Following your previous appointment with Community Outpatients Dermatology Clinic, a Minor Operation appointment has been scheduled for you.
It is very important that you attend the appointment.
Please aim to arrive 10 minutes before the start of the appointment.
If you are late less than 10 min late, you will still be seen, but you may need to wait until there is a space in the clinic. If you are more than 10 minutes late, you may be asked to book another appointment.
If you are on any anticoagulation medication such as Warfarin please make sure you visit your INR clinic at least 3 days before your appointment and make sure your INR is less than 2.5. You will be required to bring the proof of your INR range to your appointment.
If you are on Apixaban, Dabigatran, Edoxaban, Rivaroxaban or Aspirin (which has a dose more than 75mg daily) please stop these medication 48 hours prior to your appointment unless you heave a metal heart valve then continue taking these.
Depending on the type of the procedure you may be required to bring a chaperone with you to your appointment.
Read our Pre-Operative Patient Information below carefully.
If you are having a rash biopsied, you should stay off your steroid creams for 5 days before the biopsy in the area to be biopsied.
Please contact Community Outpatients Dermatology Service as soon as you can to explore if your appointment needs to be rearranged. It is important you let the service know to prevent your appointment being wasted leading to delays to other patients.
PRE-OPERATIVE PATIENT INFORMATION
Information for patients and carers
We perform curettage (scraping off), shave excisions (slicing off), cryotherapy (freezing off) and full excision (cutting off) of lesions. Lesions can either be completely removed, or a small sample taken, but all lesions are usually sent to the laboratory for testing to make an accurate diagnosis. Biopsies are usually performed for rashes or large lesions that are too big to remove completely. Very occasionally we need to close a wound with a skin graft or move a piece of skin around (skin flap) to close the wound, but this will be discussed before surgery.
BEFORE YOUR OPERATION
Drugs and medication: Please let the doctor know if you are on aspirin, beta-blockers, or any other blood thinning medication. These do not usually need to be stopped but we need to know you take them. If you are on warfarin even if your blood tests are stable, you need to have an extra INR test 1-3 days before the operation. If the result is over 3 then you will not be able to have your operation as the risk of bleeding is too high.
Allergies: Please let the doctor know any allergies to medicines or to Latex.
Pacemaker: This may affect what equipment we can use but will not prevent your surgery.
Holidays/Special Events: If you are travelling abroad or on holiday or attending a special event within three weeks of surgery, please reschedule your procedure by telephoning the number at the top of this leaflet, unless your surgery is URGENT. This is because of the risk of post-surgical complications, and dressing and stitches will need to be removed. There may also be bruising/swelling; you may not look or feel your best for a special event
Sports/Exercise: You should not swim, play sports (including golf), or exercise whilst the stitches are in place. Depending on the size and site of the surgery you may be asked to refrain from activities that will stretch that area for a period of time (3 – 4 weeks) after the stitches have been removed. Please ask if you are not sure.
Contact Lenses: If you are having surgery around the eyes and wear contact lenses, please remove them before attending.
Please Note: If you are having surgery on your head or neck, please ensure you are accompanied to surgery as you must not drive yourself home.
AFTER YOUR OPERATION
The following advice will help you understand what to expect after your skin surgery procedure. Please talk to the doctor or nurse if you have any other questions.
Will I have a dressing?
You will usually have a dressing, the size of which will be dependent on the type of surgery you have had. You will need to keep this in place for the first 48 hours after the surgery, sometimes longer depending upon the type of procedure completed, but your clinician will advise you on the day.
How long will the wound be painful for? What sort of pain?
You may feel some soreness after the anaesthetic has worn off. If this happens, you may take paracetamol (if you are not allergic to it).
What happens if my wound starts to bleed?
It is normal for a small amount of blood to come through the dressing, but if it does not stop and the dressing becomes saturated, you should press firmly over the dressing for fifteen minutes. This will usually be enough to stop any bleeding. If bleeding continues, you can try applying an ice pack to the bandaged area for fifteen minutes (a simple ice pack can be made by placing a bag of frozen peas into a dry plastic bag, to avoid wetting the bandage). If bleeding still continues, you should contact your GP, Accident & Emergency, or the Out of Hours Service in your area.
What about the risk of infection?
As with any surgical procedure there is a risk of infection. For skin surgery this risk is about 1 in 20.
Signs that your wound may have become infected usually begin 48 hours after surgery. You should seek help if you notice any of the following:
- You have increased redness around the wound.
- The wound becomes more painful even after taking painkillers.
- The wound and surrounding skin feels hot and starts to throb.
- The wound begins leaking, oozing or starting to bleed again.
- You have a raised temperature and feel generally unwell.
If you notice any of these signs and are worried that you may have an infection, you should contact your GP immediately as you may need a course of antibiotics.
What about work, exercise and other activities?
You may need some time off work depending on the type of surgery you have had and the type of work you do. As far as possible, you should relax and take it easy following the surgery. After simpler procedures this should be for a few hours and after larger procedures for a few days; the doctor or nurse will advise you accordingly at the time of your operation. It is quite normal for you to feel tired after an operation. You should:
- avoid vigorous exercise such as swimming, running, contact sports or going to the gym until the stitches have been removed and the affected area has healed.
- avoid bending, straining or lifting heavy objects as these may cause the wound to open and bleeding to start.
When can I have a bath or shower?
You will need to keep the wound and dressing dry for 48 hours, or longer if advised on the day. After this you can shower normally, but do not hold the wound directly under the shower or soak it for a long time. It is advisable to avoid soaking in a bath whilst the wound is healing and has stitches in place. You should dry the area by patting it gently with a towel rather than rubbing it dry.
When can I remove the dressing?
After 48 hours (or longer if advised on the day of surgery), carefully remove the dressing. If it is difficult to remove, you may need to wet it to allow it to come off more easily. You can leave the operation site uncovered, but if it is likely to get dirty or rubbed by clothing you can apply a light dressing or plaster, which should be changed daily.
Will I have a scar?
Surgical procedures leave a permanent scar. The stitch line will look red at first. The redness can take a number of months to fade to a pale pink colour. The stitches may look raised in the first week. The redness may take a few months to fade. You will have a permanent scar in this area which usually fades to a pale line.
Some scars can become hypertrophic or keloid.
- Hypertrophic scars are raised but do not extend beyond the edges of the original wound.
- Keloid scars are raised, sometimes itchy, and keep growing even after the wound has healed. They can become pink, red, the same or darker in colour than the surrounding skin. Keloid scars can be difficult to treat but may improve with application of a steroid ointment, silicone gel-sheet or steroid injections.
What other things should I be aware of?
- In the first week your wound may feel tender and may bleed slightly.
- Your wound may be swollen and bruised, especially if it is on the face or around the eyes. This should settle down as the wound heals.
- The area around the wound may be numb for a few months.
- You may feel a sharp pain from time to time as the wound heals.
All of the above are part of the normal healing process.
What happens to the removed skin/lesion/mole?
All skin specimens are sent to the laboratory for analysis.
When will I get my results?
You will either be given a clinic appointment to come and talk about the results, or one of the doctors may telephone or write to you and your GP to let you know the result. Please be aware that it may take up to six weeks before you receive the results.
Contacts/ Further information
If you require wound care advice, please see your GP or practice nurse in the first instance. If you need further advice: please call our Administration Team.