Post Surgical Instructions

Instructions after Treatment of Skin Cancer and Pre-Cancer

  • It is important to watch for signs of your skin cancer returning.
    • Although it is not common, skin cancer can return even if the entire tumour was removed at the time of your surgery
    • Signs of recurrence include:
      • Developing a pink nodule along or near your scar.
      • New bleeding or crusting/scabs along your scar.
    • If you note any new changes along or near your scar, you should have it looked at by your family physician, your dermatologist, or your surgeon to rule out a return of your skin cancer
  • It is equally important to watch for signs of new skin cancers developing at other sites.
    • New cancers or pre-cancers may begin as rough patches, scabs or nodules.
    • Have these checked as soon as you notice them. When they are still small, they may be able to be treated without surgery.
    • A dermatologist, or sometimes your family doctor, can treat smaller early cancers with creams or liquid nitrogen (freezing) spray. For any larger spots, your family doctor will send you to a surgeon.
  • Avoid sun exposure:
    • Most skin cancers are brought about by exposure to UV rays from the sun.
    • It is important to avoid sun exposure in order to minimize the chance of developing a new or recurrent cancer.
    • You should wear a sunscreen with a SPF of 30 or higher, applied both to your surgery site and to any sun-exposed skin.
    • It is important to reapply sunscreen frequently. If your skin is tanning or developing freckles after being in the sun, then you are getting too much exposure. Avoid this by: staying out of the sun, reapplying sunscreen more often, or wearing clothing with long sleeves and pant legs.
  • Scar Care
    • Your scar will continue to improve over the next year and a half.
    • It is very important to massage directly along your scar to help it fade and become flatter. Massage your scar at least twice per day, but up to 4 or 5 times is even better.
    • Press firmly – the skin should blanche and turn white when you use the appropriate pressure.
    • Continue massage for at least 3 months, but for up to one year and a half if you wish for further improvement in the appearance of the scar.
    • Applying moisturizing cream to the scar regularly, for at least 3 months.
  • We can triage your concerns and, if necessary, arrange for you to see Dr. Nayan for reassessment.
  • Call our office at: 519-624-8877 if you have concerns after your surgery:
    • For instance:
      • If you think you have an infection.
      • If, at 3 months you are bothered by your scar remaining thick and red, despite regular massage
      • If, at 6 months you are bothered by a persistent change in the contour of your skin.

Instructions Post Minor Surgery

YOUR RESULTS        

  • If you have had a biopsy or tumour excision, our office will call with your results, or we will discuss them with you when you have your sutures removed.
  • DO NOT assume that a lack of contact means your results were fine. Call the office if you have not had your results within 6 weeks of your procedure.

WOUND CARE

  • Keep you incision clean and dry for 24 hours.
  • After 24 hours, gently clean with soap and water. Do not use stronger cleaning agents.
    • If you have Steri-Strips, leave them in place when you wash. When the tape curls at the edges, peel them the rest of the off and follow the instructions below.
  • Pat dry after washing and apply Vaseline ointment 1-2 times daily for days.
    • Exception:          If your incision is on your hair bearing scalp, do not apply Vaseline.
  • If your incision is on your head or neck, you may leave it open to air after you have applied Vaseline, or you may cover it with a band-aid if you prefer.
  • If your incision is on your torso or limbs, cover it with a band-aid or gauze dressing once you have applied Vaseline.
  • Do not apply Vaseline on the day you have your sutures removed.
  • For your comfort, you may wish to remove any crusting that has formed along your suture line prior to having your sutures removed. You can do this by placing a warm washcloth over the crust and gently lifting it in the shower. Gentle use of a moist Q-tip may also help.
  • Sutures to come out in ___ days. This appointment will be in the office.

MEDICATION

  • It is recommended that you take something for pain upon arriving home after your procedure.
  • You may also want to take something prior to your suture removal
    • Opinions include:
      • Tylenol Extra Strength (500mg), 1/2 tabs every 4/6 hours. Do not exceed 8 tabs in 24 hours
      • Tylenol 1(available over the counter); 1/2 tabs every 4/6 hours. Do not exceed 12 tabs in 24 hours. Please note that this medication contains codeine and you cannot drive if you are taking it. Each tablet also contains 325mg of Tylenol.
      • If you take a combination of different Tylenol pills, ensure that you do not take more that 4000mg of Tylenol in 24 hours.
  • Advil and other anti-inflammation/NSAIDs are no recommended after surgery as they slightly increase rates of bleeding and bruising. You may take NSAIDs after 48 hours if you feel it necessary.
  • If you have held a blood thinner for your procedure, you may restart it the day after your procedure. If you are having ongoing slow bleeding from your wound, wait another 24-48 hours before restarting your blood thinner.

ACTIVITIES and OTHER INSTRUCTIONS

  • You may return to work the day after your procedure unless you have been instructed otherwise.
  • Avoid exercise and sports activities until your sutures have been removed.
  • It is recommended that you sleep with a dark coloured towel beneath your surgical site.

If you have questions or concerns, or you require an appointment to remove sutures, please contact the office at: 519-624-8877

Instructions Post Surgery

YOUR RESULTS

  • If you have had a biopsy or tumour excision, our office will call with your results, or we will discuss them with you when you have your sutures removed.
  • DO NOT assume that a lack of contact means your results were fine. Call the office if you have not had your results within 6 weeks of your procedure.

WOUND CARE

  • Keep you incision clean and dry for 24 hours.
  • After 24 hours, gently clean with soap and water. Do not use stronger cleaning agents.
    • If you have Steri-Strips, leave them in place when you wash. When the tape curls at the edges, peel them the rest of the off and follow the instructions below.
  • Pat dry after washing and apply Vaseline ointment 1-2 times daily for a few days.
    • Exception:         If your incision is on your hair bearing scalp, do not apply Vaseline.
  • If your incision is on your head or neck, you may leave it open to air after you have applied Vaseline, or you may cover it with a band-aid if you prefer.
  • Do not apply Vaseline on the day you have your sutures removed.
  • For your comfort, you may wish to remove any crusting that has formed along your suture line prior to having your sutures removed. You can do this by placing a warm washcloth over the crust and gently lifting it in the shower. Gentle use of a moist Q-tip may also help.
  • Sutures to come out in ___ days. This appointment will be in the office.

MEDICATION

  • A prescription for a pain medication and a stool softener will be provided to you at the hospital.
  • For pain control, it is recommended that you take Tylenol on a regular schedule and take your prescribed pain medication only as needed.
  • Tylenol Dosing:
    • Tylenol Extra Strength (500mg), 2 tablets every 4/6 hours. Do not exceed 8 tabs in 24 hours
    • Regular Strength, 3 tablets 4 times a day. Do not exceed 12 tabs in 24 hours
    • Do not take more that 4000mg of Tylenol in 24 hours.
    • Begin taking less Tylenol as you become more comfortable.
  • If you continuously take the maximum dose of your prescription pain medication (2 tabs every 4 hours), your supply will last 2.5 days. The goal is to spread the doses out so that the prescription lasts 5 – 7 days, after which time you should take over the counter pain medication only.
  • It is recommended that you begin taking the prescribed stool softener initially after surgery, and continue as needed.
  • Advil, Aspirin, Aleve and other anti-inflammation/NSAIDs are not recommended after surgery unless your surgeon has told you it is safe to do so.
  • If you have held a blood thinner for your procedure, you may restart it the day after your procedure. If you are having ongoing slow bleeding from your wound, wait another 24-48 hours before restarting your blood thinner.

ACTIVITIES and OTHER INSTRUCTIONS

  • Avoid exercise and sports activities until your sutures have been removed
  • It is recommended that you sleep with a dark coloured towel beneath your surgical site.

If you have questions or concerns, or you require an appointment to remove sutures, please contact the office at: 519-624-8877