A skin graft from behind my ear was used after MOHS surgery to remove BCC - The oculop. surgeon who did the reconstruction has told me to keep Vaseline on it but not cover it. MOHS surgeon today told me to keep it covered with a band aid and lots of Vaseline. What should I do? Does it look normal for 16 days?Also, a portion of the graft at the top has detached and is "dented in" which the doctor told me to keep Vaseline on and let it heal by secondary intention..will it heal dented in?
March 31, 2012
Answer: Healing after excision (Mohs surgery)
Skin grafts require a complete blood supply to "take" and live. Sometimes for a variety of reasons there is some compromise of the blood supply and the grafts don't completely take. It is not necessarily an all or nothing phenomenon and the graft may be partially taken. In many cases, the wound is allowed to heal and then decisions about whether any further touchups or surgery may be helpful can be made. Revisions down the road can involve further surgery sometimes or more simpler interventions like laser or dermabrasion. It is quite common for a wound (either post surgery or allowed to heal on its own) to look depressed, off color and improve dramatically with time.
It is not possible to tell completely if there is partial take of your graft from the photo, though that is certainly possible. Skin grafts can have a variety of appearances in the immediate week or two after surgery. Many, including me, do believe that "moist" wound healing, e.g. with Vaseline helps speed healing.
The final decision on when and whether to intervene and possibly revise the scar is ultimately based on how its healing and the input of both the surgeon and the patient. I'd recommend following up with the reconstructive surgeon (the oculoplastic surgeon) for his/her input.
Helpful
March 31, 2012
Answer: Healing after excision (Mohs surgery)
Skin grafts require a complete blood supply to "take" and live. Sometimes for a variety of reasons there is some compromise of the blood supply and the grafts don't completely take. It is not necessarily an all or nothing phenomenon and the graft may be partially taken. In many cases, the wound is allowed to heal and then decisions about whether any further touchups or surgery may be helpful can be made. Revisions down the road can involve further surgery sometimes or more simpler interventions like laser or dermabrasion. It is quite common for a wound (either post surgery or allowed to heal on its own) to look depressed, off color and improve dramatically with time.
It is not possible to tell completely if there is partial take of your graft from the photo, though that is certainly possible. Skin grafts can have a variety of appearances in the immediate week or two after surgery. Many, including me, do believe that "moist" wound healing, e.g. with Vaseline helps speed healing.
The final decision on when and whether to intervene and possibly revise the scar is ultimately based on how its healing and the input of both the surgeon and the patient. I'd recommend following up with the reconstructive surgeon (the oculoplastic surgeon) for his/her input.
Helpful