• (270) 554-7546
  • 2721 West Park Dr •  Paducah KY
 

Wellsprings Dermatology

 
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Patient Care Instructions

Postoperative Instructions - External Sutures

Caring For The Excision Site:

  1. Keep the site or sites dry and bandaged for 24 hours unless you have redness, itching, or swelling around the bandage. If you have redness, itching, or swelling around bandage please call the office for further instructions.
  2. After 24 hours you can shower but cannot submerge excision site under water until two weeks after procedure.
  3. After 24 hours remove the bandage and cleanse the area(s) twice a day with mild soap and water. DO NOT use Hydrogen Peroxide because it can compromise the healing of the surgical site.
  4. After 24 hours apply a thin layer of Aquaphor ointment twice a day after cleansing until your sutures are removed. DO NOT use Neosporin or Triple Antibiotic ointment. (If surgical site is on the foot or in a moist area see #5 below.)

Obtaining Results:

Please allow 2 weeks for pathology results to be finalized. If you have not received notification within 3 weeks please check your Patient Portal. You will only be notified if lesion is cancerous or if further treatment is required.

Things You Should Know:

  1. After the anesthetic wears off, you may experience some mild pain or discomfort. Usually Tylenol or over-the counter pain reliever is adequate.
  2. Please call for any unusual symptoms of pain, bleeding, or signs of infection. Signs of infection include redness, heat at surgical site, or any yellow or green colored oozing.
  3. We do not recommend Neosporin or Triple Antibiotic Ointment because many people react to Neomycin found in both of these products.
  4. When applying ointment to areas that stay moist, such as under the breast and on the feet, do not apply ointment at night. Allow the area to have air so that it does not become macerated.(sometimes these areas are hard to get dry, you can spread the area so there is no skin to skin contact and dry with a blow dryer.)
  5. You will need to return to the office in 5-7 days for suture removal of the face, 10 for the scalp, and 12-14 for suture removal of the body.
  6. When you come in for suture removal, if you have more than 2 external sutures, steri-strips will be applied.
  7. Do not remove steri-strips but allow them to peel off on their own.

To Aid In Healing And Reduce Scaring:

  1. Protect the excision site from the sun with sunscreens and/or a bandage for 1 year.
  2. You may purchase Silagen here at WellSprings Dermatology to apply after sutures come off to allow better healing and decrease scarring.
  3. All excisions of the arms, legs, and back have a tendency to spread and form a wider scar. Steri-strips and/or butterfly strips can be applied for 8-12 weeks after sutures are removed to decrease the risk of scarring.

Postoperative Instructions - Internal Sutures

Caring For The Excision Site:
  1. Keep site or sites dry for 24 hours.
  2. Wait for 24 hours to remove bandage unless you are having redness, itching, or swelling
    around the bandage. If having redness, itching, or swelling around the bandage please call the
    office for further instructions.
  3. After removing the tegaderm patch, cleanse the area(s) with mild soap and water during
    normal shower. DO NOT use Hydrogen Peroxide because it can compromise the healing of
    the surgical site.
  4. After 24 hours you may shower as usual but do not submerge under water for 2 weeks.

Obtaining Your Results:

Please allow 2 weeks for pathology results to be finalized. If you have not received notification within 3 weeks please contact out office at (270) 554-7546 or check on Patient Portal. Patient will only be notified if lesion is cancerous or if further treatment is required.

Things You Should Know:

  1. After anesthetic wears off, you may experience some mild pain or discomfort. Usually Tylenol or over-the- counter pain reliever is adequate.
  2. Please avoid Aspirin or Ibuprofen (they may thin the blood and reduce clotting time) unless previously discussed with our office or prescribed by another physician.
  3. Please call for any unusual symptoms of pain, bleeding, or sign of infection. Signs of infection include redness, streaking, heat at excision site, or any yellow or green oozing.
  4. Your excision site was closed with Polysorb suture. Polysorb suture is a dissolving suture placed under the skin. In most cases it takes about 3 months for your body to absorb the dissolving suture. (no sutures to remove)
  5. Steri-strips have been placed over the excision site and should be left alone. They will eventually peel off.

To Aid In Healing And Reduce Scaring:

  1. Protect the excision site from the sun with sunscreens and/or bandage for 1 year.
  2. All excisions of the arms, legs, and back have a tendency to spread and form a wider scar. Steri-strips and/or butterfly strips can be applied for 8-12 weeks after steri-strips have come off to decrease the risk of scarring.
  3. You may purchase a product called Silagen here at WellSprings to apply after steri-strips come off.

Photo Dynamic Therapy Treatment Care

Preparing for Blu-U with Levulan:
  1. Avoid excessive sun exposure 1-2 weeks prior to treatment.
  2. Avoid applying makeup or heavy moisturizers the day of the treatment.
  3. Do not shave the skin the morning of the treatment.

During the Treatment:

  1. You will come into the office and have the Levulan Stick (photosensitizer) applied to your skin that will be treated. You will then sit in the lobby for a specific amount of time depending on the area of the body being treated to allow the medication to become sensitized.
    (Approximately, 1 hour- face/scalp, Approximately 2 hours chest arms, & legs)
  2. After incubation, you will be placed in front of the Blu-U light box for the treatment. The treatment lasts for 16 minutes and 40 seconds.
  3. We then remove the Levulan from the skin with warm water and you will be able to leave the
    office.

We will file this procedure with your insurance carrier. You may have a deductible or co-pay due based on your individual insurance plan. If you would like to know if this service is covered or what your out of pocket expense will be, you can contact your insurance company and get a quote for the CPT code:

Face or Scalp code: 96567 and J7308 times 1

Legs or Arms code: 96567 and J7308 times 2

For more information about the treatment, please visit Levulan.com


Post Treatment Care:

  1. Avoid sunlight or bright indoor lighting for the next 48 hours. This includes bright windows, fluorescent and incandescent lighting. Limit time at computer screen, exercise caution with prolonged TV exposure and sit > 10 feet from TV.
  2. If you must go outdoors during the first 48 hours post treatment, use a thick coat of sun blocking agents containing ingredients such as zinc oxide to treated areas. You may reapply every 2 hours to provide maximal coverage. Protect the head, face, ears, and neck by wearing a wide-brimmed hat or similar head covering of light, opaque material. Wear long sleeves and pants if extremities are treated. Light weight gloves should be worn to cover backs of treated hands.
  3. Keep skin well moisturized with gentle cleansers and moisturizers such as Avene or Free & Clear Gentle Cleanser, Vanicream Lite, Cheryl Lee Hydrate, Correct, & Perfect, Ceramide Cream, Biafine, and Cheryl Lee Lip Balm. See the staff in the Skin Care Corner, as we do offer these products for sale in our facility.
  4. Avoid all products that may irritate or exfoliate
  5. Use cool compresses or ice packs as needed for swelling or itching.
  6. Tylenol or Advil may be taken according to the manufacturer recommendations for tenderness or discomfort.
  7. Daily use of SPF 30 sunscreen is recommended. Examples of acceptable sunblock’s are Vanicream, Avene, or Elta (Elta is a tinted sunscreen, for the face) or sunscreens with zinc oxide or titanium dioxide. See the staff in the Skin Care Corner, as we do offer these products for sale in our facility.

After treatment, you may experience the following:

  1. Peeling or flaking of the skin
  2. Redness
  3. Dark spots
  4. Swelling
  5. Stinging/burning-usually lasts 24 hours
  6. Tenderness
  7. Oozing
  8. These effects usually resolve in 5-7 days and should be resolved in 3-4 weeks completely.

If you experience the following, please call your care provider:

  1. Severe pain
  2. Open, weeping skin
  3. Blisters
  4. Temperature > 100.5

Note:

Follow up with Physician/Technician approximately 6 weeks post treatment


General Care Guidelines

  1. Avoid prolonged bathing and hot water while bathing.
  2. Apply cream based moisturizer to body 3-4 times per day. The best and most important time to apply is within 3-5 minutes after toweling off following bathing. Vanicream or Avene Emollient Cream are recommended products and are available in The SkinCare Corner.
  3. We recommend’ Purex Laundry Detergent Free and Clear’ and rinsing clothes twice on rinse cycle of wash. Fabric Softener and/or Dryer Sheets are not recommended.
  4. Use soap substitute, such as ‘Free and Clear Cleanser’ (available in The SkinCare Corner) for bathing. The products which produce a heavy lather have excessive amounts of detergent which ultimately can irritate the skin.
  5. Avoid scratching areas of the skin. If itching cycle starts, take oral, over the counter, medications such as Benadryl to suppress. If this medication is contraindicated for you, we advise you to avoid using.
  6. If itching persists, avoid scratching areas. Apply pressure to area or apply cold compress to help alleviate the symptom. The scratching worsens the rash.
  7. Avoid smoking in home/cars and around affected person.
 
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