Mohs surgery is a precise technique for removing skin cancer while maximizing the preservation of healthy tissue. The resulting surgical wound requires careful post-operative management to ensure optimal healing and cosmetic results. Understanding the correct bandaging protocol is important, as covering the wound plays a significant part in the overall success of the recovery process. Proper wound care starts with the initial dressing and continues until the site is fully closed.
The Role of the Initial Post-Operative Dressing
The first dressing applied by the surgical team serves several functions immediately following the procedure. This initial covering is often a bulky pressure bandage designed to apply gentle compression to the surgical site. The primary purpose of this pressure is to achieve hemostasis, controlling and preventing bleeding or fluid collection under the skin. The dressing also creates a physical barrier, protecting the wound from external contamination like dirt and bacteria, which prevents infection. Furthermore, the bandage helps maintain an optimal moisture balance, discouraging the formation of a hard scab that can delay tissue regeneration and promoting faster healing.
Standard Timeline for Initial Bandage Removal
The standard timeframe for keeping the first bandage on is typically between 24 and 48 hours after surgery. This period allows the body to form a stable clot and begin the inflammatory phase of healing. The exact duration depends on the size of the wound and the method used to close the defect. If the site was closed with sutures, a skin graft, or a flap, the initial dressing may need to remain in place for 48 to 72 hours to ensure tissue stability. Always follow the specific instructions provided by your Mohs surgeon, as they take precedence over general information.
Daily Wound Care and Redressing Procedures
Cleansing and Moisturization
Once the initial pressure dressing is removed, the focus shifts to daily or twice-daily wound care to maintain a clean, moist healing environment. Gently wash the surgical site using mild soap and water to remove crusted material or drainage. Use a soft cloth, cotton swab, or gauze, avoiding aggressive scrubbing that could damage the fragile new tissue. The wound must be kept continuously moist to facilitate the migration of new skin cells. This is achieved by applying a generous layer of petroleum jelly (such as Vaseline or Aquaphor) or a prescribed antibiotic ointment if recommended by your surgeon.
Dressing Application
The ointment should be applied thickly enough to resemble the frosting on a cake, ensuring the entire wound bed is covered and protected from drying out. Apply a fresh, clean dressing made of non-stick material, such as a Telfa pad, to prevent adherence to the healing tissue. Secure the non-stick pad with paper tape, which is less irritating to the surrounding skin. This process should be repeated once or twice daily, or whenever the dressing becomes wet or soiled, until the wound is fully closed. Continuing to cover and protect the wound is essential to minimize the risk of infection and optimize the final cosmetic outcome.
Warning Signs and When to Contact Your Surgeon
While proper home care reduces the risk of complications, it is important to recognize signs requiring professional medical attention. Immediate concerns include bleeding that does not stop, especially if the bandage rapidly soaks through or if continuous pressure applied for 15 to 20 minutes fails to staunch the flow. Any sudden, severe pain not relieved by over-the-counter medication should also prompt a call to your surgeon’s office. Signs of infection often appear a few days after the procedure and include increased redness spreading beyond the wound edges, warmth, increasing swelling, pus or cloudy drainage, or a fever above 101 degrees Fahrenheit. Recognizing these changes and contacting your surgical team promptly allows for immediate assessment and intervention.