Activity:

The patient should rest quietly in a safe place today.  No vigorous exercise for _ days.  It’s ok to return to school/work in _ days.  You should not drive a car or operate machinery or sign legal documents when taking narcotics. 

Diet:

Advance diet slowly from clear liquids to bland/soft foods and then back to a normal diet.  If there is an upset stomach or vomiting, then wait 30-60 minutes before starting with clear liquids and slowly advancing back to normal foods.  Clear liquids include water, popsicles, apple juice, tea, cola, and breast milk. 

Pain Management:

Ibuprofen and acetaminophen products can both be taken.  They can be alternated or taken at the same time.  Please follow the over-the-counter instructions. 

Non-pharmacological pain management:

Ice packs or a frozen bag of peas can be placed on the area during the first 24 hours to help with pain and swelling. 

Antibiotics:

If prescribed an antibiotic, take it as instructed and complete the whole course.  If you or your child develops a rash or other side effect, stop the antibiotic and contact our office.

Skin Wound Care:

o   It’s important to take good care of the surgical site so that it has the best possible chances of healing well without a noticeable scar.

o   Wait 24 hours before cleaning the area with soap and mild water.  Make sure to pat dry the area.  Do NOT rub on it.

o   DO NOT soak/submerge the wound underneath the water in a bathtub, hot tub, pool, lake, stream, river, or ocean.

o   Resorbable sutures usually dissolve and fall out 7-14 days after surgery.

o   If non-resorbable sutures were used, they will be removed in the office setting anywhere between 5 and 10 days after surgery.

o   Skin glue leaves a protective coating on the skin.  The glue sloughs or peels off over the first 1-2 weeks after surgery.

o   Skin staples are usually left in place 14-21 days.

o   Use a light coat of antibiotic ointment (bacitracin, neosporin) twice a day for the first 3 days after surgery.

o   After 3 days, please switch to plain Vaseline.

o   You want to avoid letting a lot of scabbing build up.

o   Use a q-tip with water to gently roll off any scabs.

o   If you are having a hard time getting the scabs off, do your best and we will look at the area together at the follow up appointment.

o   If things are healing normally, then we will review the use of a q-tip with a mixture of water and hydrogen peroxide 50:50 and gently dab the dried blood (scabs) to help dissolve them and prevent them from building up.

o   Avoid direct sunlight as much as possible and use sun screen or a hat whenever you are outside for the first 6 months after surgery.  Sun burns are really bad for the healing process and can cause unwanted scarring.

o   After 3 weeks of healing, if things are going well, then it is generally safe to start massaging the site with some vitamin E oil or cream.  Over the counter scar products can also be started at this time.

o   You can start using over the counter scar sheets at this time (3 weeks).

o   A little bit of redness on the edge of the site is normal during the first week.

o   If there is concerning redness or swelling or any drainage of foul-smelling liquid, please contact our office.  You will need to be put on an antibiotic.

o   Hypertrophic Scarring (abnormal):

o   A scar that is thickened, wide, and often raised, but if isolated to the original injury/incision.

o   Can develop 1-2 months after the injury.

o   Can be treated with steroid injections and laser therapy.

o   Keloid Formation (abnormal):

o   A raised, thickened, widened scar that grows beyond the boundaries of the original injury/incision.

o   Can develop months to years after the injury.

o   Can be treated with steroid injection and 5-FU injection and laser therapy. 

Oral Wound Care:

o   The mouth tends to heal very quickly.

o   Good oral hygiene can help with the healing process.

o   You should brush your teeth twice a day.

o   You should floss once a day.

o   Gentle rinses with a mixture of water and salt should be started the day after surgery and should be done after snacks and meals for two weeks.

o   If you were given an antibiotic mouth rinse, use this twice a day for two weeks.

o   Sutures in the mouth are resorbable and usually dissolve in 7 to 14 days.  

Additional Information:

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