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HF 4251

Wound Care for Open or Sutured Wounds Mohs Surgery Clinic

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

When to Do Wound Care

You should start wound care on                    . Keep your dressing clean and dry until then. Clean your wound              times a day until the crust has come off and the skin has healed or until the sutures are removed.

Care of the Wound

  1. Wash your hands well with soap and water. 

  2. Take off the old dressing. If it sticks, wet the edges of the dressing with water, or remove it in the shower.

  3. Shower once a day with the bandage off or clean the area under running tap water. Lather gently with soap and water, then rinse and blot dry.

  4. Apply Vaseline® (white petrolatum) in a thin layer. You may use a clean cotton swab to apply the ointment, rolling the swab gently over the wound.

  5. Cover your wound with a clean bandage. Use a Telfa®Ppad or a band-aid thick enough to soak up any drainage and protect the wound. 

If your wound was left open, Surgicel® Pmay be put on your wound to stop bleeding. When it contacts blood, it turns black or brown. This is normal. The Surgicel® will slowly come off as the wound is cleaned. Do not force it off. If some remains, it will fall off later.

Gelfoam may be put on your wound to stop bleeding. It may come off as the wound is being cleaned. Do not force it off. If it remains on the wound, it will dissolve over time.

Supplies you will need to buy:

  • Clean cotton swabs (Q-tipsP®P)

  • Vaseline® or white petrolatum

  • Band-AidsP® and/or TelfaP®P pads or clear strip, sensitive skin Band-Aids®

  • Tape

Bleeding

  • Apply direct pressure by pressing firmly over the site for 10 minutes (timed by the clock). If bleeding has not stopped, use pressure for 10 more minutes (timed by the clock).

  • If bleeding still has not stopped, call the clinic where you were seen (numbers listed below), or go to your local emergency room.

  • Reinforce, but do not remove, the soiled bandage unless told to do so. You could disturb the clot. 

Swelling and Bruising

This is fairly common but goes away in 2-3 weeks.

If your wound is on your face, head, or neck:

  • Sleep with your head raised on 2 pillows to reduce swelling.

  • Avoid bending with your head below heart level.

  • Swelling around the eyes and neck is normal if you have had surgery to the forehead, eye area, nose or cheeks. Swelling will be worse in the morning and improve during the day. Expect that swelling may last for 3 days or longer.

If your wound is on your arm or leg:

  • Wounds on the arm or leg may heal more slowly than other areas. Keep your arm or leg raised as much as you can. This will help prevent swelling and speed healing.

  • Use a compression stocking or Ace® wraps if told to do so.

Apply ice or cold compresses to prevent and reduce swelling if told to do so.

  • Do not apply ice right on the skin. Ice should be placed in a plastic bag then wrapped in a towel and applied to the bandaged wound.

  • Ice should be kept on for only 15 minutes at a time.

Pain Control 

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

  • Tylenol® 1000mg every 6-8 hours

  • Ibuprofen 600mg every 6 hours

You may take them together every 6-8 hours or taking one type alone and then the other type 3-4 hours later. Repeat this pattern, alternate medicines every 3-4 hours.

If prescribed a narcotic pain medicine, please do not drink or drive while you are taking it. It is best to take narcotics with food to prevent nausea/vomiting. They may also cause constipation. You may use over the counter stool softeners as needed. Limit use of over the counter Tylenol® (acetaminophen) if you are given a prescription that contains acetaminophen. 

Discharge pain medicine: _______________________________

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.

Activities

  • Do not do heavy activity for the first 2 days or as instructed.

  • No swimming or use of hot tubs until your wound is fully healed.

  • If you have stitches on the cheek or in the mouth area, avoid chewing on that side and talk as little as you can. Eat soft foods and rinse your mouth after eating or drinking. Avoid smoking.

Infection Control 

Infection is not common when the wound is well cared for. If you notice any of these signs of infection, please call the clinic.

  • Fever greater than 101°F

  • Increased pain or swelling of the wound

  • Pus or smelly wound drainage

  • Redness spreading out from the wound

  • Warmth around the wound site

Antibiotic medicine: ____________________________________

Scarring

All wounds cause some scarring. Time improves most scars. Cover-up make up may be used after the wound has healed. Sunscreen should be used on scars after healing. Some people may develop very thick scars, or keloids, which may need extra medical care. Call our office if this occurs and we will schedule a follow up visit.

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 451 

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 live out of the area, and have a non-urgent concern, call toll free

1-800-323-8942, during regular clinic hours.