Surgery Postoperative Instructions

Following any surgery, including Mohs, you can expect:

• Bruising on or around surgical site
• Moderate swelling
• Mild to moderate pain

For surgery on the scalp, forehead, temple, eye and nose areas: Bruising and swelling around the eyes is normal and usually lasts for several days.

For surgery to the arm, hand, leg and foot areas: Swelling on the hands and feet is also normal. Keeping the area elevated and using an arm sling or keeping sites on the arms, hands feet or legs wrapped with an ace wrap will help control the swelling.

Call 205-977-9876 if you experience any of these symptoms:

• Constant fever above 101 degrees F.
• Intense pain near surgical site
• Increased swelling, redness or uncontrolled bleeding

If bleeding occurs from the surgery site:

• Apply firm, direct pressure with a clean cloth for 20 minutes on the clock. Do not release pressure to look at bleeding status during this time. If bleeding continues after 20 minutes, apply pressure again for 20 additional minutes.
• If the bleeding persists, continue the pressure & call our office at 205-977- 9876 for further instructions.
• If bleeding stops, you may add additional gauze over the bandage or change the saturated top pressure dressing, securing bandage in place with tape.

For the first three days after surgery:

• Elevate surgical site (head, neck, arm, leg) on two pillows when lying or sitting. Elevate limb above the level of the heart.
• Do not bend over, reach or stretch or lift greater than 10 pounds (a full gallon of milk).
• Avoid alcohol, aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs for pain unless directed to do so by a physician.
• Continue to take your normal medicines, including blood thinners, as prescribed.
• Tylenol (Acetaminophen) is okay to take, or you may take the prescription pain medication given to you by our physician. However, DO NOT take Tylenol with the pain medication, as this can be damaging to the liver and kidneys and/or possibly lead to an overdose.
• NO aerobic exercise for 7 to 14 days, including brisk walking, gardening, etc. This type of activity can put your sutures under stress and interfere with healing and cause bleeding.
• If your surgery was on the head, use a cold pack around areas of swelling (such as eyes) for 20 minutes, every 2 to 3 hours you’re awake. Activate pack as directed on package and apply to areas of swelling prior to placing it in the REFRIGERATOR the first time. Do not put cold pack in the freezer. Do not place the ice pack directly on the skin.
• Do not submerge the wound in a bathtub, hot tub or pool while you have sutures.

Leave the entire bandage in place and dry. Remove the top pressure dressing on (circle one):

Monday          Tuesday          Wednesday          Thursday          Friday          Saturday         Sunday

Your Steri-Strips may stay in place after you remove your top pressure bandage. Do not forcibly remove them, but allow them to come off as you soak your incision each day. Any areas not covered by the Steri-Strips should have Polysporin — or Bactroban or Centany (mupirocin) if allergic to Polysporin — applied with a Q-tip and covered with a small, nonstick bandage.

Perform wound care 1-2 times a day until the incision is completely healed without scabbing or drainage,  typically seven to 14 days or until instructed to stop by your surgeon.

NOTE: Occasionally, the skin will react to extended use of antibiotic ointment. If you see a slight rash or redness starting on or around the incision, stop using Polysporin and change to clean uncontaminated Vaseline.

Apply Polysporin — or Bactroban or Centany (mupirocin) if allergic to Polysporin — to incision with a Q-tip and cover with a small nonstick bandage. Avoid placing tape or adhesive directly over incision. Do not let the area dry out or form a scab, as it can slow healing.

Perform wound care 1-2 times a day until the incision is completely healed without scabbing or drainage – typically seven to 14 days or until instructed to stop by your surgeon.

NOTE: Occasionally, the skin will react to extended use of antibiotic ointment. If you see a slight rash or redness starting on or around the incision, stop using Polysporin and change to clean, uncontaminated Vaseline.

Apply a new 2nd Skin bandage: Cut to size (just slightly larger than your wound), peel off blue film backing (leaving the clear film side in place), and apply to wound sticky side down. Secure in place with paper tape. If there is any drainage, you may add an additional layer of gauze to absorb the drainage. Avoid placing tape or adhesive directly over incision.

Do not let the area dry out or form a scab, as it can slow healing.

Perform wound care 1-2 times a day until the area is completely healed without any scabbing or drainage– typically seven to 14 days or until instructed to stop by your surgeon.

Do not expose the skin to the sun until it is completely healed. After complete healing, it will be able to tolerate sunscreens. We recommend products containing zinc oxide or titanium dioxide.

Mild to moderate redness is expected for 10 to 14 days after the procedure and will fade gradually over a 4- to 6-week period.

Once the wound is healed, follow these general skin care recommendations going forward:

• Use sunscreen every two hours while outside and other preventive care measures, such as sun-protective clothing.
• Dermatologist-recommended products are available at our online shop.
• For example, nicotinamide (vitamin B3) studies indicate decreases of up to 25% in some types of skin cancer when taking this supplement. Heliocare Advanced (a combination of the herbal antioxidant polypodium and vitamin B3) is available at our online shop.
• Continue regular follow-ups with your dermatologist for skin exams every three to six months.

Please call our office with any problems or questions.

• Call 205-977-9876 during business hours (Monday-Friday 8 a.m. to 5 p.m.)
• Call 205-977-9876, option 5, after hours and on weekends.