Wound care following minor surgery

Why was I given this leaflet?

Today you had a punch biopsy / curette and cautery / shave excision / excision.

The following information is a guide to caring for your surgical wound; however, your clinician may provide alternative advice at their discretion.

How can I care for my stitches when I am at home?

There are different options. We will help you understand which option suits you best. We will then select it for you from the list below:

1. You will need to have your …… sutures removed in …… days by your practice nurse at your GP surgery. We advise you to book this appointment as soon as you can to ensure that you are seen within the necessary timeframe.
2. There are no stitches to be removed
3. You may remove your dressing in …..days
4. If you have had a curettage and cautery procedure, the wound will look like a graze and does not require a dressing for more than 2-3 days, after which time it can be exposed. These wounds are slower to heal than wounds which require stitches, especially on the lower legs.

What should I expect in the first 48 hours?

Keep the dressing on for 48 hours after surgery, unless advised otherwise by the doctor or nursing staff.

If it is difficult to remove you may need to wet it, to allow it to come off more easily.

You can leave the area uncovered unless it is likely to get dirty or rubbed by clothing.

The first couple of days your wound may be tender and bleed slightly. There may be swelling and bruising around the wound, especially near the eyes.

How do I look after my wound in the first 48 hours and beyond?

You will need to keep the wound and dressing dry for 48 hours. After this time a shower can be taken but you should not hold the wound directly under the shower or soak it in the bath for a long time.

You may have been advised to remove the dressing after 48 hours, in which case, you should pat dry the area gently rather than rubbing it dry.

If you have been advised to keep the dressing on for a longer period of time, you should replace the splash-proof dressing if it gets wet.

Can I work, exercise and do other activities?

As far as possible try to relax and take it easy following the surgery. After simpler procedures this should be for a few hours, and after large procedures, a few days. 

 You may need some time off work depending on the type of surgery you have had and the type of work you do. The doctor or nurse will advise you accordingly at the time of your operation, but as a general rule 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.
• bending, straining or lifting heavy objects as theses may cause the wound to open and bleeding to start.

Are there any possible complications, side effects or risks that I need to be aware of?

Pain

After your surgery pain varies for each person and depends on what sort of operation you have had.  

A simple painkiller like paracetamol as per manufacturer details (if you are not allergic) should control any discomfort.  

Do not take aspirin or Ibuprofen unless you are already taking this for another condition, in which case you should continue to do as instructed.

Bleeding

It is normal for a small amount of blood to come through the dressing, but if it does not stop and the dressing becomes soaked, you should press firmly over the dressing for 15 minutes. 

Do not keep taking the pressure off to see what is happening.  

If still bleeding, apply an icepack for 15 minutes (frozen peas in a plastic bag are effective and avoid getting the dressing wet). In the case of a limb, elevate as much as possible. This will usually be enough to stop any bleeding. 

If bleeding continues or is not easily controlled, seek urgent medical advice by contacting GP or Dermatology or 111, if out of hours attend A&E.

Scar

Almost all procedures will leave a scar of some sort. The wound line will look dark pink at first and the edges reddened. The redness can take a few months to fade to a pink colour. 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 than the surrounding skin. Some people develop these lumpy raised scars whenever their skin is cut, others only in certain areas (chest, shoulder, back) and others never at all. Keloid scars are difficult to treat but may improve with the application of a topical steroid or injection.

Signs of infection

As with any surgical procedure there is a risk of infection.  

• The wound may feel increasingly sore, hot and may look red and inflamed
• There may be some crusting, discharge and an odour from the wound
• You may have a temperature, feel hot and sweaty, and generally unwell. 

If you experience any of these symptoms and are worried you may have an infection you should contact your GP surgery, Dermatology or call NHS 111 for further advice.

Other things I should be aware of

• You may feel a sharp pain from time to time as the wound heals.
• The area around the wound may be numb for many weeks.
• With dissolving stitches under the skin you may be able to see and feel 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.

How long will it take to receive my results?

All specimens are sent for histological evaluation to confirm the result. You will be contacted with these results, but this may take 4 to 8 weeks.

Your results may be discussed at a multi-disciplinary team (MDT) meeting and a follow up may be arranged.

Medical secretaries and receptionists do not give results.