Find extensive and detailed instructions after surgery to help with facial full thickness grafts after care.
Your skin graft has been taken from one operative site and stitched into another as a patch. A foam dressing has been stitched over the graft itself. Sometimes, a foam bolster is also stitched into the nostril to support the rim of the nose.
Initially, all the wounds will feel numb as the local anaesthetic is still in effect. Before the local anaesthetic effect wears off start taking simple, over the counter analgesia. These include paracetamol and non-steroidal anti-inflammatories (such as Nurofen, Voltaren, etc). Follow the instructions on the pack and only take them if you have no known adverse reactions to them. If you are unsure, speak to Dr Yang. You should also use ice packs on your wounds to help reduce the swelling. You can use frozen peas or ice packs wrapped in a clean tea towel or paper towel for 20 minutes on, 20 minutes off, when awake for the first 24-48 hours post-surgery.
It is normal for there to be some bleeding from the wounds for the first day or two. If this occurs, sit upright, place frozen peas or an ice pack over the region and put direct, firm pressure with a finger/s over the bleeding spot for 15 continuous minutes. This will stop the majority of bleeding. If it doesn’t, then contact Dr Yang’s rooms or his mobile. Failing this, present to the Greenslopes or St Andrew’s Emergency departments before seeing your GP. Dr Yang is responsible for your post operative care, and the emergency departments can more easily get in touch with Dr Yang and manage potential problems.
Keep your head elevated during the day AND night. Your hips should be flexed to about 30 degrees so that you are sleeping in a semi-sitting position. Building a ramp of pillows, or sleeping in a Jason recliner can facilitate this. The elevation helps to reduce bleeding, bruising and swelling. You should continue this for about 5 days and nights.
Your foam dressings will need to be kept dry and intact until your first dressing change with the nurse.
Try to refrain from any activities or positions that increase blood pressure. These include heavy lifting, bending over with your head down or significant straining. Dusty, dirty environments should also be avoided.
Once your wounds have been left undressed, you are now able to get everything wet. Let soapy water run over the wounds each day in the shower to keep them clean.
Grafts will usually look pink, but may also have patches of mottled purple. It is normal for the colour to change over the next few weeks.
After the dressings are removed, GRAFTS MUST BE KEPT LATHERED WITH VASELINE or SOFT WHITE PARAFFIN AT ALL TIMES. THEY WILL LIKELY NEED TO HAVE THE OINTMENT APPLIED AT LEAST 6 TIMES PER DAY. This cannot be overdone. If the graft is left to dry out, it will turn into a scab and heal slowly with excessive scar tissue.
After 2 to 3 weeks, the graft should be stable enough to start massaging. This should be done with a lubricant such as Vaseline, Vit E cream, or Bio-oil. Firm pressure with the fleshy part of the finger tips should be applied. The pressure should ‘milk’ the graft in the same consistent direction. If applicable, the graft should be massaged by ‘pinching’ it between a finger and thumb.
PLEASE REMEMBER: If there are any issues please contact Dr Yang or his rooms. He would prefer to know of any problems before you go to your GP as HE is RESPONSIBLE for your post-operative care.