Stratum Dermatology Clinics will be closed for the holidays from December 26th to 29th.

SHALLOW GRANULATING WOUND CARE SHEET

The wound you have should heal by secondary intention. Healing by secondary intention means that a wound will be left open (rather than being stitched together) and left to heal by itself through the growth of new tissue. The wound will heal naturally, starting from the bottom of the wound, slowly filling in until it heals to the top and closes.

A wound healing by secondary healing will require regular dressings on the treatment area, usually for up to 6 weeks however the healing time will also be dependent on the size, depth and site of the wound.

Your Doctor will either advise the use of Petroleum Jelly (Vaseline) or they may prescribe an antibiotic ointment such as Mupirocin for use after your surgery. Products such as Petroleum jelly prevents the wound from drying out and forming a scab; wounds with scabs take longer to heal. A wound which remains moist and is kept free from scabs/crust usually heals quicker and leads to a better cosmetic result.

Initially you will need to dress the wound regularly, however this will be advised by your Consultant.

You will need:

  • Shower (preferable) or water which has been boiled in a kettle
  • Cotton buds (not cotton wool)
  • Dressing Ointment as prescribed
  • Non-adherent dressing and tape, or plasters

 

Method

  • Wash your hands to minimise the risk of infection.

  • To remove the dressing, we recommend that you take a shower and remove it once it is wet (this avoids any potential damage to the skin).

  • After removing the dressing, wash the area in the shower and lightly remove residual product from the wound with your fingers or a cotton bud (do not use cotton wool). Allow the water to penetrate the wound.

  • After showering pat dry with a clean towel and apply the antibiotic ointment with a clean cotton bud This will help prevent the wound from crusting. A crust or scab on the wound will slow down the wound healing and affect the cosmetic result.

  • If a scab forms, DO NOT PICK IT. Regularly soak the scab in fresh flowing water such as the shower. The water from the shower should eventually soften the scabs and they should come away easily. Apply lots of the antibiotic ointment that has bene prescribed to keep the wound moist.

  • If the wound is irritated by clothes etc. you can apply a simple non-stick dry dressing such as a Mepore or Melonin dressing.

  • We advise against swimming or soaking the wound (e.g. in a bath) until new skin forms.

Bleeding

  • If there is any bleeding following your procedure, press firmly on the dressing for at least 20 minutes. Do not remove the dressing as this will encourage the wound to bleed more.

Wound Infection
It is normal to see some redness and have slight swelling at the site as this is part of the healing process. However, if you experience any of the following after the procedure, please contact the clinic where your procedure was performed:

  • Increasing pain at the site
  • Increasing swelling
  • Increasing redness
  • A pus like discharge

Pain Relief
The local anaesthetic will wear off after 1 to 2 hours. You may need to take pain relief e.g. Paracetamol (as long as you do not take any other medicines containing Paracetamol) to a maximum of 8 of 500mg tablets in 24 hours. Please avoid drugs such as aspirin, ibuprofen, and diclofenac (non-steroidal tablets) as these tablets increase bleeding and bruising.

Wound Massage
Only once the wound has fully healed can you start wound massage. Your clinic can advise on when is the best time to start wound massage however to do this we advise.

  • Use a lubricant to massage the wound (moisturiser or oil) for 2-3 mins every morning and night for around 12 weeks.
  • Initially (week 1) start with quite light pressure and increase the pressure every week. Run your fingers up and down the scar and in small circular motions. This will help the scar become softer, flatter and paler.
  • After massage you can then apply a silicone scar gel such a Kelo-Cote (am & pm) which helps stop over formation of collagen (which can cause raised scars) and forms a protective barrier over the scar.
  • If you decide to use an oil to massage the wound, please ensure residual product is removed from the skin prior to the application of Kelo-Cote. If using a moisturiser, please ensure this is fully absorbed prior to applying Kelo-Cote.