How do I take care of my wound site?
Simply leave your pressure dressing on intact and keep the wound site dry for the first 48 hours after your surgery. On day 3 post-op, you can wash the site with a mild soap such as Cetaphil™ or CeraVe™ Foaming Cleanser. Please remember to gently blot and not rub so as not to disrupt suture placement. Apply a thin coat of vaseline or Aquaphor™ ointment (avoid Neosporin™-due to the high risk of contact allergy). Repeat this process twice a day. If the incision is crusted or has dried blood on it, take 1 -2 tablespoons of hydrogen peroxide and dilute this in a 4 to 6 oz cup of distilled water. Store this mixture in the refrigerator and apply to the surgery site with a washcloth or gauze pads. This should help to dissolve the crusting. Following each peroxide soak, apply the ointment as directed. Feel free to contact us if you have any questions.
Where can I find steri-strips™?
We will apply your steri-strips™after your procedure. If you need to purchase more, they are available at most pharmacies or grocery stores.
What do I do if my steri-strips come off?
This often happens. Steri-strips are meant to stay on for a few days at most. At this point, you have two options. If the wound is not draining or red, simply leave the steri-strips off and apply your topical ointment as directed to your surgery site. If you want to continue to protect the area, then you can reapply the steri-strips over your incision site perpendicular to the incision. While the steri-strips are in place, you can place a thin coat of ointment over them. When the steri-strips begin to curl on their edges, you can remove them with or without dilute hydrogen peroxide (1 tablespoon of hydrogen peroxide in 4 ounces of distilled water). If we have used fast absorbable sutures on your incision, please do not remove the steri-strips for at least 7 days. When you do remove the strips, the sutures will also come off.
What do I do if I have a problem and can’t get through to the triage nurse?
We are sorry if our triage person does not call back right away. She is sometimes tied up with other patients or helping assist those with emergent needs. We do value your problem though and there are a few things you can do to get immediate attention if needed. The first step is to assess your situation. Is it life threatening? Can it wait? If you are having a true medical emergency, i.e., extensive bleeding, difficulty breathing, or if you are experiencing chest pain, then immediately dial 911 and proceed to the nearest emergency room.
What do I do if my wound site is bleeding and it won’t stop?
The key is to keep pressure and/or cold on your wound site. If your surgery is on an extremity, keep the affected limb elevated above your mid chest and place a pressure wrap directly over your surgery site. A small towel works well over the area like a tourniquet. Wrap the towel around the extremity firmly, but not too tight. If you develop numbness over the area, e.g. your limb has fallen asleep, then, this is a sign that the wrap is too tight. You can also utilize cold ice packs or frozen peas to reduce swelling. This is especially helpful for facial surgery. Place the cold compress gently over the surgery area for 10 to 15 minutes. Bleeding usually subsides within this time frame. If you feel faint, immediately lie on the floor with your legs elevated. If you have tried this and bleeding continues and/or is brisk, then call 911. For less urgent bleeding, e.g., mild oozing, please contact our office for further instructions. Continue to keep pressure on the area during this time until we get back to you. If you do not hear from us within a few minutes or if it is a weekend or after hours, please dial 911 or proceed to the nearest emergency room.
How soon before I can shower or bathe?
Not until after 48 hours. Simply take the bandage off, shower, and reapply your topical ointment. If the area is still oozing, place another pressure bandage over the surgical site. By days 3 to 4, you may no longer need a bandage, especially if the surgical site is dry and clean. Simply apply the topical ointment to your surgery site twice daily until we see you for suture removal in 7 to 14 days.
When is the best time of day to change my dressing?
Usually, the time of your morning shower or at bedtime are the best times to change your dressing. If your site is oozing or draining, you may repeat dressing changes as often as every 6 hours, however, once a day is usually what we normally recommend.
How long do my sutures stay in the skin?
This depends on a multitude of factors such as age, fragility of skin tissue, wound tension, location of the surgery and health risks such as diabetes. Normally, sutures stay in place for 7 days on the face and 10 to 14 days in other areas. If you are a quick healer, then we will sometimes remove them in 7 to 10 days. The use of fast absorbing sutures or tissue glue does not require a scheduled suture removal appointment.
The sutures look ready to come out. What should I do?
If you sutures are imbedded in the skin so that you cannot see the suture material or there appears to be a bump over where the stitch previously was, then you are probably correct… your sutures need to be removed or at least evaluated for early removal. Please contact us and we will work you in for an evaluation. Do not attempt to remove sutures on your own as you take on the risk of creating a secondary infection or a worse appearing scar.
What do I do if my surgery site is itching and red?
You may be having a reaction to your suture material, antibiotic ointment, or the adhesive tape. Initially, you can try a mild corticosteroid cream such as Cortaid™ 1% Cream (available at most pharmacies without a prescription) and apply this to the itching, red area twice daily. If your surgery area is warm, red and draining pus-like material, your wound site may be infected and needs to be evaluated at our office. Further instructions will be given to you upon inspection of your surgical site.
Will my procedure leave a scar? If so, how do I manage the scar?
Yes, all surgeries leave a scar. Some scars are more visible than others and, in our office, only 5% of cases require a scar revision procedure. Some surgical repairs take two sessions for this reason. Please let us know if you are prone to keloid scar formation or are on medications which can impair wound healing, i.e., chemotherapy, corticosteroids. All attempts will be made to conceal your scar. Makeup such as Jane Iredale™ is a great concealer. Post op massage of the wound site with plain petrolatum ointment once sutures have come out is also very helpful. Unfortunately, we can not always guarantee that you will have excellent results. This is because all surgeries carry with them inherent risks such as infection, wound separation, etc. We thank you for your understanding. If you are concerned about the way a scar is healing, please call us as soon as you notice something unusual. We would be happy to evaluate your wound site promptly and give you our recommendations.
How soon before I can resume normal activities? Should I take off work?
If your surgery is on the face, it is best to refrain from strenuous activities such as weightlifting, golf, jogging, or running for at least a week. We ask that you do not lift anything heavier than a remote control or your fork for the first 48 hours after your surgery. You may also need to take some time off work (2 to 10 days) depending on the extent of your surgery. Please make these arrangements in advance. Keep lower extremity wound sites wrapped (in an ACE™ wrap or Unna Boot™) and elevated as much as possible. If your surgery is on the back, scalp, or arms, again, avoid the weight-room, golf or heavy impact aerobics for at least 14 days.
I am feeling nauseated after taking my medications… What should I do?
This is a very common complaint especially when taking pain meds with codeine or other narcotics for the first time. As an initial approach, we ask that you try taking your pain medication with some ginger ale or crackers. If this does not work, trying halving the dose and see if your symptoms get better. Usually, your symptoms will improve after a few doses. If, after these maneuvers, you are still experiencing nausea, stop all prescription medications and call our office for direction. If severe enough, we will call in a prescription for you that treats nausea. As an aside, it is important that you inform our surgical team of any intolerance to prescription medications, local anesthetics, adhesive tapes, or suture materials prior to your procedure. In this way, we can prepare accordingly.
My surgery site is swelling… Should I be concerned?
This is often normal especially after the first 24 hours. If your surgery is on the face, i.e., nose, eye, ear, or forehead area(s), it is common to have swelling and bruising for 7 to 10 days. The impact of this can be lessened if you sleep with your head elevated and use intermittent cold compresses on your surgery site. Frozen peas and ice packs work well. If you are experiencing a severe headache, fever, chills, or bleeding, it is important to notify our office. Please contact us immediately and we will work you into our clinic schedule. If swelling is very severe, dial 911 and proceed to the nearest emergency room. Rest assured, most swelling issues resolve in short order.
What do I do if my surgery site opens up?
Do not panic. This can sometimes happen in high tension areas such as the back or leg and can occur when sitting, squatting or bending. We will need to assess the area to see if the wound will heal well on its own. Sometimes, however, the wound will need to be re-sutured. Of course, we see you immediately for any surgical concerns.
When should I start and stop my antibiotics?
Start your antibiotics 1 day before your procedure and take them daily until they are finished. (Do not start them 7 days before your procedure). They should be started 1 day prior to your procedure. Usually, antibiotics are prescribed for 7 days for facial surgeries and 10 to 14 days for other body areas.
Should I stop taking my aspirin or blood thinners?
First, off, if you take aspirin or blood thinners due to a previous heart attack or stroke, please do not stop your medications. If you are unsure, please check with your primary care doctor before stopping them. We can handle most bleeding issues so if comes down between risking another heart attack or stopping your aspirin because of a skin surgery, do not stop the aspirin or relevant blood thinner you are taking. If you are taking blood thinners electively (without a previous medical condition), and your doctor says it is “OK” to stop them, then we recommend that that they be discontinued beginning 14 days before your scheduled surgery. For a list of relevant blood thinners, please click here.
I need a refill on my medications. What should I do?
If you are requesting additional antibiotics or pain medication, please contact your pharmacy and they will fax over a medical request to our triage nurse. Our medical team will determine if more medication is necessary or if there is an alternative. If you require immediate assistance, please contact us directly.
How much time should I anticipate spending at the surgery appointment?
We recommend that you clear your entire day so that if there is a complication or you experience discomfort, you have the appropriate time set aside to deal with an unanticipated situation. Surgery is not an exact science and we believe that by setting the time aside, you will help to ensure the best outcome. Some surgeries require more time than others. This cannot always be predicted prior to scheduling. Every effort will be made to carry out your procedure in a timely fashion.
What should I bring to my surgery visit?
We recommend that you bring a book, magazine or headset (iPod/iPhone™) with you. Warm socks and a sweater are helpful, during winter months, because our office tends to be chilly. Juice, crackers, water, tea, and coffee are provided in case you get thirsty or hungry. If you are having surgery on your face, it would be wise to have someone drive you to and from your appointment so please make the appropriate accommodations ahead of time.
Will there be a facility charge at the time of my surgery?
Not normally. There is, however, a surgeon’s fee for your procedure. If you are having IV or general anesthesia, a fee from the anesthesia provider may also apply. We know that insurance coverage issues can sometimes be confusing and we are happy to help sort out any difficulties or questions which may arise. Feel free to contact our billing department if you have any questions.
How long before my pathology results are obtained and I hear from the office?
You can check for your results online using this websites EMR portal within a few days after having the test performed. Conversely, we will call you with your final results in 7 to 10 business days. If further treatment is needed, we will set up a surgical or follow up appointment. If you do not hear from us by two weeks after your biopsy or surgery, then we recommend that you contact us directly. Thank you.
What is our “no-show” policy?
If you fail to give us 48 hrs notice or do not show up for your surgical appointment , other than for a documented illness or other emergency, e.g., death in family, there will be an enforceable no show fee. Please refer to the cancellation policy that you signed for details.