Clean the area with mild soap and water and gently pat dry with a clean cloth.

Staples and Stitches: You can wash or shower 24 hours after surgery unless you're directed otherwise by your healthcare provider.If the itchiness gets worse instead of better, call your healthcare provider.Ī few general tips to keep in mind for different types of incision closures can include: Your incisions might feel itchy as they heal - this is normal. Avoid wearing tight clothing that might rub on your incisions.If you experience any bleeding, you should call your healthcare provider for instructions. If the incisions start to bleed, apply direct and constant pressure to the incisions. Inspect your incisions and wounds every day for signs your healthcare provider has told you are red flags or concerning.Always wash your hands before and after touching your incisions.Some general tips for incision care include: Taking care of your incision(s) as instructed promotes healing, reduces scarring and reduces your risk of infection.

It’s important to follow your healthcare provider’s directions when it comes to caring for your incisions after surgery. How do I care for my incisions after surgery?

Steri-Strips™ (a special kind of adhesive tape).Ī sterile dressing is usually placed over your closed incision to keep it clean and dry while the wound heals.

4 Moreover, the stapling technique is more reproducible than suturing, which requires more surgical skill and experience.Incisions can be closed in several ways, including: 2,3 This difference-coupled with the unchanged cosmetic outcome and complication rates-makes staples more advantageous for high-tension scalp wounds. A higher material cost is noted with staples however, the largest determinant of overall cost remains the surgeon’s time, which is reduced by factors of 10 or more when closing with staples. 2-4Īlthough cost was the least important variable for determining closure type in our surveyed cohort, it is likely that the overall cost of closure is frequently underestimated. 1 Interestingly, the most common reasons given for not using staples included patient discomfort, cost, and worse cosmetic outcomes, which are unsubstantiated with head and neck comparative studies. Our data suggest that surgeon closure perceptions generally are in agreement with established head and neck literature within different medical specialties that favor staple closures, particularly in high-tension areas. There was no significant difference between epidermal suture placement rates and practice setting (average, 18.1% of cases for academic providers vs 30.0% of cases with private providers P =.210).Įpidermal closure with sutures was reportedly used in an average of only 27.1% of scalp wound cases, with clinical factors such as cosmetic outcome, risk of complications, and closure time seen as either equivalent or inferior to staples.

Surgeons with less experience (≤5 years) used them more frequently (average, 42.7% of cases) than surgeons with more experience (≥16 years average, 18.8% of cases P =.037). Epidermal sutures were used in an average (SD) of 27.1% (33.5%) of scalp wound cases overall. Wound undermining was performed in an average (SD) of 83.0% (24.3%) of cases overall and was more prevalent in private vs academic settings (87.6% vs 65.7% P <.01). Regardless of epidermal closure type, deep suture placement was used in an average (standard deviation ) of 88.8% (19.5%) of cases overall, which did not statistically differ between years of Mohs experience or practice setting (Table 2). The average age of respondents was 45 years 69.1% (n =47) of respondents were male, and 76.5% (n =52) practiced in a private setting (Table 1). Sixty-eight ACMS fellowship-trained Mohs surgeons completed the survey. Statistical significance was determined as P <.05. Comparisons were made between practice habits, preferences, and surgeon demographics using t tests. Respondents indicated their frequency of using deep sutures, epidermal sutures, and wound undermining on a sliding scale of 0% to 100%. Surgeons were asked about their preferred method for scalp wound closure as well as clinical and economic variables that impacted those preferences. The 10-question survey was approved by the University of Kansas institutional review board and the executive committee of the ACMS. The Evolution of the Micrographic Surgery and Dermatologic Oncology Fellowship MethodsĪn anonymous survey was distributed from April 2019 to June 2019 to fellowship-trained Mohs surgeons using an electronic mailing list from the American College of Mohs Surgery (ACMS).

Stapled head wound