Surgical Excision

Pre-Operative Instructions

1. Please stop taking Aspirin or Vitamin E one week prior to procedure. If a physician has prescribed it for you, please check with him/her before stopping. Please notify Dr. Scheel if you are taking any other blood thinners.
2. Do not drink alcohol or eat foods containing excessive garlic two days prior, as this may increase bleeding.
3. Be sure to inform Dr. Scheel in advance of any special medical problems you may have. (heart problems, artificial joints or valves, HIV, hepatitis, etc.)
4. Please shower or bathe before you come in for your procedure, you will probably be told not to shower or get the wound wet for 24 hours. This will decrease the chance of infection.
5. You should have little or no discomfort during the procedure, if you are concerned about pain from numbing injections, please let us know, and we can call in a numbing cream for you, prior to your appointment.
6. On the day of the procedure, eat a light meal, 4 hours prior is usually best, unless instructed otherwise.
7. Wear comfortable clothing, something easily removable.
8. Don’t plan any other activities for the day, avoid bringing young children with you.

Post Operative Care

The importance of post operative care of your surgical site cannot be overstressed. The better you take care of yourself and your wound, the faster the healing and the lower chance of complications like infection and thick scarring. Eating a good diet of lots of vegetables along with some fruits and lean quality protein sources can be very helpful. So can taking a multivitamin and some extra Vitamin C (500mg). Avoid stressing, straining the area of surgery, and smoking.

There are several things that could happen immediately after surgery:

Bleeding- to reduce this limit activities for 24 hours after surgery, keep the surgery site elevated, sit up in bed rather than lying down if the surgery was done on your face or upper body, avoid stooping or bending down, avoid straining with a bowel movement, sleep on an extra pillow, avoid alcohol, aspirin, and ibuprofen for a day or two. If bleeding occurs, hold firm pressure for 20min over the bandage.

Swelling- apply an ice bag or bag of frozen peas or corn for 20minutes each hour for the first 5 hours.

Pain- Pain post-operatively is generally mild. Try 2 extra strength Tylenol every four hours if you experience moderate pain.

Post Operative Wound Care

1. Keep the wound dry for 24 hours with the bandage intact.
2. Clean the wound daily with soap and water. Do not use hydrogen peroxide or alcohol, which may both inhibit wound healing.
3. Blot the wound dry with a clean cloth.
4. Apply a thin layer of antibiotic ointment to the wound. I recommend Bacitracin or Herbal Ed’s Salve (Ho’o Lokahi). You may use Neosporin or Triple Antibiotic if you know that you are not allergic to it.
5. Cover with a band aid daily until wound is healed or stitches are removed.
6. Return to the clinic for suture removal.

Other Issues

Infection:signs of infection are increased pain, swelling, redness, or yellowish drainage several days after surgery. Call our office immediately if there are any signs of infection, 329-1146.

Scar: There will be a scar after surgery. This will decrease as the healing process continues but can be as long as 6 months. Everyone heals differently and the final scar will depend on the individual’s ability to heal. Some people will heal from surgery without a trace; others will have scars that are raised, red or itchy for several months. To decrease scarring, once the wound is healed massage Vitamin E oil on the wound for 5 min each morning and night. If the scar continues to raise, be red, or itchy, I recommend Neosporin scar care sheets with silicone to be worn 20hrs per day or overnight if the scar is in a highly visible location. If scars continue to be problematic, come back to clinic, we may be able to inject it to flatten its appearance or minimize the symptoms.