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. Call if you have any questions or concerns after you are home.

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)

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 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, rinse well. The Gelfoam® (may be
    brown-black in color) may rinse away.

  • Pat dry and keep using the peri-pad to absorb drainage and protect the wound.

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

  • Some drainage is normal. Drainage will decrease as your wound heals.

Pain Control

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

  • Tylenol® 1000mg every 6 to 8 hours .

  • Ibuprofen 600mg every 6 hours

You may take them together every 6 to 8 hours, or alternate taking one type alone and then the other type 4 to 6 hours later. Repeat this pattern, every 4 to 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, do not drink or drive while taking it. Take narcotics with food to prevent nausea. Narcotics may also cause constipation. Eat plenty of fiber to keep bowel movements normal. You may use over the counter stool softeners as needed.

Drink plenty of fluids to reduce stinging when urine passes.

Activities to Prevent Bleeding

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

  • Avoid heavy lifting.

  • Do not lift 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.

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

  • Avoid straining during bowel movements.

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

  • Avoid alcohol.

  • Avoid aspirin or medicines that contain aspirin.

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

  • If you have bright red bleeding that is soaking a pad every 10-15 minutes or go to the local emergency room.

  • 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.

  • A sudden increase in pain that is not helped by pain medicines and ice compresses.

Who to Call

UW Health E Terrace Dr. Medical Center Clinic - Dermatology/Mohs Surgery
5249 E. Terrace Drive
Madison, WI 53718
(608) 265-1288, press option 2
8am - 4:30 pm, Monday – Friday

UW Health Junction Rd. Medical Center Mohs Surgery
451 Junction Rd.
Madison, WI 53717
(608) 263-6226
8am - 4:30pm, Monday – Friday

After hours and holidays, the clinic number is answered by the paging operator. Ask for the Dermatology or Mohs Surgery doctor on call. Leave your name and phone number with area code. The doctor will call you back.

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.