Frequently Asked Questions (FAQs) About Your Surgical Procedure

Table of Contents
How do I take care of my wound site?
Where can I find Steri Strips?
What do I do if the Steri Strips come off?
What do I do if I have a problem and can't get through to the triage nurse?
What if I need a doctor or ADAS provider?
What do I do if my wound site is bleeding and it won't stop?
How soon before I can shower after surgery?
When is the best time of the day to change my dressing?
How long do my stitches stay in the skin?
The sutures look ready to come out. How should I proceed?
What do I do if my surgery site is itching or red?
Will my procedure leave a scar? If so, how do I manage the scar?
How soon before I can resume normal activities?
I am feeling nauseated after taking my medications...What should I do?
My surgery site is swelling. Should I be concerned?
What do I do if my wound site opens up?
When should I start and stop my antibiotics?
When should I stop taking aspirin or my blood thinners?
I need a refill on my medications. What do I do?
How much time should I anticipate spending at the surgery appointment?
What should I bring to my surgery visit and what should I not bring?
Will there be a surgery center facility charge at the time of my surgery?
How long before my pathology results are obtained and I hear from the office?

How do I take care of my wound site?
Simply, leave the dressing on for the first day after surgery. You can take it off the next day and wash the site with a mild soap such as Cetaphil™ or Tolerane™ Foaming wash. Please remember to blot and not rub gently so as not to disrupt the sutures. Apply a thin coat of Aquaphor™ Ointment or Bactroban™ (avoid Neosporin™-due to risk of contact allergy). Repeat this process twice daily, morning and night. If the area is crusted, you may take a tablespoon of hydrogen peroxide and dilute this in 4 ounces of distilled water. Apply this mixture to the wound site using a washcloth or 4" x4" gauze pads (can purchase at Walgreens™ or Target™ store). This should help to dissolve the crusting. Following peroxide application, apply your ointment as directed above. Once the sutures come out, we recommend Kelocote Gel™ to help to minimize scarring. All of these recommendations are a part of our post surgical kit.
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Where can I find Steri Strips?
We will provide you with Steri Strips after your procedure. If you need more, you can purchase these readily at Walgreen's™ Pharmacy or Target™ store.
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What do I do if my Steri Strips come off?
Don't panic. This is normal. Steri Strips are meant to stay on for a few days at most. At this point, you have two options. If the wound is not draining or red, simply leave the Steri Strips off. If you want to protect the area you can reapply the Steri Strips over your incision site perpendicularly to the incision. While the Steri Strips are in place, you can place a thin coat of Aquaphor™ or Bactroban™ ointment over them. When the Steri Strips< begin to curl on their edges, you can remove them with or without dilute hydrogen peroxide (1 tablespoon of hydrogen peroxide in 4 ounces of distilled water).
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What do I do if I have a problem and can't get through to the triage nurse?
Don't panic! We are sorry if our triage person cannot call you back right away. She is sometimes tied up with other patients or helping assist with the patients who need us in the office. We do value your problem though and there are a few things you can do to get immediate attention if needed. The first step is to assess your situation. Is it life threatening? Can it wait? If you are having a true medical emergency, i.e., extensive bleeding, difficulty breathing, or if you are experiencing chest pain, then immediately dial 911 as you need to be assessed ASAP by an EMT ambulance crew and possibly an emergency room physician.
If your wound site is oozing slightly, place pressure on the area using a wash cloth or small towel like a tourniquet. If you need another question answered and can't get anyone immediately, dial 904-285-7546 ext 210 or click here. The person that talks with you at these extensions is not a nurse (so they have limited medical knowledge) but they can direct your call or help you by informing a medical assistant of your dilemma.
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What if I need a doctor or ADAS provider?
If you need an ADAS provider to get involved during office hours, dial extension 202 or 204 or click here and the front end staff will relay the message to one of our providers. For after hours or holidays, you can dial our emergency notification line at 904-285-7546 ext 299. If it is a true medical emergency and you need immediate assistance, dial 911 or report to the nearest emergency room.
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What do I do if my wound site is bleeding and it won't stop?
The key is to keep pressure and/or cold on your wound site. If your surgery is on an extremity, keep the affected limb elevated above your mid chest and place a pressure wrap directly over your surgery site. A small towel works well over the area like a tourniquet. Wrap the towel around the extremity firmly, but not too tight. If you develop numbness over the area, e.g. your limb has fallen asleep, then, this is a sign that the wrap is too tight. You can also utilize a cool ice pack or frozen peas to reduce swelling. This is especially helpful for facial surgery. Place the cool compress gently over the surgery area. Bleeding usually subsides within 30 minutes. If you feel faint, immediately lie on the floor with your legs elevated. If you have tried this and bleeding continues and/or is brisk, then call 911. For less urgent bleeding (mild oozing), please dial 904-285-7546 ext 299. Please continue to keep pressure on the area during this time until we get back to you. If you do not hear from us within a few minutes or if it is on a weekend or after hours, please dial 911 or proceed to the nearest emergency room.
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How soon before I can shower or bathe?
Usually within 24 hours. Sometimes on the face we ask that you not shower until we see you the next day. For other surgeries, e.g. simple excisions on the back, you can shower the next morning. Simply take the bandage off, shower, and reapply your Aquaphor™ ointment. If the area is oozing, place another bandage dressing over the site. By days 3 to 4, you may no longer need a bandage, especially if the surgical site is dry and clean. Simply continue to use the antibiotic ointment twice daily until we see you for suture removal in 7 to 14 days. After this time, you can start using Kelocote Gel™, which will help with scar formation and healing.
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When is the best time of day to change my dressing?
Usually, at the time of your morning shower and at bedtime are the best times to change your dressing. If your site is oozing or draining, you may repeat dressing changes as often as every 6 hours, however, twice a day is usually what we recommend.
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How long do my sutures stay in the skin?
This depends on a multitude of factors such as age, fragileness of skin tissue, wound tension, location and health risks such as diabetes. Normally, sutures stay placed for 7 days on the face. All other areas have sutures left in place for 10 to 14 days. If you are a quick healer, then we would like to reevaluate your surgical area in 7 days to determine if they need to be removed in a shorter time period. Fast Absorbing sutures or wounds closed with tissue glue do not need to reevaluated unless directed so by one of our ADAS surgical team.
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The sutures look ready to come out. How do I proceed?
If you sutures are imbedded in the skin so that you cannot see the suture material or there appears to be a bump over where the stitch previously was, then you are probably correct... your sutures need to be removed or at least evaluated for early removal. Please call our office at 904-285-7546 ext 210 or click here and we will work you into one of our provider's schedule for an evaluation. Please do not attempt to remove these on your own as you take on the risk of creating a secondary infection or a worse appearing scar.
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What do I do if my surgery site is itching and red?
You may be having a reaction to your suture material, antibiotic ointment, or the adhesive tape. Initially, you can try a mild corticosteroid cream such as Cortaid 1% Cream (available at Walgreen's™ or Target™ without a prescription) and apply this to the itching and red area twice daily. If your surgery area is warm and red and draining pus-like material, your wound site may be infected and needs to be evaluated at our office. Call 904-285-7546 ext 210 to set up an immediate appointment or click here as a culture may need to be taken. Further instructions will be given to you upon assessment of your surgery area.
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Will my procedure leave a scar? If so, how do I manage the scar?
Yes, all surgeries leave a scar. Some scars are more visible than others and, in our office, 7% of cases require a revision procedure. Please let us know if you are prone to keloid scar formation or are on medications which can impair wound healing, i.e., Prednisone. All attempts will be made to conceal your scar. Makeup such as Jane Iredale™ is also a great concealer. As a cosmetic surgery center, we strive for the best cosmetic results. After your surgery you may desire to purchase a post surgical kit. We sometimes also utilize laser or injectable corticosteroid treatments to assist with scar concealment (needed in 7% of all surgical cases). As your patient advocate, ADAS dermasurgeons will take all the steps they can to ensure the best cosmetic outcome. Unfortunately, we can not guarantee that you will have excellent results. This is because all surgeries carry with them an inherent risk such as infection, wound separation, etc. We thank you for your understanding with this imperfect situation. If you are concerned about the way a scar is healing, please call us as son as you notice something appears unusual c/o 904-285-7546 ext 210 or click here. We would be happy to evaluate your wound site and review the cosmetic options that are available.
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How soon before I can resume normal activities?
If your surgery is on the face, it is best to refrain from strenuous activities such as weightlifting, golf, jogging, or running for at least 14 days. Please also refrain from bending down and avoid projects where sweating and dust exposure is common (for at least 14 days). Keep lower extremity wound sites wrapped (in an ACE™ wrap or Unna Boot™) and elevated as much as possible. If your surgery is on the back, scalp, or arms, again, avoid the aforementioned activities for at least 14 days.
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I am feeling nauseated after taking my medications... What should I do?
This is a very common complaint especially when taking products with codeine or other narcotics for the first time. As an initial approach, we ask that you try taking your medication with some ginger ale or crackers. If this does not work, trying halving the dose and see if your symptoms get better. Usually, your symptoms will improve after a few doses. If, after these maneuvers, you are still experiencing nausea, stop all prescription medications and call our office for direction. If severe enough we will call in a prescription anti-nausea suppository and/or change out your pain meds to improve your symptoms. It is very important that you relate to our medical staff prior to surgery any bad experiences with medications, anesthetics, anesthesia, adhesive tapes, or suture materials. In this way, we can take precautions ahead of time to minimize a negative experience during your recovery.
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My surgery site is swelling... Should I be concerned?
This is often normal especially after the first 24 hours. If your surgery is on the face, i.e., nose, eye, ear, or forehead area(s), it is common to have swelling and bruising for a few days. The impact of this can be lessened if you sleep on an extra pillow or at 45 degree angle and use cool compresses such as an ice pack. Frozen peas that are contained in a malleable bag also work well here. If swelling is intense, sometimes we will prescribe a short course of corticosteroids to alleviate the process. If you are experiencing a severe headache with your swelling, or fever chills or bleeding, it is important to notify us so that we can evaluate you promptly. Please call 904-285-7546 ext 210 or click here and we will work you into our clinic schedule. If it is very severe, dial 911 and proceed to the nearest emergency room. Please note that swelling can take up to 10 to 14 days to completely resolve. All swelling eventually resolves in its entirety.
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What do I do if my wound site opens up?
Do not panic. This can sometimes happen in high tension areas such as the back or leg and can occur when sitting, squatting or bending. We will need to assess the area to see if the wound will heal well on its own. Sometimes, however, our surgeons will recommend that the wound be re-sutured. Call 904-285-7546 ext 210 or click here and we will work you in for an evaluation. In the interim, you should cleanse the area with soap and water followed by the application of your topical antibiotic, e.g. Bactroban™, or Aquaphor Ointment™. Repeat this twice daily.
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When should I start and stop my antibiotics?
Start your antibiotics 1 day before your procedure and take them daily until they are finished. Do not start them 7 days before your procedure. They should be started 1 day prior to your procedure. Usually, antibiotics are prescribed for 7 days for facial surgeries and for 14 days for other body area surgeries.
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When should I stop taking my aspirin or blood thinners?
First, off, if you need aspirin or blood thinners due to a previous heart attack, or take Coumadin because of atrial fibrillation or Plavix because of a stroke, please do not stop these meds. If you are unsure, please check with your primary care doctor before stopping them. We can handle bleeding so if comes down between risking another heart attack or stopping your aspirin because of a skin surgery, do not stop the aspirin or relevant blood thinner that you are currently taking! If you are taking blood thinners electively (without a previous condition), and your doctor says it is "OK" to stop them, then we recommend that you stop any relevant blood thinners for 14 days before your surgery is scheduled. Medications which should be stopped include: Aspirin, Vitamin E, Ginseng, Gingko Biloba, St Johns Wort, Garlic tablets, Advil™ (Ibuprofen), Nuprin™, and Aleve™ (naproxen).
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I need a refill on my medications. What should I do?
If you are requesting additional antibiotics or pain medication, please contact your pharmacy and they will fax over a medical request to our triage nurse. Our medical team will determine if more medication is necessary or if there is another alternative. You should have all the necessary prescriptions needed to "carry you through" upon your discharge from our surgery center. If you require immediate assistance, please dial 904-285-7546 ext 210 or click here.
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How much time should I anticipate spending at the surgery appointment?
As a reminder, anticipate spending 1 to 4 hours with us. We recommend that you clear your entire day so that if there is a complication or you experience discomfort, you have the appropriate time set aside to deal with an unanticipated situation. Surgery is not an exact science and we believe that by setting the time aside, you will ensure that we have given you the best care possible. Some surgeries require more time than others. This cannot always be predicted prior to scheduling. Every effort will be made to carry out your procedure in a timely fashion.

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What should I bring to my surgery visit?
We recommend that you bring a book, magazine or headset (iPod™) with you. Warm socks and a sweater are helpful, during the winter months-Nov-April, because our center tends to be chilly (this helps to minimize infection risk). Juice, crackers, water, tea, and coffee are provided in case you get thirsty or hungry. If you are having surgery on your face, it would be wise to have someone drive you to and from your appointment.
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Will there be a surgery center facility charge at the time of my surgery?
Obviously, there will be a surgeon's fee for your procedure. If you are having anesthesia, an anesthesia fee from the relevant provider will also apply. In terms of a surgery center facility fee, a facility fee will be charged to you and your insurance carrier by our surgery center (Ponte Vedra Surgery Center) if your case requires a complex repair, flap, or skin graft to close the wound. Please check with your insurance carrier or our billing department for information on coverage, deductibles and co-pay information. If your insurance company is one that we do not participate with, you will be responsible for the facility fee. We know insurance coverage issues can be confusing and we are happy to work with you to help sort out any difficulties or questions which may arise. You may contact our billing department c/o billing@adasderm.com or call 285-7546 ext 203.
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How long before my pathology results are obtained and I hear from the office?
It usually takes up to two weeks to get your pathology results back. Usually (99% of the time), we will either call you or send you a card in the mail with your final results. If further treatment is needed, we will help you set up a surgical or follow up appointment. If you do not hear from us within two weeks after your biopsy or surgery, then we recommend that you call us at 904-285-7546 ext 210 or click here. The take home message is that one way or another our office should communicate your results to you. Not hearing from us does not mean that everything is all right; rather, it means that you will need to take the step to call us to verify your final pathology results, or schedule an appointment with one of our providers.
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