Dermatology - Wound care following Mohs surgery

This information leaflet explains how to look after the wound

Pain relief

Normal sensation will return in 1-2 hours time.

Take pain relief e.g Paracetamol (as long as you are not taking any other medicines containing Paracetamol) 4-6 hourly if the area becomes uncomfortable.

Do not exceed eight 500mg tablets in 24 hours. Please avoid drugs such as aspirin (unless taking for a medical reason) or Ibuprofen as these tablets increase bleeding and bruising.

Bleeding

This is uncommon. If the wound should bleed do not disturb the dressing and just apply continuous pressure for at least 20 minutes.

If the bleeding persists please contact the Mohs team on 0161 206 1021/1024.

After 5pm and weekends please contact your GP or go to your local Emergency Department or Walk in Centre.

Wound infection

It is normal to have some redness, swelling and bruising at the wound site. This is part of the healing process. However, if you experience any of the following changes please contact the Mohs unit or arrange to see your GP as they may indicate an infection.

• Increasing redness
• Increasing swelling
• Increasing pain
• Fluid discharge

Care for sutured wound

Your wound has been closed with stitches.

Your wound has been covered with dressings and a pressure pad to help prevent bleeding. It is important to keep this in place for 48 hours unless otherwise advised.

Please keep the dressing dry to reduce the risk of infection.

• After 48 hours remove all the dressings carefully. If the dressing is stuck, soak with warm water
• Gently wash the wound with warm tap water and pat dry. Apply a smear of the prescribed antibiotic ointment
• There is no need to apply a fresh dressing unless the area catches on clothing
• Repeat morning and evening for one to two weeks

Skin graft

Some patients who have had a skin graft may have a bolster dressing sewn in place over the area. This should remain in place and completely dry until you have the sutures removed. Your nurse will advise you following your surgery.

Steri-strips

Patients who have had skin grafts may have steri-strips applied to the wound following suture removal. These will help to support the wound as it heals and ideally these will remain in place for 7 days. You can wash your wound gently taking care not to rub too hard when drying your face. Remove the Steri-strips after a week and follow the advice given by your nurse.

Care for secondary intention wounds

Your wound has been left to heal naturally.

Your wound has been covered with dressings and a pressure pad to help prevent bleeding. It is important to keep this in place for 48 hours unless otherwise advised. Please keep the dressing dry to reduce the risk of infection.

You may have been offered District Nurse support to help with your wound care. They will contact you within 2 days following surgery. If you haven’t heard from them within 48 hours contact the Mohs Surgery Unit.

If you have decided to care for the wound yourself please follow the following instructions.

• Remove all dressings carefully after 48 hours. If the dressing is stuck, soak with warm water
• Gently wash the wound with warm tap water and pat dry
• Apply a smear of the prescribed ointment Cover the wound with a sterile dressing. This can be an ordinary plaster or dressings you would normally use at home
• Repeat once daily unless otherwise instructed taking care not to allow the wound to crust/scab over

When you go home

• You may feel quite tired after surgery - we recommend that you rest and take things easy
• Avoid heavy lifting and vigorous exercise that might affect the wound area for least 3-4 weeks. Such activities can cause the scar to stretch and become unsightly or even for the wound to open up. If you have any concerns please contact us or your GP
• Please avoid smoking for at least 3-4 days after surgery, as smoking slows down the wound healing process
• Please try and avoid alcohol for 3-4 days after surgery, as this can make your wound bleed more

Follow-up appointment

Mohs Surgery Unit, Dermatology Outpatient Department

Date:

Appointment time:

Contact information Notes

If you have any queries or concerns regarding your wound or appointment please do not hesitate to contact the Mohs Unit on 0161 206 1021/1024.

There is a 24 hour answering machine, which is checked several times a day (Monday to Friday 8.30-5.30) or email mohsenquiries@nca.nhs.uk

Out of hours, please use the following:

Emergency GP services
Minor Injuries Unit