Care of your wound following diagnostic punch biopsy of the skin

Relief of pain

The local anaesthetic that you have had will wear off over the next one to two hours.

You may need to take simple pain relief, eg. paracetamol (as directed on the manufacturer’s packet) to cover the next 12 to 24 hours. Aspirin should be avoided as it increases your risk of post-operative bleeding. Check with your GP if you have been prescribed other analgesia.

Bleeding

The biopsy (sample site) will be checked for bleeding before you leave the department. If bleeding occurs at home, do not disturb the dressing. Apply a pad to the area. Do not lift the pad from the wound for a full 10 minutes.

If possible, elevate or raise the area, eg. arm or leg. If bleeding persists you will need to visit your practice nurse or local Emergency Department for assessment. A clean dressing will be provided once bleeding has settled if this is necessary.

Be extra vigilant for bleeding if you take anticoagulants, eg. aspirin or warfarin.

You will have been given a ‘practice nurse letter’, please remember to take this with you when you see the practice nurse.

Stitches

Stitches or sutures will normally be removed (after five to 14 days ) at your own surgery by the practice nurse.

Occasionally punch biopsies do not need stitches. The wound is then left to heal naturally. You will need to book an appointment with the practice nurse well in advance of needing stitches removed or dressings renewed.

If you are concerned about discomfort when the stitches are removed, consider taking a simple pain relief, eg. paracetamol, an hour before your appointment.

Activity

You should try and rest as much as much as possible for the remainder of today. Remember you have had a small operation.

Sport is best avoided for the next three days and up to one week if your skin sample has come from a place located over ‘active’ muscles, especially the legs or shoulders. Stretched stitches may mean the wound will not hold together to heal properly or may leave a bumpy scar.

Bathing

The area should be kept covered for the next three days. Ideally, the wound should be covered until the stitch comes out. If bathing, never leave a wet dressing in place. Wash your hands and change it for a plain plaster. A wet dressing increases your risk of infection.

Test results

The skin sample will be sent to the laboratory for analysis. You and your GP will be informed on the result of the test, usually by letter, but please state a preference at the time of your surgery. You may be sent a dermatology appointment for results to see a specialist nurse or doctor if further discussion is needed. The results are usually available after three weeks, but sometimes may take longer if they are discussed at the multi-disciplinary meeting or if a further opinion is required.

Complications

The signs of infection can be any of the following:

• Increasing pain at the site
• Swelling
• Redness
• A pus-like discharge

If you are concerned about any of the above, see your practice nurse promptly, taking with you your ‘practice nurse letter’. Your practice nurse is the first point of contact. The practice nurse will be able to assess your wound if you suspect it is infected.

If you experience persistent pain after 48 hours you may need advice from your GP.

Feedback

Comments and suggestions that give us feedback on our practice, e.g. delays in wound healing, pain or dressing problems, (and the good things as well) are helpful. Please contact the Dermatology Specialist Nurse using the phone numbers or email address given below.

Ref: 15-17-106
Review: 11/19