Dserra1 Asking Again About the Slow Healing Process After MOHS?

It is now going on month two and the wound is still seeping pus .. are we suppose to allow it to crust ?? Should I be removing this when we wash his hair ?? He has had a stroke just over a year ago and worries as to washing his hair .. I try using peroxide now with a q-tip to clean the seepage but I also clean the wound with it and have applied small amount of vaseline and a bandage .. I will be calling the doctor but due to his insurance he has no visits left this year .. I need to know ...

Doctor Answers 5

Healing Process After Mohs Surgery

Thank you for your question. It would be rare for a wound to still be draining at this time after surgery, and the most appropriate response would be to follow up with your surgeon for evaluation. This draining fluid could be normal if the wound is draining a clear fluid after being allowed to heal by second intention healing (serous fluid), and was not closed initially. Also, any white fibrinous tissue, could be fibrin which is a normal building block of tissue healing, versus actual pus. This would be considered a normal response to healing, and not consistent with infection. The recommendation is to call your MD as soon as you can, and schedule an appointment for wound evaluation. I hope this helps.

Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

Wound healing after Mohs

From your description it sounds as if the scalp wound after Mohs was left open to heal in by second intention. Scalp wounds tend to ooze and create a creamy layer of 'pus' but are not necessarily infected.  If the site is tender and the skin around the edge is bright red, this could indicate infection. Don't be afraid to wash the wound while in the shower, using Johnsons Baby Shampoo, rinse thoroughly and apply a thick layer of Aquaphor and cover with a dressing.  Dressings should be changed daily.  If it is tender, the scalp is red and swollen and if there is a foul odor, he needs to have it checked by his surgeon.

Steven Swengel, MD
Los Gatos Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Wound Healing After Mohs Surgery

If the wound is "seeping pus," you need to see the doctor who performed the surgery. The signs and symptoms of infection include pus, redness, tenderness/pain, fever, etc. Irrespective of whether you have any office visits left on your insurance, your doctor will want to see it, especially if it is not healing as expected or could possibly be infected. Good luck.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

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Slow healing after Mohs on scalp

It sounds like you are taking good care of the site. You should be cleaning it a few times a day, just as your are, gooping it up with Vaseline, and keeping it covered. Washing his hair with a gentle shampoo is just fine, as often as he will let you. The pus you are describing is probably not pus unless the area is surrounded by redness, and very painful. Then it could be an infection. Otherwise, your body creates a sticky yellow fluid that actually helps to heal sites. The head is one of the toughest and longest spots to heal up, but it sounds like you are taking care of it well. If either of you has concerns, the physician who treated you should see you regardless of the insurance issues. Most of the time post-op visits for Mohs aren't billed. They are part of the initial surgery fee paid.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Healing issues after Mohs repair are uncommon

If you believe the wound is infected and 'seeping pus' - then by all means go see your surgeon. He/she is obligated to see you in the office if you are having a complication - depsite your insurance issues. All good surgeons want to see their patients that are having post-op problems.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

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.