For the initial 24 hours (sometimes the doctor will advise you 48 hours), keep the wound dry.
The wound will be covered with a dressing at the completion of the operation, and you will be supplied with dressings to use until your sutures are removed.
In the first few hours, the wound may ooze a little amount of blood or fluid. If blood becomes visible through the dressing, then change the dressing.
After 24 hours, it is okay to get the wound wet in the shower. Remove the dressing first, have a shower. Don’t specifically wash or rub the wound. After the shower, pat the wound dry with a clean towel and apply another dressing.
Change the dressing daily until you are seen for your removal of sutures. For small wounds on the face or other areas where a dressing is a nuisance, and the area has a low risk of infection or abrasion, you can apply vaseline several times a day to the wound to maintain a seal.
If you get your dressing wet, remove it and replace it with a dry dressing. Wet dressings can trap water against the skin and cause the skin to become white and soggy. This ‘macerated’ skin can break down easily.
Wound infections
Wound infections occur in about 2% of skin cancer surgeries.
Signs are:
- pain out of keeping to what would be expected (i.e. mild discomfort which would not interfere with sleep, and which would get better day by day)
- redness or swelling of the wound, or pus visible in the wound.
Please take action as soon as you see or suspect infection – the earlier an infection is treated the less of a problem it may be.
If you have been given a prescription for antibiotics to commence (sometimes, if the doctor feels there is a higher than usual risk of infection), then start them. Make contact with the practice nurse to arrange to come in for review and for us to manage things as needed.
It is rare for people to become significantly unwell from a wound infection, the issue is that the wound won’t heal and sometimes the sutures need to be removed for the infection to clear, then the wound needs to heal by itself which can take a couple of weeks.
Suture removal and ongoing care
Sutures are usually removed one week after the surgery, by the practice nurse. An appointment for this is usually made at the time of the surgery. Larger wounds and wounds on the leg or back may need the sutures to be in for 10 and occasional 14 days, depending on how well and rapidly the wound heals.
For larger operations (excisions, rather than punch biopsies), ongoing care is needed.
A scar takes 3 months to gain its full strength and a scar is only ever 85% as strong as normal skin. Keeping the wound covered with a paper tape such as ‘micropore’ for 3 months can improve the healing and appearance of the scar, and reduce the risk of the scar widening through being stretched. The tape does not need to be changed daily, just when it becomes worn or dirty.
It is always hard to give prescriptive advice about what people can and can’t do. Certainly, for the week the sutures are in and the week following the removal of the sutures, a wound will have very little strength and be prone to rupturing if force is applied across the wound.
After that, it becomes a little bit of common sense – keeping the wound covered with micropore tape, and gently trying the activity and paying attention to how much tension there feels to be across the wound.