Tyler McKinnon, PA-C
How should I care for my wound site? (hint: as little as possible, AS GENTLY AS POSSIBLE)
Post Op care is an important aspect of any excisional skin procedure. Both patients and Providers want the eventual scar to heal as beautifully, transparently, and quickly as possible. Follow these tips to facilitate the best possible outcome.
- Be gentle with the site. In general, we don’t have many wounds that break open after a procedure. Most Providers place plenty of sutures of sufficient strength to hold a wound together. Don’t believe me? Why don’t you just try break that sucker open! (just kidding, please don’t.) However, just because the wound stays together while you curl 70 lb. dumbbells for half an hour (I’m jealous), doesn’t mean that the tension you just placed on the wound edges of your bicep excision doesn’t A) significantly slow the healing and B) thicken the scar tissue and hence, the visible permanent scar. You don’t have to confine yourself to bed for a month straight, but, please, be cognizant of any tension placed on the wound, and take steps to mitigate or avoid it. One month is a good rule of thumb, but more time is needed if you really want to ensure a perfect scar.
- Be gentle with the site. I know, you already read about being gentle. Well, no, this isn’t a mistake. This is “be gentle, part 2: hygiene edition”. Most people think that a wound needs to be cleaned. You would be correct if this was a skinned knee, however, when we perform an excision, we ensure that everything is clean in the first place (NOT sterile, however… that’s an interesting topic for another time). Any subsequent cleaning will irritate the site, slow down the healing process, and worsen the scar appearance over time. DO NOT use soap. AT ALL. DO NOT use alcohol. AT ALL. DO NOT use hydrogen peroxide. AT ALL. DO NOT touch the site. AT ALL. OK, unless you are applying Vaseline® ointment gently with a Q-tip® or a clean finger, which you should do twice daily to keep the site moist and protected along with a BAND AID® or gauze. Running water is alright, though not encouraged. Standing water is discouraged, like submerging in a bath, pool, hot tub, lake, etc.
- DON’T be proactive. What I mean here is: DO NOT do anything contrary to the above instructions, thinking that your wound is the exception to the rule. It isn’t. Cleaning will not help. We have a very low rate of infection from excisional procedures. If you have an infection or some other rare complication occurring, washing is likely to make it worse, actually. I love talking to my patients and reassuring them, and I love when they reach out to me with questions. That is your first step if you ever are thinking that your wound is not behaving. Call me. Text me. Send me a picture. I will give you good advice on how to proceed, and together we will keep things healing well.
- Be gentle patient with the site. See what I did there? Clever, right? OK not really. But, important point: scar tissue can take up to 2 YEARS to fully mature. It may be a little pink for a few weeks in the beginning, or for months on the lower legs, but, rest assured, the pinkness will fade. The same goes with any tightness in the area if skin was removed. The skin will loosen over time with no effort on your part. Most other potential issues (discomfort, etc.) will improve over time as well. Once again, if you have any doubts, your Dermatology Provider will be happy to discuss it with you (see tip #3).