Mohs surgery is a precise technique used to remove skin cancer, particularly effective for growths on delicate areas such as the nose. This procedure involves removing thin layers of cancerous tissue until no cancer cells remain, aiming to preserve as much healthy skin as possible. Proper post-operative wound care, especially bandaging, is important for effective healing and to minimize complications. Bandaging helps protect the delicate surgical site on the nose, supporting the healing process and contributing to a favorable outcome.
Preparing for Bandaging
Before applying a new bandage, thorough preparation of the wound and gathering of supplies are necessary to promote a clean healing environment. Begin by washing your hands diligently with soap and water to ensure cleanliness. The initial bandage applied by the surgeon should typically remain dry and intact for 24 to 48 hours, or as directed. After this initial period, gently remove the old dressing, which can be moistened with water if it adheres to the wound.
Next, carefully clean the wound area, as instructed by your doctor, using mild soap and water or a mixture of half water and half hydrogen peroxide. Gently wash around the wound with a clean cloth or cotton ball, avoiding direct scrubbing of the delicate new tissue. Pat the area dry with a clean, soft towel or gauze, ensuring no moisture remains.
Assemble all necessary supplies within easy reach, including non-stick dressing pads, medical tape (often paper or cloth for sensitive facial skin), cotton-tipped applicators, and any prescribed ointments like petroleum jelly or Aquaphor. Non-stick pads, such as Telfa, are designed to cover the wound without adhering to it, preventing damage to the healing tissue upon removal. Paper tape is frequently recommended due to its gentleness on facial skin, reducing irritation. Position yourself in a well-lit area, perhaps with your head elevated using several pillows if the surgery was on the face or scalp, to help minimize swelling.
Applying the Nose Bandage
Begin the application process by gently applying the prescribed ointment to the wound. Use a cotton-tipped applicator to spread a generous layer of petroleum jelly, Aquaphor, or other recommended ointment directly over the incision and any sutures. This step is important for keeping the wound moist, which supports optimal healing and helps prevent scab formation, as wounds heal better in a moist environment. Avoid using your fingers directly to apply the ointment to minimize the risk of introducing bacteria.
Next, prepare the non-stick dressing pad by cutting it to a size that completely covers the wound, extending at least 1 centimeter beyond the incision site. Carefully place the cut non-stick pad over the ointment-covered wound, ensuring it lies flat and fully protects the surgical area. This layer creates a barrier, allowing the wound to heal undisturbed and preventing the outer tape from sticking to the delicate tissue.
To secure the pad, apply strips of medical tape, such as paper tape, around the contours of the nose. Start by securing one end of a tape strip to a stationary part of the nose or adjacent facial skin. Gently pull the tape across the non-stick pad and adhere the other end to the opposite side, ensuring the pad remains in place without excessive tension. You may need multiple strips, potentially overlapping slightly, to fully secure the dressing, adapting to the unique shape of your nose. The goal is a secure bandage that protects the wound without causing discomfort, allowing for normal breathing.
Maintaining the Bandage and Monitoring Recovery
After applying the bandage, ongoing care is important for proper healing and to prevent complications. Generally, the bandage should be changed daily, or as specifically instructed by your surgeon. Some initial pressure dressings might stay on for 24 to 48 hours, with subsequent changes occurring more frequently. Consistency in changing the dressing helps keep the wound clean and moist, fostering an optimal healing environment.
When it is time to change the bandage, gently remove the old one to avoid disturbing the healing wound. If the bandage is stuck, moisten it with water to loosen the adhesive. After removal, carefully inspect the wound for any changes that might indicate a complication. Normal healing includes some mild redness, swelling, and possibly a small amount of clear or yellowish drainage.
However, be alert for signs of infection, which include increased redness spreading beyond the wound, warmth, persistent or worsening pain, significant swelling, or the presence of pus or foul-smelling drainage. A fever of 100.4°F (38°C) or higher can also signal an infection. Excessive bleeding that saturates the dressing and does not stop with firm, continuous pressure for 20-30 minutes, or signs of an allergic reaction to the tape or ointment (like a rash or severe itching), also warrant attention. If any of these concerning symptoms appear, contact your doctor promptly for guidance.
Avoid activities that could irritate the wound or dislodge the bandage. This includes strenuous exercise, heavy lifting, or bending over at the waist, especially for the first 48 hours to one week, as these can increase the risk of bleeding or swelling. Avoid direct water pressure on the surgical site when showering, and do not pick at any scabs that may form, as this can interfere with healing and increase scarring. Protecting the wound from direct sunlight is also important, as UV exposure can affect healing and scar appearance.