The doctor will select the most appropriate procedure and wound repair technique. The procedure will be performed in a dedicated operating room, where all equipment, processes, sterilization and disinfection comply with the Australian General Practice Accreditation standards. Meticulous care is given to hemeostasis (the control of bleeding) and wound repair (suturing technique).
The patient can prepare for the procedure buy looking after their general health. Taking Vitamin C 1000 mg daily for a week before the procedure and during would healing is believed to assist the bodies natural repair functions. Showering with an antibacterial wash such as “Hibiclens” or “Physohex” for a couple of days prior to the procedure will reduce the number of bacteria that normally live on the skin therefore the risk of wound infection. If you are taking blood thinning drugs you may be asked to stop these for a period prior to the procedure, if this can be done safely.
In the first 24 to 48 hours following the procedure it is important to rest and where possible to elevate the wound. Excessive movement or agitation of the wound during this time can lead to secondary hemorrhage (bleeding).
In some circumstances you will be asked to return to have the dressing removed and the wound checked. If not you will be instructed to remove the dressing usually 24 or 48 hours after the procedure. At this time the wound can be washed daily in the bath or shower using soap and a wash cloth. If there is dried blood or ointment on the wound clean this away. It is especially important not to allow dry blood, scabs or crusts to remain along the suture line or between the wound edges as these interfere with the bodies healing cells bridging the wound.
After washing gently pat the wound dry with a clean towel. A very light smear of betadine solution (not ointment) along the wound after bathing can help prevent infection, but be careful not to use too much or it will encourage scabbing. Sometimes you may be prescribed an antibiotic ointment to use on the wound. In our climate if wounds can be kept clean they are best at this stage left open to the air. If necessary or if you prefer they can be covered with a non-stick dressing but changed daily after bathing. It is usual to develop a slight redness around the suture line and sutures as healing is taking place. But this should not be excessive and the wound should not ooze or weep. The wound will usually be tender to touch but not greatly painful. Paracetamol is the preferred painkiller if required. If you have any concerns regarding the wound please advise us immediately and come in for a check
Following the removal of sutures usually adhesive strips will be applied to the wound as there is a particular risk of the wound breakdown at this stage. It is important to be careful not to apply significant stress to the wound in the first few days after removal of sutures. Wounds on the lower limbs seem to come undone with squatting and around the back and shoulders with bending or stretching.
Complications of Skin Cancer Removal may include:-
Hemorrhage and hematoma formation
Wound infection
Wound breakdown
Allergic reaction to anaesthetic, antiseptic agents or dressings
Poor cosmetic result
Hypertrophic (thick) scar formation or Keloid Scar formation is more common in predisposed individuals and at some sites especially over the upper arm (deltoid area) and over the sternum (breast bone).
Incomplete excision - failure to remove the entire tumor.
Accidental damage to other structures most commonly nerves. (Small nerve and vessel branches along the wound are always cut during excision and it is common for there to be a small area of numbness around the wound)
In the case of skin flap repair and skin grafting there is a risk of incomplete uptake of the graft or flap. With flaps this is common at the tips or corners, and with grafts is mostly a problem on the lower limbs especially in those with poor circulation.
If you have any concerns or questions about this information please make sure you clarify them with the Doctor.
Surgical excision of skin cancers ranges from simple to very complex. Wound healing is dependant on many factors including the patient’s general health, body site (wounds on the head and neck for example heal far better than those on the lower leg or foot), type of wound closure, the absence of infection or hematoma formation (blood collection under the wound)and post operative care. The best outcome requires a team effort between the Doctor and Patient.
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