Post-operative advice for patients who have had skin surgery

The following advice will help you to know what to expect after your skin surgery procedure. Please talk to the doctor or nurse if you have any other questions.

Will I have a dressing?

You will usually have a dressing, the size of which will be dependent on the type of surgery you have had. You will need to keep this in place for the first 48 hours after the surgery.

How long will the wound be painful for? What sort of pain?

You may feel some soreness after the anaesthetic has worn off. If this happens, you may take paracetamol (if you are not allergic to it). If you have been prescribed antibiotics, you should take them. They can be taken at the same time as paracetamol or codeine. If you are unsure, please ask the doctor or nurse.

What happens if my wound starts to bleed?

It is normal for a small amount of blood to come through the dressing, but if it does not stop and the dressing becomes saturated, you should press firmly over the dressing for fifteen minutes. This will usually be enough to stop any bleeding. If bleeding continues, you can try applying an ice pack to the bandaged area for fifteen minutes (a simple ice pack can be made by placing a bag of frozen peas into a dry plastic bag, to avoid wetting the bandage). If bleeding still continues, you should contact your GP, Accident & Emergency, or this department (see contact details at the end of this leaflet).

What about the risk of infection?

As with any surgical procedure there is a risk of infection. For skin surgery this risk is about one in 20.

Signs that your wound may have become infected usually begin 48 hours after surgery. You should seek help if you notice any of the following:

• You have increased redness around the wound.
• The wound becomes more painful even after taking painkillers.
• The wound and surrounding skin feels hot and starts to throb.
• The wound begins leaking, oozing or starting to bleed again.
• You have a raised temperature and feel generally unwell.

If you notice any of these signs and are worried that you may have an infection you should contact your GP immediately as you may need a course of antibiotics.

What about work, exercise and other activities?

You may need some time off work depending on the type of surgery you have had and the type of work you do. As far as possible, you should relax and take it easy following the surgery. After simpler procedures this should be for a few hours and after larger procedures for a few days; the doctor or nurse will advise you accordingly at the time of your operation. It is quite normal for you to feel tired after an operation. You should:

• avoid vigorous exercise such as swimming, running, contact sports or going to the gym until the stitches have been removed and the affected area has healed.
• avoid bending, straining or lifting heavy objects as these may cause the wound to open and bleeding to start.

When can I have a bath or shower?

You will need to keep the wound and dressing dry for 48 hours. After this you can take a bath or shower, but you should not hold the wound directly under the shower or soak it in the bath for a long time. After bathing, you should dry the area by patting it gently with a towel rather than rubbing it dry.

When can I remove the dressing?

You should keep the dressing on for 48 hours. After this time, carefully remove the dressing. If it is difficult to remove, you may need to wet it to allow it to come off more easily. You can leave the operation site uncovered, but if it is likely to get dirty or be rubbed by clothing you can apply a light dressing or plaster, which should be changed daily.

If you have steri-strips (adhesive paper strips) across the wound, please remove these after five days if your wound is on the face, or after 10 to 12 days if the wound is on the body or limbs. The steri-strips will begin to peel off gradually. If you have been given more, please reapply as your nurse advises. These can be left in place until your stitches are taken out.

Your wound may have been closed with dissolvable stitches. The time for these to dissolve can vary. Most will start to dissolve or fall out within a week or two. However, sometimes they need a little encouragement. If your wound is on the head, face or neck, gently massage the area when showering after five to seven days if the stitches are still in place. This will help them to dissolve. If your wound is on the body/ limbs please gently massage the area when showering after 12 to 14 days if the stitches are still in place.

When will the stitches be removed?

You have ………………………………………………………….. stitches.

If you have non-dissolvable stitches, these will need to be removed by the practice nurse at your GP surgery or Clinic 7 in …….. days (date for removal: ...... /...... /...... )

Will I have a scar?

Most surgical procedures leave a permanent scar. The stitch line will look red at first. The redness can take a number of months to fade to a pale pink colour. The stitches may look raised in the first week. The redness may take a few months to fade. You will have a permanent scar in this area – this usually fades to a pale line.

Some scars can become hypertrophic or keloid.

• Hypertrophic scars are raised but do not extend beyond the edges of the original wound.
• Keloid scars are raised, sometimes itchy, and keep growing even after the wound has healed. They can become pink, red, the same or darker in colour than the surrounding skin. Keloid scars can be difficult to treat but may improve with application of a steroid ointment, silicone gel-sheet or steroid injections.

What other things should I be aware of?

• In the first week your wound may feel tender, and may bleed slightly.
• Your wound may be swollen and bruised, especially if it is on the face or around the eyes. This should settle down as the wound heals.
• The area around the wound may be numb for a few months.
• You may feel a sharp pain from time to time as the wound heals.

All of the above are part of the normal healing process.

What happens to removed skin?

All skin specimens are sent to the laboratory for analysis.

When will I get my results?

You will either be given a clinic appointment to come and talk about the results, or one of the doctors may telephone or write to you and your GP to let you know the result. Please be aware that it may take up to six weeks before you receive the results.

Contacts/ Further information

If you require wound care advice please see your GP or practice nurse in the first instance. If you need further advice:

In an emergency

• Call the Emergency Department on 01223 217118

For routine enquiries

• Monday to Friday 08:30 to 16:00: Call 01223 596245. Leave a message including your name, date of birth, hospital number and a brief description of your concern. One of the nurses will call you back.
• Out of hours (weekends, bank holidays or at night): call your GP practice or out of hours GP.