I had a mohs performed 4 days ago and it seems I'm forming large scabs. This worries me for when I have the 11 staples removed in one week. What's the best way to lessen the scabbbing?
How Do I Take Care of Staples on Scalp from Mohs Surgery? (photo)
Doctor Answers (6)
Post Operative Care for Sutures or Staples
Post-operative care is a funny thing, as each surgeon has his/her preference as to post-operative care. So it is always recommended to ask your doctor how he/she wishes you to care for your wound.
Here is some basic information:
- Scab is bad. You do not want a scab to form as it slows healing
- Cleanse the wound. Some surgeons want you to clean with soap and water, others recommend sterile saline, others hydrogen peroxide (either full strength or half/half with water). Most recommend cleaning wounds once or twice daily.
- Keep the wound moist. Moist wounds heal faster and often better than dry wounds. Therefore a petrolatum-(Vaseline)-based ointment works best. Such include Bacitracin, Polysporin, Neosporin, or Bactroban (available by Prescription), which are all antibiotic ointments. Some physicians recommend Vaseline or Aquaphor Healing Ointment.
- To cover or not to cover, that is the question. If you keep the wound moist with a petrolatum-based ointment, it may not be necessary to cover the wound--as long as the ointment stays on the wound. On areas that are prone to coming in contact with clothing or bedding, it is often preferable to cover the wounds to avoid making a mess.
Mohs post care for scalp
The issue with scabs is that scabs cause scars. We were all told as children not to pick scabs because it meant something was healing. But what it actually meant was that something was scarring. So, you can shower and try to lightly remove the scabs after your scalp has been wet for a for minutes. Don't scrub, but just lightly rub, even with a q-tip or two. If that's not getting the scabs off you can take some gauze or a thick papertowel, wet it and place it over the area. Let it sit for awhile. The wetness will loosen the scabs. After the scabs are off, goop it up with Vaseline or Polysporin and keep it gooped up for the entire week. This will help it not scab over, and will allow new pink fresh skin to begin filling in the area. If you have any questions or issues, call the surgeon's office. I often see my patients a day or so out for post-wound checks just to make sure they are cleaning everything properly and it looks good. Any doctor should be willing to see you if you have a post-wound concern.
Mohs and Reconstructive Surgery
Caring for your wound following Mohs and Reconstructive surgery is important to the cosmetic outcome of your scar. For my own patients, I recommend generous vaseline to the area of the suture line or staples to prevent the formation of scabs. Also you can used a warm compress a few times a day to soften up any scabs and if you pat gently without too much force you should be able to remove most scabs that have formed. Every surgeon has slightly different preferences so I would recommend you check with your Mohs surgeon who performed the procedure on how you should care for your area following skin cancer surgery. From the photo it looks like you're doing a pretty good job taking care of it.
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Post op staples care
The post op care for a stapled wound is very much the same as that for a stitched wound and it's always a bit more challenging on the scalp since you can't see the area yourself and hair is covering everything. We recommend the following to our patients: keep the wound clean and dry for the first two days followed by cleaning the area with soap and water (might be easier to do in the shower initially as the crust can become adherent) and perhaps have someone help you with a cotton swab or clean washcloth to gently remove any dried blood or crust that has formed. Then apply Vaseline to the site and if possible cover with a bandage (sometimes too challenging on the scalp). There should not be any crust left on the wound as this inhibits optimal healing.
Staples for scalp repair after Mohs
You should be washing the area with light suds during the shower. You can get this from antibacterial soap but even Suds from shampoo should help. Often times I'll have patients use a small amount of hydrogen peroxide on the healing surgical wound itself to help remove crust. But being four days out and because the hydrogen peroxide and temporarily Bleach your hair I think you can easily get away with light manual washing with soap and water.
Lastly be sure to apply ointment such as Vaseline for 2 to 4 times a day at the site. Keep it moist will help it heal the best and minimize scar.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.