Information For Patients Undergoing Skin Surgery
The surgery will be performed in the out patient theatre at the Winterbourne Hospital or Harbour Hospital.
Preparation for surgery – The operation will be performed under a local anaesthetic. You can eat and drink as usual prior to the procedure. Please take all your usual medication including aspirin. It is preferable to have someone accompany you to the hospital as it is advisable that you do not drive immediately after the operation. It may not be possible to drive after surgery to the face, head and hands.
The procedure – Local anaesthetic will be injected into the site of surgery. This causes a stinging sensation lasting several seconds. The area then becomes numb and no discomfort should be felt. The lesion is excised and sent to the laboratory for pathological analysis. The wound is closed with stitches – both underneath the skin which will dissolve over several months and sometimes also on the skin surface. A dressing will be applied. If you have had a skin flap or graft performed the dressing may be quite large and bulky. You may be prescribed a course of antibiotic tablets to be taken after the surgery. It is important that we know if you have any antibiotic allergies.
Removal of stitches – This will be between 5 and 21 days after the procedure depending on the part of the body. This can either be done at The Harbour Hospital or by arrangement with the practice nurse at your GP surgery.
Skin biopsy analysis – This is performed by the pathologists. The result is usually available within 1 to 2 weeks.
Care for your surgical wound – Keep the area completely dry for 24 hours. At this stage the dressing can be removed. Using boiled water that has been allowed to cool, gently wash the area once a day using cotton wool or gauze and apply a thin smear of antibiotic ointment if this has been prescribed. If you prefer you can keep the wound covered with a simple dressing which should be changed daily. If the wound starts to bleed apply firm pressure for 15 minutes, this should stop the bleeding. Slight bleeding in the few hours after surgery is common and is aggravated by activity. Hot drinks or bending over at the waist can cause bleeding of face wounds. Swelling and bruising is common especially after facial surgery and can be lessened by use of an ice pack. Use extra pillows after facial surgery and elevate the leg after lower limb surgery.
Do not use make up near a wound until the surface has completely healed. Avoid swimming until the stitches are removed. The scar will be strong by 30 days – and is at its weakest the first few days after the stitches have been removed. Too much activity can put strain on the healing scar. This can lead to stretching of the scar or bursting of the wound. For surgery on the leg avoid any long walks for about a month.
Pain – When the local anaesthetic wears off after 2 to 3 hours, the area may be uncomfortable. Take paracetamol 2 tablets every 4 to 6 hours (a maximum of 8 tablets in 24 hours). Alcohol – do not drink any alcohol for 24 hours after the operation.
Smoking – Impairs the skin’s ability to heal. If you are able to stop smoking for 2 weeks before and after the operation the overall wound healing will be improved.
The scar – All skin surgery results in permanent scar formation. Scar tissue is red for 3 to 6 months and then usually fades to white The appearance of a scar usually improves over 12 months as it ‘matures’.
Aspirin – If you take a ‘mini aspirin’ daily continue to take it, but please inform us at the time of surgery.
Medical Conditions – If you have diabetes, epilepsy, a pacemaker, prosthetic heart valves or any other significant medical conditions then please let us know.
Warfarin – The INR ideally should be less than 3. Please get your INR checked 2 days before the procedure. Do not alter your warfarin dose unless this has been advised by the doctor prescribing the warfarin. Please bring your anticoagulation book to the operation.
Other blood thinners – Apixaban, Rivaroxaban and Clopidogrel. Continue to take as usual but please let us know you are taking this type of medication.