Dermatology day surgery

Why am I having surgery?

You are having surgery to remove the skin cancer on your head or neck. Following the surgery your wound will be closed by bringing the sides together, or using nearby skin to cover the area (skin flap) or skin from a different area of your body called a skin graft.

Are there any risks?

• Any surgery can leave bruising or swelling
• The wound may get infected or fail to heal
• The lump may not be completely removed
• The healing process can take longer if you smoke as it lowers the oxygen levels in your blood

Will I be left with a scar?

You may have a scar after surgery, but this can fade in time if you take wound care advice. Ask your doctor or nurse for more information.

Will I need to let you know I can attend the appointment?

Yes, it is important that you let us know as soon as possible that you are able to attend the appointment.

You can contact the Dermatology Outpatient Department on the telephone number at the end of this page.

Can I drive after the surgery?

You should not drive for at least 48 hours after the surgery. You will need to arrange for someone else to drive you home or use another form of transport. Drivers need to check their insurance policy before returning to drive.

How long will the procedure take?

The surgery will take about 1 hour and you will be able to go home afterwards. It is important that you keep the day after surgery free, as you may need to return for the dressing to be removed.

Can I eat or drink before the surgery?

You can eat and drink as normal before surgery.

Do I stop taking blood thinning medication before surgery?

Aspirin

If you are prescribed aspirin, please carry on taking this unless you are told otherwise.

Clopidogrel

If you take clopidogrel please discuss with your GP if it is safe to stop this medication for a short time. We would need you to stop for 7 days before your surgery but your GP may feel that it is best for you to continue to take this medication.

Warfarin

If you are prescribed warfarin, please make sure that you have your INR (International Normalised Ratio) checked 3 days before the surgery. If your INR is below 3.0, then it is safe to continue warfarin for the surgery. If your INR is above 3.0 please discuss this with your surgeon to check if it is safe to proceed with the surgery. Please contact the Dermatology Department with the result of your INR on Tel: 0300 422 5396.

Rivaroxoban/apixaban

Please check with your GP if it is safe to stop this medication for a short time. We would need you to stop for 1 day before your surgery. Your GP may feel that it is best for you to continue to take this medication.

Low molecular weight heparin

If you are prescribed low molecular weight heparin please confirm with your GP/clinician in charge.

Arriving for surgery

Please allow enough time for travelling to the hospital and parking. You should plan to arrive at the Dermatology Reception at least 10 minutes before your appointment time. On arrival your details will be checked and you will be shown to the waiting area.

Will I be given anaesthetic?

Yes, but you will be awake for the procedure as it is local not general anaesthetic. The local anaesthetic will be injected into the skin around the lump. You will feel a stinging sensation lasting for a few seconds before the area becomes numb.

How long will it take for the anaesthetic to wear off?

The anaesthetic will take about 2 hours to wear off. If you have any pain or discomfort you may take pain relief such as paracetamol. Please follow the instructions on the pack.

Can I eat and drink after the surgery?

Yes, you can eat and drink after surgery, although you may be asked to avoid eating foods that require a lot of chewing.

Wound care

A dressing will be placed over your wound after surgery. You may have a pressure dressing on for one day. It is important to keep the wound and dressing dry until the stitches have been taken out.

If the wound bleeds, press firmly on it with a pad of clean tissue for 5 to 10 minutes, using the flat of your hand while sitting upright. Sleeping with raised pillows or in a sitting position for 1 to 2 days following the surgery will help to reduce the bruising around your face.

Try to avoid bending, lifting or carrying heavy objects until a few days after the stitches have been removed.

When will the stitches be taken out?

You may be given an appointment to have your stiches taken out in Dermatology Outpatients for about 1 week after the surgery. Alternately you may be advised to make an appointment with the practice nurse at your GP’s surgery to have the stitches removed.

Will I be prescribed any medication?

You may be given antibiotics after surgery to reduce the risk of infection.

If your wound becomes sore, inflamed or begins to ooze, you may need to take antibiotics. If you are worried please contact the Dermatology Outpatient Department for advice. The number is at the end of this page. At weekends or bank holidays please contact NHS 111 for advice.

Can I travel after my surgery?

You are advised not to travel abroad or for long distances after your surgery, so that if you have any infection or bleeding, it can be dealt with quickly.

When can I return to work?

Returning to work after surgery depends on the type of treatment you have had and what your work involves. We can discuss this at the time of the surgery.

Will I have a follow-up appointment?

A follow-up appointment may be arranged, but this depends on the type of surgery you have had and how your wound heals.

Keeping our records up to date

If you change your address, telephone number or GP please contact the Dermatology Outpatient Department to update your record.

Contact information

If you have any questions or concerns, please contact the Dermatology Outpatients Department during office hours. If you are concerned and the clinic is closed, please contact NHS 111.

NHS 111
Tel: 111

Dermatology Outpatients
Gloucestershire Royal Hospital
Tel: 0300 422 8193/8454
Monday to Friday, 8:30am to 4.30pm

An answer machine is available if we are unable to answer your call. Please leave your name and contact number and we will return your call the next working day.