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November 25, 2009
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Mohs Surgery (cont.)

How do I take care of my surgical area after Mohs surgery?

It is generally required to check with your surgeon for their specific wound-care instructions just after surgery. Often, you will be asked to go home and take it east for the rest of the day. A few patients like to return to work and resume their work the day after surgery. It may be advisable to avoid heavy lifting and exercise, especially the first 24-48 hours after surgery. Your physician will usually give you more detailed instructions depending on the area and size of the surgery. You will have usually have a bulky "pressure" dressing on the surgery area for one day. You may be asked to keep the area dry for 24 hours. Swimming pools, oceans, and Jaccuzis are usually not permitted while the stitches are in. These may increase your chance of infection. Many physicians allow you to shower the next day after surgery. Wound care may require cleaning the wound with soap or hydrogen peroxide two to three times a day and applying an over-the-counter antibiotic ointment to the area. Mild swelling is not uncommon the first day or two after surgery and can be lessened by use of an ice-bag application, ice cubes or chips in a small Ziploc baggie, or frozen peas in their bag. Leaving the dressing in place, use cold pack application every five to 15 minutes every hour for the first eight to 24 hours after surgery. Swelling is more common around for surgeries around the eyes or lips. Sleeping propped up on a few pillows or in a reclining chair may help decrease swelling after surgery of the head and face area.

The surgical area may ooze a little blood or clear liquid especially in the first few hours after surgery; activity may aggravate this. Hot drinks or bending over at the waist can also initiate or worsen bleeding of face wounds. If bleeding occurs, firm pressure applied directly to the site for 10-15 minutes may be helpful. Most bleeding will stop if you apply enough pressure. Your surgeon should be notified if bleeding that persists. Rarely, a visit to the hospital emergency room may be necessary for severe bleeding.

Your surgeon will need to know if pain is increasing after one to two days after your surgery or if you are having fever or other concerning symptoms. In such cases, you may need to be seen at the surgeon's office. The surgical area may need to be promptly checked for bleeding or infection. Limiting hot foods, hot drinks, and heavy chewing for 48 hours may help decrease the chances of postoperative bleeding for wounds around the mouth or cheek areas. Your physician will let you know their recommended wound care.

Most patients are advised to try to avoid applying makeup or powder directly on a fresh wound unless the surface is fully healed. Skin-colored tape strips called Steri strips are available to minimize wound leakage and help cover up a visible wound. It is important to follow your own physician's instructions for wound care.



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