Should I Remove my Bandage and Let my Stitches Air out 4 Days After Mohs Surgery?

Question

Just had Mohs surgery on my forehead 4 days ago. Can I take the bandage off for good and let the stitches air out now? Going to have them removed three days from now.

Hooman Khorasani, MD · Answer

Thanks for your post.  I hope you are healing well after Mohs reconstruction.  After every Mohs procedure you should be provided with written and verbal instructions about wound care so you should have crystal clear directions on how to care for the wound.  Please contact your surgeon as they may have forgotten to provide you with these instructions.  Every surgery is different and every surgeon has their own wound care preferences.  I hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

It is very important to follow your surgeon's instructions after skin cancer surgery. I perform many of these and have a wound care protocol that may differ from others. The status of your scar will depend on how well you care for the incision. Raffy Karamanoukian, Los Angeles

Sam Naficy, MD, FACS · Answer

Each situation is unique and only your surgeon knows the specific details of your procedure and should be the person commenting on post-operative questions such as this. In our practice we do remove the dressing after 1 day

Eric T. Carniol, MD · Answer

You should speak to your surgeon. However, we know that ointment on a wound allows the healing to proceed about 15% faster by one study, and antibiotic ointment makes it heal up to 28% faster. Keeping a bandage on a wound keeps the ointment in place. Airing it out unfortunately lets the wound dry. If the bandage comes off, more ointment and another dressing should go on. Good luck!

Nicholas S. Karter, MD · Answer

I would recommend first and foremost to follow the instructions provided by your surgeon. You could always call the office and ask if you are unsure.  That being said, my typical recommendation for all surgical incisions, including Mohs procedures, is to clean the incision line four times daily with hydrogen peroxide on a Q-tip followed by application of Vaseline or Aquaphor.  Cleaning with the hydrogen peroxide allows crusting to be removed.  An application of Vaseline or Aquaphor provides a moist environment for healing.  Typically skin, especially the top layer (epidermis), heals most effectively in an environment which is moist and free of obstructions.  I would avoid antibiotic ointments such as neomycin or bacitracin as consistent application can sometimes cause skin reactions.  Cleaning with hydrogen peroxide and application of Vaseline or Aquaphor should provide the most expedited healing time and least visible scar.  I hope this helps, good luck!!

Christopher Crosby, MD, PhD · Answer

One of the most common misconceptions about wound healing is that "getting air" is beneficial. Wound healing is typically most effective in a moist environment. I always recommend that my patients keep their post Mohs surgery sites clean and dressed with an ointment like vaseline at least until sutures are removed.

Arlo J. Miller, MD, PhD · Answer

We typically recommend keeping wounds smothered in vaseline.  My wife jokes that I talk about vaseline as much as they talked about Windex in My Big Fat Greek Wedding.  But the truth is about 10% of the population develops allergies to neomycin or bacitracin, the key ingredients in neosporin.  If you are allergic to either of these and use them, the wound gets red, angry looking, and often appears infected.  How ironic is that?If the wound is NOT already infected, there is solid evidence that topical antibiotics don't prevent infection any more than vaseline doesReally, really good data shows that for most wounds, keeping them moist shortens wound healing times by about 50%Also, we find that if you've kept vaseline on the stitches, they are usually much easier to remove.  Finally, my opinion of aquaphor is that its pretty much expensive vaseline.  To me, it feels about the same and I've never felt its worth paying 10X the price for.

Barbara Jemec, MD, FRCS(Plast) · Answer

Why don't you just make an appointment with your doctor early and they can decide, take the bandage off, if possible , and then you are not left guessing if it was the right thing to do?All the best

Andrew Kaufman, MD · Answer

Generally, it's an old wive's tale that you let the air get to a wound and it heals better. As a general rule, if you keep the wound clean, moist and covered, it will heal quicker and better. Your surgeon should have given you instructions as to how to care for the wound. I would follow them and if there is any reason to believe that the wound is not healing well or could be infected, contact your doctor.

F. Victor Rueckl, MD (in memoriam) · Answer

Generally, it is best to follow your surgeon's instructions for post care, as he or she will know what they did and what they are intending to happen. For most of my patients including Mohs patients, I have them keep the area covered as I left it, for about 2 days. After that I have them remove the bandage and clean the site with 1/2 peroxide and 1/2 water and apply Polysporin. To help wounds heal you want to keep them clean (free from scabs and dried blood) and moist (with Polysporin or Vaseline). Then I have them put a clean bandage back on. Mostly because I don't want the sutures to rub and frankly, because other people don't like to see sutures on people's faces. But really, follow your surgeon's post care instructions, or call and ask them.

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