After Excision Surgery
Detailed instructions for optimal wound healing after a dermatologic excision.
Quick Answers by Topic
First 24-72 Hours
- 1
Keep the pressure bandage
Leave the original bandage from surgery for 24-72 hours. If it loosens, reinforce it with adhesive tape.
- 2
Manage bleeding
Minor oozing is normal in the first 24-48 hours. If there is active bleeding, apply firm pressure for 10 minutes at a time, then reassess.
- 3
Manage swelling
Swelling peaks at days 3-4, especially on the face. Elevate the area. Apply cold compresses (ice pack for 5 minutes, once per hour) to reduce swelling.
- 4
Pain management
Take paracetamol (Acamol) or dipyrone (Optalgin) as needed. Avoid aspirin and ibuprofen for 48 hours unless medically necessary.
Daily Wound Care
- 1
Remove the bandage
After 24-72 hours, gently remove the bandage.
- 2
Wash gently
Clean the wound with lukewarm water and soap once or twice daily. Do not scrub or use direct water pressure.
- 3
Apply ointment
Apply antibiotic ointment (from the prescription) to keep the wound moist and prevent infection.
- 4
Rebandage
Cover with a non-adhesive bandage (not gauze pads which absorb the ointment). Continue until the wound is fully healed.
Prescriptions
- Antibiotic ointment: the prescription lists 2 options - get whichever is available. No need for both.
- Oral antibiotics (if prescribed): take with a large glass of water. Avoid lying down for 30 minutes after. Separate from calcium and iron supplements by 2 hours.
- Pain medication: paracetamol or dipyrone as needed.
Stitches & Follow-up
- If closed with non-dissolving stitches: remove according to the discharge summary instructions
- Face: 5-7 days. Trunk/limbs: 10-14 days. Over joints: 14 days.
- If closed with dissolving stitches and glued bandage: avoid wetting for 48 hours, then be gentle. If it loosens, reinforce.
- If a skin graft was placed: do not remove the bandage until your follow-up visit.
Dried Blood Crust (Eschar)
A wound heals best when kept moist. A dry blood crust slows healing. Do not pull it off. Instead, soften it by covering with a thick layer of Vaseline or antibiotic ointment. If needed, gently dab with 3% hydrogen peroxide on a cotton swab.
What to Avoid
- Tension, pulling, or friction on the wound - avoid stretching the area
- Around the nose/mouth: avoid chewing hard foods for several days
- On the legs: elevate when possible
- Swimming, hot tubs, or soaking until fully healed
- Sun exposure on the scar for 12 months - use SPF 50+
- Smoking - significantly impairs healing
When to Contact Us
- Severe pain that worsens instead of improving
- Expanding redness beyond the wound edges
- Purulent discharge or bad smell
- Severe or worsening swelling
- Body temperature above 38.5 degrees
- Bleeding that does not stop after 20 minutes of firm pressure
- Stitches that have come apart
