Skin cancer removal procedures such as Mohs surgery, excision, or electrodesiccation and curettage (ED&C) create wounds that require specific care for proper healing. Understanding wound repair and post-procedure care is vital for a smooth recovery.
How are Skin Cancer Wounds Closed?
If feasible, the wound is extended by removing two triangles of normal skin and the wound edges are stitched together into a straight line. This is called a side-to-side closure or linear closure. Wound care for linear closures typically involves gently cleaning the area daily and applying petrolatum or Aquaphor and sometimes a dressing for 1-2 weeks.
Sometimes the wounds are too large for this type of linear closure and need to be treated differently. How we choose to close those wounds is determined by various factors including the wound size and location, patient preference, the patient’s underlying health, and whether there is sufficient adjacent loose skin to stretch and rearrange into the wound.
Sometimes the best choice is not to repair the area at all, but to let it heal naturally. This is called “second intention healing” or “healing by granulation”. Sometimes this choice will eventually result in a better cosmetic result than repairing the area by a flap or a graft (See “Skin Flap Repair”).
After your skin cancer is removed and the wound is created, your surgeon will discuss the various options available and you will decide together which option to choose.
How Can I Help My Skin Cancer Removal Wound Heal?
If we choose to allow the wound to heal by second intention, your surgeon and staff will explain how to take care of the wound. This usually involves cleaning the wound daily with soap and water (done easily in the shower) and then applying some ointment (petrolatum or Aquaphor) and a dressing.
This type of second intention wound healing usually takes 4 to 12 weeks to heal completely.
What Happens if My Wound Isn't Healing?
How long it takes to heal varies based on any underlying medical conditions and the location of the wound. For example, patients with diabetes usually take longer to heal.
The further the wound is from the heart, the longer it may take to heal. Wounds on the face usually heal within 4-6 weeks, but wounds on the shins may take 12 weeks or longer.
Our physicians are extremely knowledgeable in helping difficult wounds to heal. They employ various tricks including using special dressings and applying special medications that can be used on uncooperative wounds. If the wound does not heal as expected, there are other repair options we can consider, including skin flaps or grafts.
What Can I Expect During the Wound Healing Process?
Mild bleeding may occur following any skin surgery. If bleeding should occur, apply direct, constant pressure without stopping for 20 minutes. If the area is still bleeding after two rounds of pressure, then call the office, even if it is after regular office hours. You will always be able to reach one of us.
You can expect some mild discomfort after the anesthetic wears off. Usually plain acetaminophen (Tylenol) is sufficient to control the pain. Swelling and bruising are quite common after this type of surgery and should resolve in 2-3 weeks.
Skin cancers can often involve the nerves of the skin and it may take as long as a year or two until normal sensation returns. It is possible that the area may stay numb permanently.
Anytime a skin cancer is treated, no matter with what method, a scar results. Scars from second intention healing are usually red and hard in the beginning, but improve over time and become much lighter in color and softer. The maximum improvement may take as long as 1-2 years.
Our physicians have many techniques to help improve the cosmetic result of the scar including steroid injections, dermabrasion, and lasers. These techniques are not usually offered before 2-3 months post-operatively.
Our doctors can answer any questions you might have regarding wound care after a skin cancer procedure. Please call us if you have any questions or concerns.