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Frequently Asked Questions (FAQs) About
Your Surgical Procedure
Table of Contents
Simply, leave the dressing on for the first day
after surgery. You can take it off the next day and
wash the site with a mild soap such as Cetaphil®.
Please remember to blot and not rub gently so as not
to disrupt the sutures. Apply a thin coat of
Aquaphor®
or Bactroban® (avoid Neosporin®). Repeat this
process twice daily, morning and night. If the area
is crusted, you may take a tablespoon of hydrogen
peroxide and dilute this in 4 ounces of distilled
water. Apply this mixture to the wound site using a
washcloth or 4” x4” gauze pad (can purchase at
Walgreen’s™). This should help to dissolve the
crusting. Following peroxide application, apply your
ointment as directed above.
We will provide you with steri strips after your procedure
in a surgical kit or you can purchase these readily
at Walgreen’s™ Pharmacy or Target™. If you need
to, you may also come by our office (call our triage
nurse first at 285-7546 ext 210) and we will do
our best to accommodate you. Please call ahead
before showing up to our office so that we can have
these ready for you. To get an operator, dial 285-7546 extension 202 or 204 for the best
service.
Don’t panic. This is normal. Steri Strips
are meant to stay on for a few days at most.
At this point, you have two options. If the wound is not draining
or red, simply leave the Steri Strips off. If
you want to protect the area you can reapply the
Steri Strips over your incision site
perpendicularly to the incision. While
the Steri Strips are in place, you can place
Aquaphor™
or Bactroban™
ointment over them. When the
Steri Strips begin to curl on their
edges, you can remove them with or without dilute hydrogen
peroxide (1 tablespoon of hydrogen peroxide in 4
ounces of distilled water).
Don’t panic! We
are sorry if our triage person cannot call you back
right away. She is sometimes tied up with other
patients or helping assist with the patients who
need us in the office. We do value your problem
though and there are a few things you can do to get
immediate attention if needed. The
first step is to assess your situation. Is it life
threatening? Can it wait? If you are having a true
medical emergency, i.e., extensive bleeding,
difficulty breathing, or if you are experiencing
chest pain, then immediately dial 911 as you
need to be assessed ASAP by an EMT ambulance crew
and possibly an emergency room physician.
If your wound site
is oozing slightly, place pressure on the area using
a wash cloth or small towel like a tourniquet. If
you need another question answered and can’t get
anyone immediately, dial 904-285-7546 ext 210. The person that talks with you at these
extensions is not a nurse (so they have
limited medical knowledge) but they can direct your
call or help you by informing a medical assistant of
your dilemma. For prescriptions, call the pharmacy
and have them fax us a request or you can leave a
message and this will be taken care
within 24 hours. If you need Dr Harvey to get
involved during office hours, dial extension 202
or 204 and the front end staff will relay the
message to him. For after hours or holidays, you can
dial our emergency notification line at 904-285-7546 ext 299.
What do I do if my
wound site is bleeding and it won’t stop?
The key is to keep pressure and/or cold on your
wound site. If your surgery is on an extremity, keep
the affected limb elevated above your mid
chest and place a
pressure wrap directly over your surgery site. A
small towel works well over the area like a
tourniquet. Wrap the towel around the extremity
firmly, but not too tight. If you develop numbness
over the area, e.g. your limb has fallen asleep.
then, this is a sign that the wrap is too tight. You
can also utilize a cool ice pack or frozen peas to
reduce swelling. This is especially helpful for
facial surgery. Place the cool compress gently over
the surgery area. Bleeding usually subsides within
30 minutes. If you feel faint, immediately lie on
the floor with your legs elevated. If you have
tried this and bleeding continues and/or is brisk,
then call us at 904-285-75476 ext 202 or
204. For after hours, please dial
904-285-7546 ext 299. Please continue to
keep pressure on the area during this time until we
get back to you. If you do not hear from us
within a few minutes, please dial 911 or proceed to
the nearest emergency room.
How
soon before I can shower or bathe?
Usually within 24 hours. Sometimes on the face we
ask that you not shower until we see you the next
day. For other surgeries, e.g. simple excisions on
the back, you can shower the next morning. Simply
take the bandage off, shower, and reapply your Aquaphor ointment. If the area is oozing, place another
bandage dressing over the site. By days 3 to 4, you
may no longer need a bandage, especially if the
surgical site is dry and clean. Simply continue to
use the antibiotic ointment twice daily until we see
you for suture
removal in 7 to 14 days.
Usually, at the time of your
morning shower and at bedtime are the best times to change
your dressing. If your site is oozing or draining,
you may repeat dressing changes as often as every 6
hours, however, twice a day is usually what we
recommend.
This depends on a multitude of
factors such as age, fragileness of skin tissue,
wound tension, location and health risks such as
diabetes. Normally, sutures stay placed for 7 days
on the face. All other areas have sutures left in
place for 10 to 14 days. If you are a quick healer,
then we would like to reevaluate your surgical area
in 7 days to determine if they need to be removed in
a shorter time period. Fast Absorbing sutures or
wounds closed with tissue glue do not need to
reevaluated unless directed so by one of our
surgical team.
If
you sutures are imbedded in the skin so that you
cannot see the suture material or there appears to
be a bump over where the stitch previously was, then
you are probably correct... your sutures need to be
removed or at least evaluated for early removal.
Please call our office at 904-285-7546 ext
210 and we will work you into one of our
provider’s schedule for an evaluation. Please do not
attempt to remove these on your own as you take on
the risk of creating a secondary infection or a
worse appearing scar.
You may be having a reaction to your suture material, antibiotic ointment, or the adhesive tape.
Initially, you can try a mild corticosteroid cream
such as Cortaid
1%
Cream (available at Walgreen’s™ or Target™ without a
prescription) and apply this to the itching and red
area twice daily. If your surgery area is
warm and red and draining pus-like material, your
wound site may be infected and needs to be evaluated
at our office. Call 904-285-7546 ext 210 to set up an immediate appointment as
a culture may need to be taken. Further instructions
will be given to you upon assessment of your surgery
area.
Will my procedure leave a scar? If
so, how do I manage the scar?
Yes, all surgeries leave a scar. Some scars are more
visible than others and, in our office, 7% of cases
require a revision procedure. Please let us know if you are prone to keloid scar
formation or
are on medications which can impair wound healing,
i.e., Prednisone. All attempts will be made
to conceal your scar. As a cosmetic surgery center,
we strive for the best cosmetic results. After your
surgery you may desire to purchase one of our
scar
care kits.
We sometimes also utilize laser or injectable
corticosteroid treatments to assist
with scar concealment. As your patient advocate, our
surgeons will take all the steps they can to ensure
the best cosmetic outcome. Unfortunately, we can not
guarantee that you will have excellent results. This
is because all surgeries carry with them an inherent
risk such as infection, wound separation, etc. We
thank you for your understanding with this imperfect
situation. If you are concerned about the way a scar
is healing, please call us as son as you notice
something appears unusual c/o 904-285-7546 ext
210. We would be happy to evaluate your
wound site and review your available cosmetic options.
If your surgery is on the face,
it is best to refrain from strenuous activities such
as weightlifting, golf, jogging, or running for at
least 7 days. Please also refrain from bending down
and avoid projects where sweating and dust exposure
is common (for at least 7 days). Keep lower
extremity wound sites wrapped (in an ACE™ wrap)
and elevated as much as possible.
If your surgery is on the back, scalp, or arms, again
, avoid the aforementioned activities for at least 14
days.
This is a very common complaint
especially when taking products with codeine or
other narcotics for the first time. As an initial
approach, we ask that you try taking your medication
with some ginger ale or crackers. If this does not
work, trying halving the dose and see if your
symptoms get better. Usually, your symptoms will
improve after a few doses. If, after these
maneuvers, you are still experiencing nausea, stop
all prescription medications and call our
office for direction. If severe enough we will call
in a prescription anti-nausea suppository and/or
change out your pain meds to improve your symptoms.
It is very important that you relate to our medical
staff prior to surgery any bad experiences with
medications, anesthetics, anesthesia, adhesive
tapes, or suture
materials. In this
way, we can take precautions ahead of time to
minimize a negative experience during your recovery.
This is often normal especially
after the first 24 hours. If your surgery is on the
face, i.e., nose, eye, ear, or forehead area(s), it
is common to have swelling and bruising for a few
days. The impact of this can be lessened if you
sleep on an extra pillow or at 45 degree angle and
use cool compresses such as an ice pack. Frozen peas
that are contained in a malleable bag also work well
here. If swelling is intense, sometimes we will
prescribe a short course of corticosteroids to
alleviate the process. If you are experiencing a
severe headache with your swelling, or fever chills
or bleeding, it is important to notify us so
that we can evaluate you promptly. Please call
904-285-7546 ext 210 and
we will work you into our clinic schedule. Please
note that swelling can take up to 10 to 14 days to
completely resolve. All swelling eventually resolves
in its entirety.
Do not panic. This can
sometimes happen in high tension areas such as the
back or leg and can occur when sitting, squatting or
bending. We will need to assess the area to see if
the wound will heal well on its own. Sometimes,
however, our surgeons will recommend that the wound
be re-sutured. Call 904-285-7546 ext 210 and we will work you in for an
evaluation. In the interim, you should cleanse the
area with soap and water followed by the application
of your topical antibiotic. Repeat this twice daily.
Start your antibiotics 1 day before your procedure and take them daily
until they are finished. Do not
start them 7 days before your procedure. They should be started 1 day prior to your
procedure. Usually, antibiotics are prescribed for
7 days for facial surgeries and for
14 days for other body area surgeries.
First, off, if you need aspirin
due to a previous heart attack, or take
Coumadin
because of atrial fibrillation or
Plavix
because of a
stroke, please do not stop these meds. If you are
unsure, please check with your primary care doctor
before stopping them.
We can handle bleeding
so if comes down between risking another heart
attack or stopping your aspirin because of a skin
surgery, do not stop the aspirin or relevant
blood thinner that you are currently taking!
If you are taking blood
thinners electively (without a previous
condition), and your doctor says it is
“OK” to stop them, then we recommend that you stop
any relevant blood thinners for 14 days
before your surgery is scheduled. Medications which
should be stopped include:
Aspirin, Vitamin
E, Ginseng, Gingko Biloba, St Johns Wort, Garlic
tablets, Advil (Ibuprofen), Nuprin,
and Aleve (naproxen).
If you are requesting
additional antibiotics or pain medication, please
contact your pharmacy and they will fax over a
medical request to our triage nurse. Dr Harvey and
our medical team will determine if more medication
is necessary or if there is another alternative. You
should have all the necessary prescriptions needed
to “carry you through” upon your discharge from our
surgery center. If you require immediate assistance,
please dial 904-285-7546 ext 210.
As a reminder,
anticipate spending 1 to 4 hours with us. Use the
front entrance for check in.
Some surgeries require more time than others. This
cannot always be predicted prior to scheduling.
Every effort will be made to carry out your
procedure in a timely fashion.
We recommend that you bring a book, magazine or
headset (iPod) with you. Warm socks and a sweater are
helpful, during the winter months-Nov-April, because
our center tends to be chilly (this helps to
minimize infection risk). Juice, crackers, water,
tea, and coffee are provided in case you get hungry.
If you are having surgery on your face, it
would be wise to have someone drive you to and from
your appointment. For more information, click
here.
Obviously, there will be a
surgeon’s fee for your procedure. If you are having
anesthesia, an anesthesia fee from the relevant
provider will also apply. In terms of a surgery
center facility fee,
“A facility
fee may be charged to you and your insurance carrier
if your case requires a complex repair, flap, or
skin graft to close the wound”.
Please check with your insurance carrier or our
billing department for information on coverage,
deductibles and co-pay information. If your
insurance company is one that we do not participate
with, you will be responsible for the facility fee. For more
information, you may contact our billing department
at 285-7546 ext 203 or 206.
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If you
have any specific questions about your surgery which are not
found on this page,
please
call Ponte
Vedra Dermatology
& Aesthetic Surgery at (904) 285-7546 or email
amy@pvderm.com. |
