Mohs surgery is a precise technique primarily used for skin cancer treatment. Often, reconstructive surgery is required afterward. While sometimes the reconstruction is simple, in other cases, more extensive procedures like flaps or grafts are necessary. The following instructions aim to facilitate optimal healing post-surgery.

First Dressing Change

• When to Change: After 72 hours.
• How to Change: Gently remove the old dressing. We recommend to let the dressing get wet in the shower and then to remove it gently once out of the shower. Alternatively, use alcohol to gentle remove bandage. Clean the surgical site with soap and water. Apply petroleum jelly or bactroban ointment, and cover with non-stick gauze and tape.

Follow-Up Visit

• Your follow-up visit details will be provided by your healthcare provider. Ensure to keep this appointment for proper wound assessment and care. Sutures generally are removed between 7-14 days after surgery.

Post-Surgery Instructions and Wound Care

Day of Surgery

• Rest for the remainder of the day.
• Apply ice for 15 minutes on and off for 4-6 hours to minimize swelling.

Medication

• Acetaminophen (Extra Strength): Take two 500 mg tablets every 6 hours.
• Ibuprofen: If experiencing breakthrough pain while on acetaminophen, take 400 to 600 mg of Ibuprofen at the 3-hour mark.
• If you are prescribed antibiotics, take it with food and water

Dressing Care

• Keep the pressure dressing on and dry for 72 hours.
• If the dressing becomes soiled, replace it gently with a pressure dressing.
• If Tegaderm dressing is used, brief showers are permissible.

Cleaning and Bandage

• After 72 hours, remove the dressing and clean the site daily.
• Avoid letting a scab form; keep the site moist with ointment.
• Change the bandage after each cleaning.

Special Precautions and Activity Restrictions

• Face Surgery: Avoid hot foods, minimize facial expressions, and chew gently for the first 72 hours. Expect bruising especially if surgery was around the nose, eyes, or forehead. Sleep propped up with three pillows and ice the area in the morning for the first three days.
• Arm/Leg Surgery: Keep the ACE bandage on, adjust if tight, and elevate the limb to avoid swelling.
• No swimming while sutures are still in place
• No heavy exercise, heavy lifting or bending down for three weeks.

Managing Bleeding

• Minor oozing is normal.
• Apply continuous pressure for 15-30 minutes if bleeding occurs.
• Contact the office or visit the emergency room if bleeding is profuse.

Infection Signs

• Look out for swelling, redness, yellow/green drainage, foul odor, increased pain, fever, or chills.
• Contact the office immediately if these symptoms occur.
  • Office Number: 786-607-4544 (after-hours option available).

Scar Care and Healing

• Scar Maturation: It takes up to 12 months for a scar to remodel and mature. Initially, the scar will be pink and may be bumpy due to internal sutures, which can take up to 3 months to dissolve.
• Improving Healing: For optimal healing, use excellent sun protection on the scar and apply a recommended scar gel twice daily for 3 months once sutures are removed.
• Hypertrophic Scars: In cases of hypertrophic scarring, additional treatments like intralesional Kenelog or laser therapy may be recommended for optimal outcomes.