Pre-Surgical Advice Sheet

What you need to know before the procedure

On the bottom of the page there is an embedded .pdf you can print with the information below.

General Advice

Coronavirus changes:      Please click here for updates on changes regarding Coronavirus. Also check the “On the day section of this document”

Marking Up:                      In case we remove multiple lesions and / or lesions that are a bit inconspicuous it would be helpful if you could mark those with a circle around them. This helps for us not to forget any removals or indeed remove something unwanted.

Rest:                                   Cancel Commitments: After Minor Surgery it is important take it easy for 1-2 days. This means no exercise, no heavy lifting, no DIY, no alcohol etc.

Exercise:                            It is important for any minor surgical wound that has been sutured not to get stretched too much. The more you stretch the wound the wider and more stretched the scar will look. Keep exercise to a low level for at least 7 days.

Dressing:                            Keep the wound covered for at least 48 hours up to 7 days as per instructions by the team. Dressings we use vary depending on requirements.

Bleeding:                           Should your wound bleed or discharge you need to apply pressure for 30-60 minutes and bleeding should stop. Afterwards you should apply a new dressing. At the earliest opportunity change the dressing. If a back wound is bleeding put on a good bit of gauze or similar and sit against a chair to apply pressure for an hour.

Shower:                             Do not get your wound wet for 48 hours (let a permanent crust form first)

Alcohol:                             Do not drink alcohol for 48-72 hours (alcohol increases the risk of bleeding and infection)

Redness/ Infection:         Buy some antiseptic. Should your wound look inflamed or infected, please apply some simple iodine or other antiseptic on a cotton wool bud to the wound repeatedly every few hours.  If its getting worse call our service on 07973663355 or Dr Kittel on 07968 945280.

Stitch removal:                 The nurse will advise you about this on the day. Please book your stitch removal as soon as possible after surgery. If you have dissolvable sutures you do not need to book an appointment. During Coronavirus we may offer you suture removal kits for self removal of stitches.

Pain:                                   Pain after Minor Surgery is usually well controlled using simple over the counter medicines like Paracetamol, Ibuprofen or Co-Codamol. Avoid Aspirin, which is contained in some products like Anadin and Anadin Extra. Always read the drug information leaflet. Purchase painkillers before your procedure.

Scarring:                            Scars don’t always look good to start with. After 6-8 weeks significant scar shrinkage sets in and results look very different. You can help better scarring by 1) using silicone gel (available online) 2) using Mepore or any other Tape vertically to scar for 8 weeks to support the strength of the scar. 3) Also, Vitamin D deficiency has been associated with poor healing in burn victims recently and as such good Vitamin D levels are likely to be soon discovered as beneficial for good wound healing after surgery. There is not yet any evidence on this recommendation, but I believe that particularly in Winter and in patients with low sun exposure a dose of 2000-3000iU of Vitamin D (2-3 tablets) for 2-3 weeks beforehand and 2-3 weeks after surgery is beneficial.

Forms                                 Please ensure you have completed our application form, pre-consent form and consent form online. Other forms, like an exemption of lab test agreement etc are sometimes mailed. You should have been sent individual links to this, which will put the form into your own medical records.

On the day:                       Most Minor Surgery consultation appointments are between 6pm and 8pm. Procedures are generally between 3 and 7pm. Please wait in your car on arrival and text 07973 663311 to let us know you have arrived. Please include your name, car make, car registration and which car park you are parked in in the text.

Specific Advice

Shave Excisions:               These are usually small excisions with small wounds. Keep them covered with a small piece of Mepilex Border or a spot plaster for 2-7 days depending on advice on the day. You only need to keep them dry for 24-48 hrs. depending on advice. Wait for the crusts to fall of naturally. Do not scratch them off as cosmetic results can worsen.

Large Excisions:                You need to keep those covered and safe for longer. Should the wound crack and Dr Kittel not be available the wound should be immediately re-sutured in a Minor Injuries Unit. Sometimes they may feel no suturing is required and the wound should heal from back to front. Following this, please call Dr Kittel / TVSS at your earliest opportunity.

Xanthelasma:                    Do not wash the area until crusts have formed (usually 48 hours). Wait for all crusts to fall off by themselves. We do not recommend covering these. Occasionally you may experience swelling and redness of the surrounding tissues, which usually settles on its own or with some Antihistamines i.e. Piriton or Cetirizine and Anti-inflammatories i.e. Ibuprofen (please ask your pharmacist).

Blood thinning:                 For all but very small procedures we require for blood thinning medications should usually be stopped 2 weeks before the procedure and restart them 1 week after the procedure. Please only stop blood thinning medications if your specialist and / or GP agree. If they disagree, we need to carefully discuss this at the consultation.

EMLA cream:                    Emla Cream is a Local Anaesthetic cream that we recommend you buy and apply under clingfilm or a transparent plaster 2-3 hours before the procedure only for certain moles and skin tags or if you very worried about the local anaesthetic. This reduces the need for Local Anaesthetic Injections. Please download the online leaflet on https://minorsurgery.co.uk/cms/wp-content/uploads/2017/02/EMLA-cream.pdf

Questions?                        TVSS is always happy to help if you are worried. Just call or email.

Minor Surgery Preparation Advice Sheet 2020

Dr Martin Kittel, GMC 44 58 638