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HF 4230

Caring for Perineal Wounds: Mohs Surgery Clinic

This handout tells you how to care for your wound once you are home. We will go over the handout with you before you leave. If you have any questions or concerns after you are home, please call the phone number at the end of this handout.

Wound Care

Your wound may be packed with a material called Gelfoam®. This helps to stop bleeding. Do not try to remove it. It will slowly wash out on its own when cleaning your wound.

Supplies 

  • Peri-bottle (single nozzle squirt-type)

  • Peri-pads (such as Kotex®)

  • Bar or liquid soap 

  • A “donut” for sitting (if needed)

In the First 24 Hours 

  • Gently squirt lukewarm water from a peri-bottle after each time you go to the bathroom. 

  • Squirt from front to back, rinsing the perineum well. 

  • Gently pat dry using a clean cloth or toilet paper. 

  • Use a clean peri-pad to absorb drainage. 

  • Change your peri-pad at least every 4 hours.

After 24 Hours 

  • Begin your sitz baths. Fill the bathtub with lukewarm water (many inches high) and soak for 15 to 20 minutes. 

  • If you have pain or pressure, sit on a folded towel or use a “donut.” The warm water will cleanse and soothe the wound area. 

  • Use a mild soap and gently lather, rinsing well. You may notice the Gelfoam® (which may be brown-black in color) will rinse away. 

  • After you have patted dry, keep using the peri-pad to absorb drainage and protect the wound. 

  • Do your sitz baths 3 to 4 times daily or as often as you can handle it.

Bleeding

Avoid alcohol, ibuprofen, naproxen, aspirin, or medicines that contain aspirin while your wound is healing unless your doctor approves. These may increase the chance of bleeding. 

If you have bright red bleeding that is soaking a pad every 10-15 minutes, call the clinic where you were seen or go to your local emergency room. Some drainage is normal. Drainage will decrease as your wound heals.

Tips to Prevent Bleeding

  • For the first few days, prop your hips and legs up on pillows as much as you can.

  • Avoid straining during bowel movements.

  • Avoid heavy lifting. Do not lift more than 5 pounds for the first week, then as directed by your provider.

  • Avoid tight clothing that will cause rubbing around the wound.

  • Avoid sexual activity until the site is well healed, and there is no crust, drainage, or pain at the site.

Pain Control 

Unless your doctor tells you otherwise, you may take both Tylenol® or ibuprofen to help control your pain. We suggest:

  • Tylenol® 1000mg every 6-8 hours

  • Ibuprofen 600mg every 6 hours

You may take them together every 6-8 hours, or alternate taking one type alone and then the other type 4-6 hours later. Repeat this pattern, every 4-6 hours.

Limit use of over the counter Tylenol® (acetaminophen) if you are given a prescription that contains acetaminophen.

If prescribed a narcotic pain medicine, please do not drink or drive while taking this medicine. Take narcotics with food to prevent nausea/vomiting. Narcotics may also cause constipation. You may use over the counter stool softeners as needed. 

If you have a sudden increase in pain that is not helped by pain medicines and ice compresses, please call the clinic where you were seen. You may have bleeding under your skin and need treatment.

Drink plenty of fluids to reduce stinging when urine passes. Eat plenty of fiber to keep bowel movements normal. Take a stool softener if needed. 

Activities

  • Avoid heavy activities for the first 2 days or as told by your doctor. 

  • Do not lift any objects more than 5 pounds for at least the first week. 

  • No sexual activity until there is no crust, drainage, or pain at the site.

  • No swimming or hot tub use until. There is no crust, drainage or discomfort at the site.

Infection

Infection is not common when the wound is cared for. Take an antibiotic if one was prescribed for you.

Antibiotic medicine____________________

When to Call the Doctor

Call if you have bright red bleeding that is soaking a pad every 10-15 minutes. Call if you have any signs or symptoms of infection:

  • Fever greater than 101ºF for 2 readings taken 4 hours apart.

  • Increased pain or swelling of the wound.

  • Pus or smelly wound drainage.

  • Redness spreading out from the wound.

Phone Numbers

If you have any questions or concerns call the Dermatology/Mohs Clinic where you were seen weekdays between 8:00 am and 4:30 pm. After clinic hours, holidays and weekends, the clinic number will be answered by the paging operator. Ask for the Dermatology or Mohs Surgery doctor on call. Leave your name and phone number with the area code. The doctor will call you back. 

UW Clinic East Dermatology/Mohs Surgery 

5249 E. Terrace Drive

Madison, WI 53718 

(608) 265-1288, press option 2

UW Clinic West Mohs Surgery

451 Junction Rd.

Madison, WI 53717

(608) 263-6226

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.