Hello my name is Adrian Richards, I’m a Consultant Plastic Surgeon and I’m the Surgical Director of Aurora Clinics. Today I’m going to be talking a little bit about the recovery period following surgical incision of a skin lesion. So by surgical incision I mean that the skin has been cut to the full depth to remove the full thickness of the skin and the wound has been stitched. So normally the wound will be stitched internally with absorbable stitches and these internal stitches actually hold the skin together so the external stitches, the ones you see, are just holding the skin gently together but.
Aren’t actually doing any of the pulling work, that’s done by the deep stitches which you wont see. So the superficial stitches, just to really sort of approximate them from the top of the skin. Now, depending on where in the body the stitches are they will be removed at a different time, and this is really just to stop the dot marks that you sometimes get around on either side of the scar, so the old fashioned scar will be a scar in the middle, dots on the side. The dots are caused by growth of the top layers.
Of the skins down the sides of where the stitches are, and this only occurs if the stitches are left in too long and the best time to remove the stitches varies from side to side. So on thin skin areas, such as the face, we tend to remove the stitches at about five days. On thicker areas such as the palm of the hand where the skin is really quite thick we can leave the stitches for up to two weeks without getting the surrounding dots. So when you’ve had your skin lesion removed we will give you, or you should be given an appointment.
Recovery following surgical removal of skin lesions
To have your stitches removed, and it’s very important that you do attend this so that the nurses or doctors can check that everything is healing well, and remove the stitches as planned and hopefully give you the results of your histology at that stage. So in the intervening period, if you’ve had an operation on your face it’s very important to try and reduce the excess blood flow to the area, so that means in the first couple of days avoiding anything that increases blood flow. Aerobic activity, alcohol, and in particular.
Any sort of leaning down activity which puts your head lower than your heart because that tends to cause blood to rush to the face and more chance of bleeding and swelling of the area. So try and keep your head up, a couple more pillows at night to reduce the swelling, and that applies to any area of the body. So try and elevate whichever bit as far as you can and reduce everything that causes blood to go there. If it is tender once the anaesthetic wares off we tend to recommend that you just.
Take paracetamols, that is actually very effective at controlling the pain, and nonsteroidal drugs such as Ibuprofen, Volterol are generally not recommended because they can increase the risk of bleeding, they can thin the blood and you are more likely to get bleeding from the areas. So generally we don’t recommend those. So normally paracetamol should be absolutely fine and if the pain is not controlled by paracetamol we normally encourage you to contact us because it might be good just to check everything is okay, because normally after these procedures it really shouldn’t be that uncomfortable.
So we like you to keep the wound try until you have your stitches removed, so you can shower and just try and keep the area as dry as possible, and the dressings we use will stay on for a week. When the stitches are removed the nurse or doctor will give you instructions about what to do with the scar. The scar normally heals very well initially, then it will go through a red phase which lasts two to three months following surgery, and thereafter the scar tends to settle. The reason you get the red.
Phase is that the body is trying to heal the area. Once the body senses it’s healed it remodels the scar and then the scar becomes flatter, paler, and eventually we hope that the scar will turn to a very fine silvery line which is difficult to see, and as I mentioned we try and orientate it along a natural crease so it’s difficult to see. So surgical removal is generally done under local anaesthetic. The anaesthetic itself going in is slightly uncomfortable, but thereafter you shouldn’t feel any pain, and the recovery.