTION: Minimize infection risks by avoiding oceans, pools, or Jacuzzis for 2 weeks. Minimize scars and stretching by limiting your activity:  NO heavy lifting, straining, stretching, exercise for 2 wks.

SCARS: For best results, please keep scars protected from sunlight for 6 months. Surgical scars continue to mature and improve for average of  3-9 months. Keloid or red/ thick scars can be treated with cortisone injections. Poor aftercare or improper activity precautions may result in adverse effects and poor wound scars.

*****Please note feet and lower legs are always much, much slower to heal, often taking 4-8 weeks.

 **Please call & Return to office if any of these symptoms occur: (949) 582-7699**

1. Bleeding that does not stop after firm constant pressure.

2. Signs of infection such as increasing redness, pain, red streaks, swelling, heat, tenderness, or yellow pus.  If cant get into office right away, go to urgent care or the emergency room.

 

 
















THE  SKIN CENTER WOUND CARE INSTRUCTIONS:

BIOPSY CARE:                                                                                                               TSCFRM  revised 12-24-06

1.       Please keep area bandaged, clean and dry until the next morning.  You may shower the next morning.

2.       After the Band-Aid is removed, clean the wound once or twice a day with hydrogen peroxide

or soap and water.

3.       Apply a thin layer of antibiotic ointment ( Neosporin, Polysporin, or Bacitracin) or Aquaphor healing ointment after each cleaning.  Moist wounds generally heal quicker.

4.       If the area is in an easily irritated area (waist) apply a new band aid.  Otherwise, can leave open

but moist with antibiotic ointment.

5.       Avoid swimming pools/hot tubs/ Jacuzzis until wound has healed. Otherwise cleanse immediately                          after getting out of the water.

6.       Keep scar protected form sunlight. Use sunscreen and/or a band aid after the area has healed.

7.       If your wound becomes red, hot, swollen, more painful, or has red streaks, these may be signs of infection. Please call our office and return for a wound check.

LIQUID NITROGEN( FREEZING OR BURNING OFF)

1.       You may shower, bathe and use your normal make-up to the treated areas.  Ok to wash areas.

2.       Often the treated areas look WORSE before getting better ( blister, scab, turn pink/dark).

3.       Blisters may develop, some may be blood blisters.  If these are very uncomfortable you may

take a small needle (cleaned with alcohol) and puncture the blister.  It is best not to remove the

skin as it acts like a band aid.

4.       If the area is dry or scabbed, you may apply a thin layer of Aquaphor or antibiotic ointment (Neosporin, Polysporin, or Bacitracin) 2-3  times  a day since moist wounds tend to heal better.

 

 

 

C & D   also called “ scrape and burn” of skin cancers ( ELECTRODESSICATION)

1.       Keep the area bandaged, clean and dry until the next morning.  You may shower the next morning.

2.       After the bandage is removed, clean the area twice a day with hydrogen peroxide, making sure to remove any crusting and apply a thick layer of antibiotic ointment and put on a fresh band aid.  These wounds heal faster with a moist dressing.

3.       These wounds can take up to a month to heal and do not be surprised to see it go through several

cycles of crusting and redness before they heal over.

4.       At about 1-2 months after the procedure the area may start to become thick, itchy, or painful.  This is

not return of cancer but is the formation of a hypertrophic or thick scar.  The symptoms are

easily treated with a cortisone injection in the office. Please call to schedule a visit to treat this.

SURGICAL CARE:

1.       Please keep the large  bulky  dressing on for 24 hours without removing.  Keep dry for 24 hours. You may shower after the first 24 hours.  Please avoid baths, Jacuzzis or swimming until suture removal.

2.       Remove the large outer dressing after 24 hours. Do not remove any butterfly strips ( called steri- strips), they will fall off on their own.  These butterfly tapes usually stay on  until suture removal. If they fall off earlier, you may start cleaning the area twice a day with hydrogen peroxide and apply a thin layer of antibiotic ointment and a light gauze dressing.

3.       Please help to minimize bleeding by limiting activities for the first 24 hours.  If bleeding occurs, apply firm constant pressure on the  bandage for 10-15 minutes. That will usually stop minor bleeding.

4.       For facial surgeries, minimize swelling of the area by applying ice bags for ten minutes to the area several times a day and by sleeping on several pillows.

5.       Minimize infection by avoiding any ocean water, pool or Jacuzzi water until suture removal.

6.       Minimize scar formation and stretching by limiting your activity:  NO heavy lifting, straining, stretching, exercise in the area of the surgery for a minimum of two weeks.

7.     RETURN FOR SUTURE REMOVAL in # ______ DAYS. Average  5-7 days for face, 11-14 days for chest, back, arms and 14-18 days for feet and legs.

SCARS:

For best results, please keep scars protected from sunlight for 6 months. We offer in office laser scar treatment. Laser is best when started at 3-4 weeks after surgery. Mederma scar treatment cream is also available in our office . Surgical scars continue to mature and improve for at least 3-9 months. Keloid or red/ thick scars can be treated with cortisone injections. Poor aftercare or improper activity precautions may result in adverse effects and poor wound scars.

Please note feet and lower legs are always much, much slower to heal, often taking 4-8 weeks.

 

Please call our office if any of these symptoms occur: (949) 582-7699

1.      Bleeding that does not stop after firm constant pressure of 20 minutes.

2.      Any signs of infection such as increasing redness and pain, red streaks,  increasing swelling and heat, increasing tenderness, yellow or white pus drainage from the wound.