Mohs surgery is a precise technique for removing skin cancer while preserving healthy tissue. Proper post-operative care, especially bandaging, is essential for promoting healing and achieving the best cosmetic result. The duration a bandage is worn depends on wound size and the method of closure (stitches, skin graft, or healing by secondary intention). Following specific guidelines protects the wound from contamination and supports natural repair.
The Initial 24-48 Hour Period
The initial bandage applied by the surgeon is typically a thick pressure dressing. This dressing must remain in place and stay completely dry for the first 24 to 48 hours after the procedure. This initial compression controls minor bleeding, reduces swelling, and protects the wound from the external environment.
This period allows the body to begin hemostasis and inflammation, and an undisturbed dressing stabilizes the site. Keeping the bandage dry is important because moisture can compromise the sterile environment and increase infection risk. If the initial bandage becomes saturated or falls off prematurely, contact the surgical office immediately for guidance. Applying firm, continuous pressure to the site for 20 to 30 minutes helps control unexpected bleeding.
Daily Dressing Change Routine
Once the initial pressure dressing is removed (24 to 48 hours post-surgery), a routine of daily or twice-daily dressing changes begins. This phase maintains a moist wound environment, which speeds healing and minimizes scarring. Supplies should include non-stick pads (such as Telfa), paper tape, and an occlusive ointment (like petroleum jelly or Aquaphor).
The process starts with gentle cleaning using mild soap and water or a mixture of half-strength hydrogen peroxide and water, as directed by your physician, to remove crusting or drainage. Pat the area dry with a clean cloth or gauze. Apply a generous layer of moisturizing ointment directly to the wound to keep the tissue soft and prevent dry scab formation.
Secure a clean, non-stick dressing over the site with paper tape. Following this routine ensures the wound remains covered and heals efficiently. During these changes, monitor for signs of infection, such as increasing redness, warmth, excessive drainage, or pain.
Criteria for Discontinuing Bandages
Daily bandaging continues until the wound achieves complete epithelialization, meaning the surgical site is fully covered with new skin. This duration typically lasts one to three weeks, depending on the size, location, and method of repair. Wounds closed with stitches require bandaging until suture removal, usually between seven and fourteen days.
For wounds healing by secondary intention (closing naturally without sutures), bandaging continues until the raw area is entirely resurfaced. The primary criteria for stopping dressings is when the site is no longer an open wound requiring environmental protection. The wound is then covered by a dry, protective layer of skin and no longer needs daily ointment and covering.
Water exposure is a major consideration. While showering is permitted after the initial 24 to 48 hours, soaking the wound in a bath, hot tub, or pool is prohibited until the wound is fully closed and cleared by the surgeon due to infection risk. Applying high SPF sunscreen to the newly healed scar is advised to prevent discoloration and promote the best cosmetic outcome.