How to properly care for surgical wounds after suture removal. What are the signs of normal healing versus potential complications. When should you seek medical attention for post-operative bleeding or discharge. How to change dressings and manage pain after surgery.

Understanding the Basics of Surgical Wound Healing

Surgery is a complex medical procedure that involves cutting through various layers of the body, including skin, fatty tissue, muscle, and sometimes bone and cartilage. To ensure proper healing, surgeons use stitches or staples to close all layers of the wound. It’s crucial to understand the healing process and what to expect in the days and weeks following your surgery.

Internal stitches, designed to dissolve on their own, typically disappear within 2 to 3 weeks. External stitches or staples, however, need to be removed by a healthcare professional, usually within 7 to 14 days after the surgery, depending on the location and type of procedure.

Normal Post-Operative Discharge

Is it normal to have discharge after surgery? Yes, it’s perfectly normal to experience some clear or bloody discharge on the wound covering or bandage (dressing) for the first few days after surgery. This is part of the natural healing process. However, if you find yourself changing the dressing more than three times a day due to excessive bleeding or discharge, it could be a sign of a problem, and you should contact your healthcare provider immediately.

Essential Post-Operative Wound Care Instructions

Proper wound care is crucial for optimal healing and to prevent complications. Here are some essential guidelines to follow:

• Keep the wound clean as directed by your healthcare provider
• Change the dressing as instructed, or sooner if it becomes wet or stained with blood or fluid
• Avoid showering or bathing for the first few days; instead, use a sponge for cleaning
• Once drainage stops, you may shower unless instructed otherwise by your surgeon
• Avoid soaking the wound (no baths or swimming) until sutures or staples are removed and the wound is fully healed

How does smoking affect wound healing? Smoking can significantly interfere with the wound healing process. If you’re a smoker, it’s strongly recommended that you quit or at least abstain during the recovery period. Your healthcare provider can offer guidance and resources to help you quit smoking.

Step-by-Step Guide to Changing Surgical Dressings

Changing your surgical dressing properly is essential for preventing infection and promoting healing. Follow these steps:

1. Wash your hands thoroughly before and after changing the dressing
2. Remove the old dressing carefully, avoiding yanking it off
3. If the dressing sticks to the wound, you may need to moisten it slightly for easier removal
4. Clean the wound gently with clean water or saline using gauze or a clean washcloth
5. Avoid using soap, alcohol, hydrogen peroxide, or any other cleanser unless directed by your doctor
6. Pat the wound dry gently if instructed to do so
7. Apply a new, clean dressing as directed by your healthcare team
8. Dispose of the old dressing in a sealed plastic bag

Types of Surgical Dressings

What are the different types of surgical dressings? There are various types of dressings used for wound care, but two common types are:

• Dry dressing: Uses dry gauze, or a “nonadherent” dressing if the wound is still draining
• Wet-to-dry dressing: Involves applying moist gauze directly to the wound, then covering it with a dry pad

Always follow your healthcare team’s specific instructions regarding the type of dressing to use and how to apply it.

Managing Pain and Medications After Surgery

Pain management is a crucial aspect of post-operative care. Your doctor may prescribe specific pain medications, but over-the-counter options like acetaminophen or ibuprofen can often provide relief for mild to moderate pain.

If you’ve been prescribed antibiotics, it’s crucial to complete the entire course, even if you start feeling better before finishing the medication. This ensures that the infection is fully cleared and reduces the risk of antibiotic resistance.

Can aspirin be used for post-operative pain relief? Aspirin should never be used for pain relief in anyone under 18 years of age who is ill with a fever, as it may cause severe liver damage. Additionally, if you have chronic liver or kidney disease, a history of stomach ulcers or gastrointestinal bleeding, or are taking blood thinners, consult your healthcare provider before using any pain medications.

Recognizing Signs of Complications and When to Seek Help

While some discomfort and minor bleeding are normal after surgery, it’s important to be aware of signs that may indicate a complication. Seek immediate medical attention if you experience:

• Excessive bleeding or discharge requiring frequent dressing changes
• Signs of infection, such as increased pain, redness, swelling, or fever
• Difficulty breathing or swallowing
• Chest pain or discomfort
• Symptoms of a stroke (face drooping, arm weakness, speech difficulty)

In case of severe symptoms or emergencies, don’t hesitate to call 911 or your local emergency services.

The Importance of Follow-Up Care and Wound Monitoring

Regular follow-up appointments with your healthcare provider are crucial for monitoring your wound healing progress and addressing any concerns. These appointments may include:

• Wound checks to assess healing and detect any signs of infection
• Removal of external stitches, staples, or tape
• Review of any culture results that may affect your treatment
• Discussion of imaging test results, such as X-rays, ultrasounds, or CT scans

How often should you have follow-up appointments after surgery? The frequency of follow-up appointments can vary depending on the type of surgery and your individual healing process. Your healthcare provider will give you specific instructions on when to schedule these appointments.

Special Considerations for Different Types of Surgeries

While general wound care principles apply to most surgeries, certain procedures may require specific care instructions. For example:

Orthopedic Surgeries

Orthopedic surgeries, such as joint replacements or fracture repairs, often involve additional considerations like:

• Proper limb elevation to reduce swelling
• Specific exercises or physical therapy to maintain flexibility and strength
• Use of assistive devices like crutches or walkers

Abdominal Surgeries

After abdominal surgeries, patients may need to:

• Follow a special diet to promote healing and prevent complications
• Avoid lifting heavy objects or strenuous activities for a specified period
• Monitor for signs of internal bleeding or infection

Cosmetic Surgeries

Cosmetic procedures often require additional care to optimize aesthetic outcomes:

• Specialized dressing techniques to minimize scarring
• Careful sun protection to prevent discoloration
• Gradual return to normal activities to avoid stress on incision sites

Always follow the specific post-operative instructions provided by your surgeon, as they will be tailored to your particular procedure and individual needs.

Long-Term Wound Care and Scar Management

As your surgical wound heals, it’s important to consider long-term care to minimize scarring and promote optimal healing. Here are some strategies to consider:

Scar Massage

Once your incision has fully healed and your doctor gives approval, gentle massage of the scar tissue can help:

• Improve circulation to the area
• Reduce scar tissue buildup
• Increase flexibility of the surrounding skin

Topical Treatments

Various over-the-counter and prescription topical treatments can aid in scar management:

• Silicone-based gels or sheets to flatten and fade scars
• Vitamin E oil to moisturize and potentially improve scar appearance
• Prescription creams containing ingredients like tretinoin or hydroquinone for specific scar issues

Sun Protection

Protecting your scar from sun exposure is crucial, especially in the first year after surgery:

• Use a broad-spectrum sunscreen with at least SPF 30 on the scar when exposed to sunlight
• Consider covering the scar with clothing or bandages when outdoors
• Limit direct sun exposure to prevent hyperpigmentation of the scar tissue

How long does it take for a surgical scar to fully mature? The scar maturation process can take up to 12-18 months. During this time, you may notice changes in the scar’s appearance, including its color, texture, and size.

Nutrition and Lifestyle Factors for Optimal Wound Healing

Your body’s ability to heal is greatly influenced by your overall health and lifestyle choices. Consider the following factors to support optimal wound healing:

Balanced Diet

A nutrient-rich diet can significantly impact wound healing. Focus on:

• Protein-rich foods to support tissue repair
• Vitamin C-rich fruits and vegetables to promote collagen production
• Zinc-containing foods to support immune function and wound healing
• Adequate hydration to maintain proper blood flow and tissue health

Physical Activity

While it’s important to avoid overexertion, gentle movement can promote healing:

• Follow your doctor’s guidelines for resuming physical activities
• Engage in approved exercises to improve circulation and prevent complications like blood clots
• Gradually increase activity levels as your healing progresses

Stress Management

Chronic stress can impair wound healing. Consider stress-reduction techniques such as:

• Deep breathing exercises
• Meditation or mindfulness practices
• Engaging in enjoyable, relaxing activities within your doctor’s approved limits

How does stress affect wound healing? Stress can suppress immune function and increase inflammation, potentially slowing down the healing process. Managing stress effectively can contribute to faster and more efficient wound healing.

By following these comprehensive guidelines for post-operative wound care, monitoring for potential complications, and maintaining a healthy lifestyle, you can significantly improve your recovery process and achieve optimal healing outcomes. Remember to always consult with your healthcare provider for personalized advice and to address any concerns that may arise during your recovery journey.

Post Op Wound Check, Bleeding

Surgery involves cutting through layers of skin, fatty tissue, muscle, and sometimes bone and cartilage. Stitches or staples are used to close all layers of the wound. The stitches on the inside will dissolve in about 2 to 3 weeks. Any stitches or staples used on the outside need to be removed in about 7 to 14 days, depending on the location.

It is normal to have some clear or bloody discharge on the wound covering or bandage (dressing) for the first few days after surgery. If your wound was stitched closed, you should not have to change the dressing more than 3 times a day in the first few days. Bleeding or discharge requiring more frequent dressing changes can be a sign of a problem. If this occurs, notify your healthcare provider right away.

Home care

Different types of surgery require different types of care and dressing changes. It is important to follow all instructions and advice from your surgeon, as well as other members of your healthcare team.

Wound care

• If you smoke, get help to quit. Smoking interferes with wound healing. Ask your healthcare provider about ways to quit.

• Keep the wound clean, as directed by your healthcare provider.

• Change the dressing as directed. Change the dressing sooner if it becomes wet or stained with blood or fluid from the wound.

• Bathe with a sponge (no shower or tub baths) for the first few days after surgery, or until there is no more drainage from the wound. Unless you received different instructions from your surgeon, you can then shower. Don’t soak the area in water (no baths or swimming) until the tape, sutures, or staples are removed and any wound opening has dried out and healed.

Changing the dressing

• Wash your hands before changing the dressings.

• Carefully remove the dressing and tape; don’t just yank it off. If it sticks to the wound, you may need to wet it a little to remove it, unless your healthcare provider told you not to wet it.

• Wash your hands again before putting on a new, clean dressing.

• Gently clean the wound with clean water (or saline) using gauze or a clean washcloth. Don’t rub it or pick at it.

• Don’t use soap, alcohol, hydrogen peroxide, or any other cleanser.

• If you were told to dry the wound before putting on a new dressing, gently pat it dry. Don’t rub.

• Put the old dressing in a sealed plastic bag and throw it in the trash. Don’t reuse it!

• Wash your hands again when you are done.

Types of dressings

Your healthcare team will tell you what type of dressing to put on your wound. Follow your healthcare team’s instructions carefully, and contact them if you have any questions. Two common types of dressings are described below. You may have one of these or another type.

• Dry dressing. Use dry gauze. If the wound is still draining, use a “nonadherent” dressing, which shouldn’t stick to the wound.

• Wet-to-dry dressing. Wet the gauze, and squeeze out the excess water (or saline), before putting it on. Then, cover this with a dry pad.

Medicines

• If you were given antibiotics, take them until they are used up or your healthcare provider tells you to stop. It is important to finish the antibiotics even though you feel better, to make sure the infection has cleared.

• You can take acetaminophen or ibuprofen for pain, unless you were given a different pain medicine to use. ( Note: If you have chronic liver or kidney disease, or have ever had a stomach ulcer or gastrointestinal bleeding, or are taking blood thinner medicines, talk with your healthcare provider before using these medicines.)

• Aspirin should never be used in anyone under 18 years of age who is ill with a fever. It may cause severe liver damage.

Follow-up care

Follow up with your healthcare provider, or as advised, for your next wound check or removal of stitches, staples, or tape.

• If a culture was done, you will be notified if the results will affect your treatment. You can call as directed for the results.

• If imaging tests, such as X-rays, an ultrasound, or CT scan were done, they will be reviewed by a specialist. You will be notified of the results, especially if they affect treatment.

Call 911

Call 911 if any of these occur:

• Trouble breathing or swallowing

• Wheezing

• Hoarse voice or trouble speaking

• Extreme confusion

• Extreme drowsiness or trouble awakening

• Fainting or loss of consciousness

• Rapid heart rate or very slow heart rate

• Vomiting blood, or large amounts of blood in stool

• Discomfort in the center of the chest that feels like pressure, squeezing, a sense of fullness, or pain

• Discomfort or pain in other upper body areas, such as the back, one or both arms, neck, jaw, or stomach

• Stroke symptoms (spot a stroke “FAST”)

  • F: Face drooping. One side of the face is numb or droops.

  • A: Arm weakness. One arm feels weak or numb.

  • S: Speech difficulty: Speech is slurred, or the person is unable to speak.

  • T: Time to call 911. Even if symptoms go away, call 911.

When to seek medical advice

Call your healthcare provider right away if any of the following occur:

• Fluid or blood soaking 5 or more bandages a day during the first 3 days after surgery

• Fluid or blood still draining from the wound more than 3 days after surgery

• Increasing pain at the site of surgery

• Fever of 100.4º F (38º C) or higher, or as directed by your healthcare provider

• Redness around the wound

• Pus coming from the wound

• Vomiting, constipation, or diarrhea

Post-operative instructions following excision of skin lesion

This page will give you information following excision of a skin lesion. We hope it will help you and your recovery. It is not a complete guide, so if you have any queries please do not hesitate to ask a member of staff.

Local anaesthetic

If you have had an injection to make the area numb (Local anaesthetic) it may remain numb for up to 4 hours. If the lip or nose area has been numbed please be careful, do not drink anything hot or very cold (i.e. ice lolly from freezer) until the feeling has returned.

Bleeding

There can be some bleeding after any operation. If this occurs, apply firm pressure with a clean tissue for 15 minutes. If there is a dressing in place, leave it on but press on top of the dressing.

Do not keep taking the pressure off to see what is happening. If the dressing is very discoloured you may replace it later when the bleeding has stopped. This should control the bleeding but if bleeding continues or is not easily controlled, seek urgent medical advice by contacting Virgin Care Dermatology/GP or if out of hours attend A&E.

Pain control

You were given a local anaesthetic injection prior to your surgical procedure to numb the skin. The effect of this will wear off gradually over about an hour. If you feel any pain or discomfort at the site of operation after the anaesthetic has worn off you may take your preferred pain killer. Paracetamol is usually adequate. Do not take aspirin unless you are already taking this for other medical reasons.

Infection

If your wound becomes hot, swollen and very painful or oozes pus, it may be infected. You may require antibiotics. Seek medical advice by contacting the Virgin Care Dermatology or your own GP.

Care of wound

If you have had a dressing applied remove it after two days. Bathe or shower as normal after that. Being careful to pat the wound dry rather than rubbing it.

Removal of stitches

Stitches have to be left in for different periods of time, depending on the circumstances. You will have been told when they need to come out. Certain types of stitches do not need to be removed; you will be advised if these stitches are used to close your wound and they will eventually dissolve but this can take several weeks.

If the stitches come out before they are due to be removed or if the wound opens up, please contact Virgin Care Dermatology during work hours.

If paper strips (steri-strips) have been used to cover the stitches it is best not to wet them. This causes them to come off. To promote healing and moisturise the scar once the sutures have been removed apply a thin layer of soft paraffin ointment (i.e. Vaseline) along the scar each day. Please use a new pot or tube of Vaseline to prevent contamination of the wound.

Scarring

Almost all procedures will leave a scar of some sort. This is most pronounced in the first weeks following surgery, after which it will fade but not disappear.

Some individuals can develop thickened (keloid) scars. This is most likely to occur on the chest and back. Stretching of scars can also occur at these and other sites, though this will be minimized if you rest the area for several weeks following surgery. It can take up to a year until the final scar result is reached. If you are unhappy about your scar ask your GP to refer you back to Virgin Care Dermatology.

How will you get the results?

The lesion (piece of skin), which has been removed will be sent to the Pathology Department to be assessed. Depending on the result of these tests, you may or may not need a further appointment. You will be informed whether a further appointment may be necessary at the time of surgery. The results will be sent by letter in the post to you or discussed at your next appointment.

Stitches Removal – Primary Care Medicine – Irvine, CA

Millions of people visit urgent care centers every year for treatment and repair of cuts and lacerations. Doctors have several ways of repairing a wound, depending on the type and extent of a laceration, its location on the body, and the ability of the patient to protect the cut during the healing process. Often, stitches are the answer – working to close wounds, manage bleeding, minimize the risk of infection, and achieve aesthetically appealing recovery with minimal scarring.

Did you know…

they are also known as sutures, stitches are medical thread used to shut a wound and secure it while it heals. How do you know when to visit a urgent care facility for stitches?

• The laceration is located on the face
• You are unable to manage the bleeding after 10 minutes of firm pressure
• The laceration is longer than a half inch
• The laceration is very deep or is gaping open
• The edges of the wound are jagged

Keep in mind that some wounds require medical attention even if they do not need stitches. Examples include puncture wounds, lacerations caused by a rusty object, and wounds caused by an animal.

Frequently Asked Questions

Is there anything I should do at home before I am able to receive urgent care for a laceration?

Yes. The first goal is to control the bleeding by applying firm pressure to the wound for several minutes using a clean cloth. Once bleeding is under control, rinse the wound with clean, cool water to remove any dirt or debris inside it. Cover the area with a bandage or sterile gauze until you can get to an urgent care facility. So long as bleeding is under control, it is safe to wait up to 12 to 18 hours before getting stitches.

What should I expect while getting stitches?

Your doctor will examine the wound for any debris. The laceration site will then be numbed and cleansed, and the edges of the wound pulled together. The stitches are threaded through to each side and tied off with a knot to hold them in place. The number of stitches required depends on the size of the wound.

How will I care for my laceration after receiving stitches?

It is important to keep the stitches clean and dry. You may also be instructed to change your bandage and apply antibiotic ointment periodically. Some stitches – especially those used for deep wounds – are designed to dissolve over time. Others will need to be removed within a 3 and 14 days, depending on the wound.

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Absorbable versus nonabsorbable sutures for skin closure: a meta-analysis of randomized controlled trials. Ann Plast Surg.
2016;76(5):598–606.

54. Slieker JC,
Daams F,
Mulder IM,
Jeekel J,
Lange JF.
Systematic review of the technique of colorectal anastomosis. JAMA Surg.
2013;148(2):190–201.

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Tissue adhesives for traumatic lacerations in children and adults. Cochrane Database Syst Rev.
. 2002;(3):CD003326.

56. Zempsky WT,
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Lyle CT,
Hedbloom EC.
Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives. Int Wound J.
2005;2(3):272–281.

57. Zempsky WT,
Parrotti D,
Grem C,
Nichols J.
Randomized controlled comparison of cosmetic outcomes of simple facial lacerations closed with Steri Strip Skin Closures or Dermabond tissue adhesive. Pediatr Emerg Care.
2004;20(8):519–524.

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Buettner P,
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Can sutures get wet? Prospective randomised controlled trial of wound management in general practice. BMJ.
2006;332(7549):1053–1056.

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A prospective, randomized pilot evaluation of topical triple antibiotic versus mupirocin for the prevention of uncomplicated soft tissue wound infection. Am J Emerg Med.
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Antibiotics to prevent infection of simple wounds: a meta-analysis of randomized studies. Am J Emerg Med.
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2002;66(12):2231–2236.

Recovering from Mohs Surgery : SLU

Post-Surgical Information for Patients of SLUCare

Once your skin cancer has been removed through Mohs surgery, there will be an open
wound. Two options are available for healing:

Allow the wound to heal on its own. This is appropriate if the wound is extremely small or in a location where a scar
is cosmetically acceptable. Daily care of the wound is required. Depending upon the
size, may take up to 4 to 6 weeks for the wound to heal completely, but infection,
bleeding and pain are uncommon.

Close the wound with sutures (stitches). This option is appropriate when scarring must be kept to a minimum or when the natural
healing process would be inadequate. Most reconstructive surgery can be performed
on the same day as your Mohs surgery. The wound may be closed by shifting nearby tissue,
or by taking skin from another area of your body (often in front of or behind the
ear, or from the neck, collarbone region or thigh). Skin grafts may require a “bolster”
dressing — a special bandage sutured over the area. This dressing remains over the
graft for a week or until sutures are removed.

Reconstruction After Mohs Surgery

In some cases, wounds from Mohs surgery can be extensive and may require the assistance
of another surgeon. We will help you find a SLUCare physician or a physician close
to your home who can perform these procedures.

There may also be times when your personal physician refers you to SLUCare for Mohs
surgery with a plan to perform reconstructive surgery for you shortly afterwards.
A delay between your Mohs surgery with us and reconstructive surgery with another
doctor may not be convenient, but it will not cause ill effects. It is often necessary
as the Mohs surgery may require most of the day.

Following reconstruction, we will provide you with further written instructions for
the care of your wound, along with verbal explanations from the doctor or nurse and
phone numbers (both day and night) in case of questions.

Recommendations for After Mohs Surgery

You can expect minimal discomfort after Mohs surgery; pain can usually be managed well with acetaminophen (Tylenol).
Significant discomfort should be reported to us.

You may experience some localized swelling and bruising, which may not be at its worst until three to four days after surgery. Some swelling
and bruising is normal and should improve within a week.

If you have surgery on your forehead or nose, you may experience some swelling of your eyelids, which, at times, may nearly close them due to swelling and bruising settling in
that area. Similarly, swelling and bruising may occur down the neck, and rarely the
chest, when surgery is performed on the chin or jawline area. To help reduce swelling
and bruising, apply an ice pack for 20 minutes each hour while awake for the first 48 hours following Mohs surgery.

While bleeding rarely occurs after Mohs surgery, a little blood or seepage on the dressing is normal.
If you notice active bleeding (meaning the bandage is soaked with blood), remove the
bandage and apply firm pressure over the area with dry gauze or a dry cloth for 20
minutes.

If bleeding continues, contact our office or the on-call dermatologist (after office
hours). On rare occasions, it may be necessary to have the bleeding stopped by cauterization.

We recommend you limit vigorous physical activity, excessive bending over or exercise
for seven days after your Mohs surgery to allow your wound to heal and prevent bleeding
or damage to your stitches.

Sutures are usually removed five to 10 days after surgery. We will follow you through
the post-operative period to assure you are healing well and to determine if additional
procedures are necessary.

Once Your Mohs Surgery Wound Heals

Scars tend to improve over the course of several months, with significant improvement
noted during the first month. In some cases, scar revision or resurfacing of the scar
may be of benefit after Mohs surgery.

If you are doing well at the time of suture removal, we may discharge you to the care
of your referring dermatologist.

It is important that you keep regular follow-up examinations with your dermatologist.
You are at increased risk of developing additional skin cancer and pre-cancers. Early
diagnosis and treatment will benefit you. Examination of your surgical site is also
needed to monitor for any recurrence of your treated skin cancer.

Incision Care After Surgery | CS Mott Children’s Hospital

Topic Overview

After surgery, you will need to take care of the incision as it heals. Doing so may limit scarring, may help you avoid pain or discomfort, and may help lower the risk of problems like infection.

Your doctor used either stitches, staples, tissue glue, or tape strips to close the incision. And you will need to keep the area clean, change the dressing according to your doctor’s instructions, and watch for signs of infection.

Tips for reducing the risk of infection

To reduce the risk of infection:

• Ask your doctor how long you need to keep the area dry. Follow your doctor’s instructions exactly.
• Look at the incision every day, checking for signs of infection (see below).
• Change the dressing as your doctor recommends.

Do not:

• Scrub or rub incisions.
• Remove the tape strips (such as Steri-Strips) from incisions unless your doctor tells you to.
• Use lotion or powder on incisions.
• Expose incisions to sunlight.
• Take a bath unless you can keep the incision dry. Instead, take showers or sponge baths until your doctor says it’s okay to take baths. Before you shower, cover the dressing with a plastic bag or use another method of keeping it dry.

You may notice some soreness, tenderness, tingling, numbness, and itching around the incision. There may also be mild oozing and bruising, and a small lump may form. This is normal and no cause for concern.

Signs of infection

Call your doctor if you notice signs of an infection, such as:

• A yellow or green discharge that is increasing.
• A change in the odor of the discharge.
• A change in the size of the incision.
• Redness or hardening of the surrounding area.
• The incision is hot to the touch.
• Fever.
• Increasing or unusual pain.
• Excessive bleeding that has soaked through the dressing.

Changing a dressing

Before you start, make sure you have gauze pads, a box of medical gloves, surgical tape, a plastic bag, and scissors. Then:

1. Prepare supplies by opening the gauze packages and cutting new tape strips.
2. Wash and dry your hands. Put on medical gloves.
3. Loosen the tape around the old dressing.
4. Remove the old dressing.
5. Clean the incision if your doctor told you to do so. (See instructions below.)
6. Inspect the incision for signs of infection.
7. Hold a clean, sterile gauze pad by the corner and place over the incision.
8. Tape all four sides of the gauze pad.
9. Put all trash in a plastic bag. Remove your gloves last.
10. Seal plastic bag and throw it away.
11. Wash your hands.

Cleaning an incision

To clean the incision:

• Gently wash it with soap and water to remove the crust.
• Do not scrub or soak the wound.
• Do not use rubbing alcohol, hydrogen peroxide, or iodine, which can harm the tissue and slow wound healing.
• Air-dry the incision or pat it dry with a clean, fresh towel before reapplying the dressing.

Caring for stitches, staples, tissue glue, or adhesive strips

Stitches or staples normally cause some redness and swelling where the stitch enters the skin, along with mild irritation and itching. Some drainage from the incision may be expected for the first few days after surgery. But if the discharge does not decrease after a few days, becomes bright red with blood, or contains pus, contact your doctor.

The incisions may be protected with tissue glue or small adhesive strips (such as Steri-Strips) instead of a dressing or bandage. If glue was used, be sure to dry the incision area right away if it gets wet. The glue will fall off on its own after a bit of time. If adhesive strips were used, leave them in place until they become loose or fall off on their own.

Other incision care tips

After some surgeries, you may be given special instructions other than these for taking care of the incision. Be sure to follow those instructions carefully. If you are confused by the instructions or you have a question, call your doctor’s office. If the office is closed, leave a message with the answering service. If your pain has increased or you suspect you may have an infection, call your doctor as soon as possible.

Don’t expose your incision to direct sun for 3 to 9 months after surgery. As an incision heals, the new skin that is formed over the cut is very sensitive to sunlight and will burn more easily than normal skin. Bad scarring could occur if you get sunburn on this new skin.

Cuts, Scrapes & Scar Management: Parent FAQs

It is almost impossible for a curious and active child to avoid some scrapes and cuts. And…while a kiss from mom or dad and some TLC is often all that is needed, it sometimes takes a little more know-how to help wounds heal properly.

The following FAQs will help you prevent serious bleeding and other problems such as scarring when your child gets a cut.

What’s the best way to treat a small cut or scrape?

Almost all active bleeding can be stopped by applying direct pressure with clean gauze or cloth over the site for five or ten minutes. The most common mistake is interrupting the pressure too early in order to peek at the wound. 

• 
  Once bleeding stops: Gently wash the wound with soap and water for five minutes. If your child persistently objects, try soaking the wound in the bathtub. Cleaning the wound will decrease the chance of infection and prevent dark spots caused by dirt trapped in the skin.

• 
  After cleaning: Apply a small amount of antibacterial ointment to keep the wound moist and cover it with a dry gauze or bandage until healed.

How do I know whether or not my child needs stitches?

Here are some guidelines to help you determine whether or not stitches are needed:

• Cuts that go all of the way through the skin may benefit from stitches.

• Any cut that is gaping open with visible dark red muscle or yellowish fat should probably be closed, even if it is small.

• Any cut that is gaping and is more than ½ inch long should probably be closed. Get a ruler and measure it if you are not sure. Cuts smaller than this may not require closure, but if they are gaping, then it is best to have them checked out.

• Small cuts that are not gaping may not require actual stitches but may still benefit from steri-strips.

• If your child has a cut that is deep, gaping, or in a cosmetically sensitive area, call your pediatrician to determine if stitches are needed.

What are the options available nowadays for closing a small cut?

• 
  Skin glue was approved for use in 1998 and has become very popular. It is applied by rubbing it over the cut while the cut is being held closed. It is a good choice for straight cuts and is quick and painless. If done well, the cosmetic outcome is the same as stitches. However, it cannot be used to close a wound that has any tension on it from muscle usage. This is because skin glue is not as strong as stitches and, when used in areas of tension, the risk of the cut reopening is high.

• 
  Steri-strips (or “butterfly” bandage closures) are narrow adhesive strips placed over a cut, with a bit of tension to keep it closed. They are used for small cuts that are not very deep or over a joint or areas of tension. If they stay in place for at least three days, the outcome can be just as good as stitches. However, they are not as strong as stitches and do not stay in place well.

• 
  Stitches provide more strength and little to no risk of being pulled off too soon. However, they can be traumatic due to the time and pain involved in putting them in. Absorbable sutures are stitches that do NOT need to be removed. Non-absorbable sutures are stitches that need to be removed, usually 5-12 days later, depending on the location.

• 
  Staples are most often used for cuts in the scalp (within the hair). They are very fast and close the cut almost as well as stitches.

How soon after an injury does my child need to see a doctor for stitches?

Most cuts can generally be closed as long as 24 hours after the injury. Some cuts should be closed sooner, but it is very safe to wait at least 8 hours to have a cut closed.

If you do decide to wait: Wash your child’s cut under the faucet to get out any dirt. Do not let the cut dry out. Wet some gauze pads and tape them over the cut. Change the gauze every two hours to keep it moist.

My child’s cut is on his face. Should I be concerned about scarring from the stitches?  

Facial cuts in children usually heal remarkably well and with very little scarring. Pediatric plastic surgeons recommend that most facial cuts be repaired using simple interrupted sutures. The suture size and needle type are specifically designed for the delicate skin of the face.

How can I make my child’s scar less visible?

There are some simple things you can do to help minimize your child’s scar appearance once the skin has fully healed.

Note: Scars cannot be completely erased, and no treatment can return your child’s skin to exactly the way it looked before the injury.

• 
  Sun protection. Damaged skin is very susceptible to becoming permanently discolored by the sun for up to 6 months after an injury. It is very important to minimize sun exposure to the healing cut. Keep it covered with a hat or clothing as much as possible or use a broad sunscreen to minimize darkening of the scar (called “hyperpigmentation”). Do not apply sunscreen until two weeks after the cut.

• 
  Scar massage. Scars may soften and flatten more quickly when they are massaged. To do this, use your fingers to apply moderate pressure and massage the scar in circles.

• 
  Silicone sheets or gels. Silicone products may help soften, flatten, and improve the coloration of a scar if used for at least 12 hours a day.

My child has a scar seems to be getting bigger. Should I be concerned?

Sometimes, no matter what you do, a scar might not look as good as you want it to. Most of the time, this is a cosmetic issue. Occasionally, there are medical problems that can arise.

• 
  Hypertrophic scar. These are prominent scars that form as a wound heals and may be pink, red, or purple. These are often thick and raised, but they do not extend beyond the initial injury.

• 
  Keloid. These scars have spontaneously enlarged to form a firm, smooth growth. They are typically raised above the surface of the skin, look shiny, rough, and irregular in shape. They can be pink, red, or purple. Some keloids can become quite large, much larger than the original injury and often extend beyond its original borders. 

If you suspect a hypertrophic scar or keloid, talk to your child’s pediatrician. You may be referred to a pediatric plastic surgeon to see if treatment is needed.

Additional Information:

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

90,000 Dressings, stitching / removal of stitches in the clinic, appointment, consultations in Moscow, m. Khovrino

Dressing, stitching: when necessary

In case of injury, the victim requires first aid. Depending on the degree of injury, the method of wound treatment is selected.

Small cuts are washed and disinfected with antiseptics. They can then be bandaged.
For more serious injuries, qualified medical assistance is required.
In what cases it is necessary to contact the clinic M-Vita

There are situations when surgical treatment of the wound is necessary. Such manipulations are recommended to be carried out in an equipped operating room with special instruments and suture material.

• Deep cut (longer than 1.5 cm).
• After applying a tight bandage, the wound continues to bleed for 10 minutes.
• Foreign particles have entered the wound that cannot be removed by yourself.
• When injury is caused by a dirty or rusty object.
• When a wound is sustained by a bite from an animal or another person.

Important: it is better if a doctor takes care of extracting a foreign object from the wound. Otherwise, bleeding and dangerous complications can be caused.

Why suture

• Stitching the edges of a large wound accelerates healing.
• Stitching an open wound will avoid the risk of infection.
• Reducing the consequences of the formation of rough scars and scars.

Trauma advice

It is recommended to apply stitches within 6 hours after injury. The loss of time is fraught with an increased risk of infection.
Urgently seek qualified help in case of severe bleeding, when the wound is contaminated, after being bitten by sick animals.

In the M-Vita clinic, specialists will competently treat any type of wounds, carefully apply stitches, contributing to the correct fusion of tissues without the formation of ugly scars.

Memo after circumcision – Clinic “LITS” – a modern medical center in St. Petersburg

CLINIC DOCTORS PERFORMING THE PROCEDURE

Andrologist, Urologist

Experience: 5 years

Reception at:
Moskovsky prospect, 176

Andrologist, Urologist

Experience: 39 years

Reception at:
2nd Sovetskaya st.4B

What symptoms can be after circumcision:

• Pain. Any surgical intervention with tissue damage in the postoperative period may be accompanied by pain. Pain, as a rule, can only bother the first 1-3 days.It can be easily removed with anesthetic tablets. If the pain persists for longer or does not go away after taking medication, you should contact the operating urologist.
• Edema . By the end of the first day, tissue edema appears in the area of ​​surgery. This is the body’s natural response to tissue damage. Not only the suture area can swell, but also the head and external opening of the urethra. Physiological edema disappears by the end of the first day.
• Changing the color of fabrics. After circumcision, superficial hematomas may form on the glans and shaft of the penis, resulting in cyanosis of the tissues. There may also be redness of the head and urethra. These symptoms are normal.
• Change of urine stream . The swelling can cause the outer opening of the urethra to narrow, so the jet is sprayed out. Do not be afraid, after 2-5 days the edema will subside and the function will be fully restored.

Hygiene and dressings.

Starting from 2 days, you can go to the shower with a water temperature not higher than 40C. In order not to wet the bandage on the penis, a condom is put on, which is fixed at the base of the penis with a bandage or elastic band. It is better to take a condom size XXL so as not to squeeze the organ after circumcision. During the day, make sure that the dressing does not move or get wet after urinating.

Dressings should be done daily until the sutures are completely healed. To do this, purchase at the pharmacy: sterile gauze wipes, medical gloves, hydrogen peroxide 3%, chlorhexidine, baneocin powder, flucarcinol, ear sticks, self-fixing elastic bandage.

After the operation, the ichor may separate for several days and the napkins will stick to the skin. In order not to injure the seam, pour on top with plenty of chlorhexedine solution, wait 5 minutes. until the napkin is soaked, then carefully remove it. First, pour the seam with a solution of peroxide, in the area of ​​the wound it will foam. Then wash off the peroxide well with chlorhexedine solution and blot with a sterile napkin. Wait a little until the surface is completely dry and anoint the seam with flucorcin with an ear stick.Then put dry wipes and wrap with self-fixing bandage. The bandage should not press.

General questions.

1. Power supply. No restrictions. Eliminate alcohol completely in the first weeks after circumcision. Alcohol is incompatible with antibiotics and causes vasodilation, which can cause bleeding.
2. Sports. Avoid playing sports for at least 14 days until the stitches are completely healed.
3. Erection. The first days, an erection can appear not only in the morning, but also during the day. Many are afraid that if there is an erection, the stitches will disperse. This is not the case, modern suture material is able to significantly stretch with an increase in volume while maintaining the strength of the suture fixation. To reduce an erection, try to get up and start moving in the morning at the first sensations, apply cold, sleep in swimming trunks that hold the penis.
4. Stitches. Threads and knots may prick the surrounding tissue slightly and itch.The primary scar after circumcision is formed by 10 days. The stitches are removed for 10-14 days, depending on the condition of the wound. Removal of stitches is painless and is performed without the use of painkillers. After removing the stitches, the scar is dense and sensitive to touch. By 2-3 months, the scar will become soft, extensible, it will not be distinguished from the surrounding tissues, sensitivity will be restored.
5. Sex after circumcision. Until complete healing and removal of stitches, sex should be excluded. Initially, sexual intercourse after the operation may be accompanied by unpleasant sensations in the area of ​​the sutures, this is due to the fact that the tissues in this area are not yet stretched for the first time.In general, after circumcision, the quality of sexual life improves significantly, intercourse becomes longer, sensations are brighter, plus a visually open head looks more attractive for women.

Recommendations after dental surgery | Polyclinic IVTE UB RAS

Recommendations after dental surgery

The results of the operation should be monitored as regularly as the doctor prescribes.Do your best to ensure that the postoperative period proceeds with minimal discomfort. Without good, consistent, professional, supportive post-surgical care, surgery may not produce the desired results.

Such care is an absolute necessity!

90,000 Effects of using drainage tubes after surgical removal of lymph glands in the groin

What are the lymph glands?

Lymph glands are part of the body’s immune system [that] enlarge or swell as the body fights infection.They are located in many places in the body, including the neck, armpits, and groin.

Why are lymph glands removed?

Surgical removal of lymph glands in the groin (inguinal lymph nodes) is an important part of the treatment of several types of cancer, including melanoma and other types of skin cancer, and squamous cell carcinoma of the penis, vulva, and surrounding skin. Sometimes complications can occur after removing these lymph nodes, such as a wound infection, bruising (hematoma), or accumulation of lymphatic fluid in the area [of the wound] (seroma).

Why are drainage tubes inserted after surgery?

Surgeons may insert plastic drainage tubes into areas from which lymph nodes have been removed. These tubes are inserted at the end of the operation, after the lymph nodes are removed. The purpose of the drainage tubes is to drain any fluid or blood that may accumulate in wounds and cause complications. The drain usually remains in place until the amount of drainage fluid from it has decreased to a certain volume over a 24-hour period (usually less than 30-100 ml), although some surgeons remove the drain at a certain time after surgery (this can vary from 1 days to more than one week).Patients can remain in the hospital as long as the drain remains in place, although many surgeons allow patients to leave the hospital and monitor the drain on an outpatient basis.

However, it is unclear whether placement of a drainage tube reduces, increases, or has no effect on complications following this type of surgery. Also, the best time to retrieve the drainage tubes is not known.

Purpose of this review

The purpose of this review is to review all randomized clinical trials (RCTs) that compare what happens to patients who had drainage after inguinal lymph node removal versus patients who did not.We also searched for RCTs that investigated the effect of drain removal at different times. We searched the medical literature up to September 2014 to collect all available evidence.

What did this review find?

We did not find any RCTs comparing what happens when drainage is used or not used after surgical removal of the inguinal lymph node, and therefore we still do not know if drainage is useful in this context.

Condition of the gums after tooth extraction

Extraction of a tooth is a traumatic procedure for the gums, since an open wound remains in the place where the operation was performed. Careful adherence to the dentist’s recommendations will help speed up the healing process and get through it as comfortably as possible.

Carrying out a procedure

The tooth extraction procedure is carried out with the use of effective, modern pain relievers, therefore, painful sensations during the operation itself, as a rule, do not occur.

The operation begins immediately after the anesthesia has taken effect. A scalpel is used to loosen the ligament that supports the tooth.

If the procedure is traumatic, or the edges of the wound are enlarged too much, the dental surgeon may use self-absorbable sutures. But most often the wound is simply closed with a gauze swab with a special hemostatic agent. To stop the bleeding, you need to lightly, but firmly press the tampon to the wound with closed jaws.After 20 minutes, you can spit out the gauze.

Gum condition

Pain in the gums can occur after the end of the anesthetic drug, that is, after 3-4 hours. After the procedure, the patient is often worried about the return of painful sensations, the release of the ichor (for 4-6 hours. After the operation, the wound looks quite frightening, especially if a wisdom tooth was removed.

In the absence of pathology, the healing process occurs in several stages.

Day after procedure

At the initial stage, the hole left in the place of the torn out tooth is filled with a scarlet blood clot. It is not recommended to delete it, as it performs several functions:

• protects the wound from infections;
• eliminates bleeding from blood vessels;
• promotes the formation of new tissue that will fill the empty space.

To avoid the destruction of the blood clot, it is recommended that you refuse to brush your teeth on the day of the operation.Smoking is accompanied by inhalation of smoke, which creates negative pressure in the mouth. This can help pull the clot out of the well. It is not recommended to blow your nose or spit. Rinsing the mouth should also be excluded, you can simply put the solution into your mouth and keep it for a while without rinsing. Gentle rinsing can be shown only in the presence of inflammatory and purulent processes.

Three days later

The blood clot begins to change, thicken.Gray and white stripes of fibrin appear on it, after which the formation of new gum tissue begins. Painful sensations may still occur. But they are much weaker, have a pulling character. The patient may be bothered by bad breath. This is considered normal and is due to the formation of a blood clot. Forced not brushing your teeth also leads to the formation of bacteria and the appearance of unpleasant odors.

To rinse the mouth, it is imperative to use special solutions that the doctor will recommend.The appearance of pain from touching the gums, increased pain during a meal serves as a signal of the need to visit the dentist’s office again. If the tissues of the edges of the hole have acquired a red tint, it is also worthwhile to immediately consult a specialist.

Fourth to eighth days

The gums no longer hurt, there is no bleeding, the swelling goes away. In the middle of the socket, there is a yellowish-gray mass surrounded by pink patches of new gum tissue.At this point, you can rinse your mouth as usual. After a week, the gum looks almost completely pink. The process of bone formation begins at the site of the extracted tooth. Discharge from the hole, temperature, painful sensations are completely absent.

After 2-3 months and beyond

The gum gradually hardens, the space remaining from the tooth is filled with maturing bone tissue. By the beginning of the 4th month, the gum bone tissue completes its formation. The gums can be called completely healed.

If wound healing occurred with suppuration, then wound tightening can last up to six months.

Gum healing process

The healing rate of the gums depends on several factors:

• individual characteristics of the patient’s immunity;
• the success of the operation;
• is the location of the extracted tooth.

If the tooth is in a hard-to-reach place, has crooked roots, or its crown has been significantly destroyed, then the extraction procedure becomes more complicated.During manipulations, the tooth may begin to crumble, leaving fragments in the gum. In this case, cutting the gum tissue, detaching it from the bone, removing the tooth in parts, using a drill is required. These traumatic procedures prolong the healing time of the gums after surgery.

Slight swelling of the gums is normal. The temperature may rise slightly (due to an immune reaction). The swelling usually subsides within three days.

A noticeable swelling of the gums is also observed after cutting it.This swelling goes away in about one week.

Possible complications

An increase in the cheek, further spread of edema, persistent increase in temperature, increased pain, nausea, and weakness should be considered alarms. If the healing process is disturbed, the following complications may occur:

1. Formation of cysts. It is a fluid-filled fibrous growth.
2. Flux .Formed after the penetration of the infection into the hole, and then into the periosteum. The resulting inflammation is characterized by severe swelling of the cheeks from the side of the sore gums. There is severe pain, redness of the gums. The formation of a flux requires immediate medical attention. Therefore, it is necessary to carefully protect the site of the extracted tooth from possible infection.
3. Alveolitis. This is a complication arising from the inflammatory process of the socket in the jawbone. The infection enters due to a violation of the integrity of the protective blood clot.The onset of the disease is characterized by inflammation of the outer layers of the hole, spreading into the deep layers of the bone. Alveolitis is accompanied by aching pain during eating, swelling and redness of the gums. There is a putrid odor from the mouth. The patient feels chills, headache, fever. The onset of the disease most often occurs during the extraction of molars located on the lower jaw. It is necessary to get medical help on time in order to avoid the spread of infection to other organs.One of the dangerous complications of the disease is osteomyelitis.

Removing wisdom teeth is a more complicated procedure, so gum inflammation often occurs after surgery. At the same time, discoloration or swelling of the gums should not be of concern to the patient. Often after surgery, there are difficulties with opening and closing the mouth. This is a consequence of surgery. To get to a hard-to-reach place, the doctor asks the patient to open his mouth as wide as possible.The pressure exerted on the tissues leads to their swelling. On the 3rd day, the discomfort usually disappears completely. The appearance of purulent contents in the hole, fever, acute pain, profuse bleeding – all these signs require an immediate visit to the dentist.

Recommendations after tooth extraction

There are recommendations, adherence to which significantly accelerates the healing process of the gums. Not only the rate of wound healing depends on them, but also the absence of probable complications.The main recommendations of a doctor in the postoperative period may be as follows:

• you need to refuse too hot, spicy food that irritates the gum tissue;
• in the early days, damage to the clot must be carefully avoided; you must be extremely careful to observe oral hygiene;
• About 3 hours after the tooth extraction procedure, you need to refrain from eating;
• in the next three days, you need to eat only soft food, no sweets, alcohol, hot drinks;
• on the first day after the procedure, it is recommended to sleep on a high pillow;
• during the week it is recommended to exclude visits to the sauna, solarium, sunbathing on the beach, to reduce physical activity;
• on the first day, it is forbidden to brush your teeth in order to avoid damage to the blood clot;
• Do not try to pick at the clot with your finger, toothpick or tongue;
• a 20-minute cold compress should be applied to the operation area, every 2 hours;
• It is recommended to use oral baths, followed by rinsing with antiseptic agents.

The postoperative period requires careful attention to the patient’s health. A complication arising from neglect of the rules will require much more time, money and effort to heal the wound.

Removal of stitches in Moscow – the best clinics and medical centers: reviews, doctors, prices

Removing stitches is a procedure that is carried out some time after they are applied. In most cases, the suture is removed after the wound has completely healed and a scar has formed.But the seams must be removed in the event of the development of an inflammatory or purulent process.

It is necessary to remove the stitches in a timely manner, otherwise the risk of complications in the form of exudate formation increases, since the fixing material is a foreign body for the body.

Main indications

The main indication for the procedure is partial or complete wound healing. Usually, the sutures are removed 6-7 days after they are applied. If they are applied in places with more intensive blood circulation (neck, head), the period is reduced to 3 days.

How to prepare for the procedure

No special preparation is required on the part of the patient. In the dressing room, the doctor will inform the patient exactly why and how the procedure will be performed. Also, the specialist will tell you what complications may arise and what the patient should do in this case.

Features of the procedure

Before starting the procedure, the suture is treated with an antiseptic. The end of the seam knot is grasped with special tweezers, then pulled away in the direction opposite to the seam.If the seam is made with silk thread, then it is dissected with the help of medical scissors, having previously brought them under it. After that, the thread is removed and deposited in a previously prepared container (basin). The wound is re-treated with an antibacterial agent, a sterile bandage or dressing is applied to it.

Easier to remove the stitches imposed on the skin and mucous membrane. In this case, an experienced nurse can carry out the procedure, in other cases the participation of a surgeon is required.

Surgical clamps are used to remove stitches made with special staples.The procedure can be carried out in several stages, provided that the wound heals well. Occasionally, minor bleeding may occur after the suture is removed, which is considered normal.

The duration of the manipulation depends on the method of application and the size of the seam. Removal of staples takes from 3 to 5 minutes, threads – from 10 to 15.

Hospitalization after the procedure is not carried out, home care is prescribed using antibiotic therapy and local treatment.

Heap after removal | novodent86.ru

You had a tooth removed. What’s important?

PERMISSIBLE STATES AFTER PROCEDURE

• Possible painful sensations in the area of ​​the hole, which are well controlled by anesthetic.
• Edema may appear on the second or third day after the operation. This is the body’s natural response to surgery. The edema will begin to decrease at the end of the third, the beginning of the fourth day.
• A short-term rise in temperature to 38C is possible during the first few days after tooth extraction, the appearance of a hematoma (bruise) in the operation area (often on the second or third day), as well as limited or painful opening of the mouth.
• There may be temporary numbness or sensory impairment of the facial skin tissue and the site of the extracted tooth.
• On the first day, it is possible to isolate ichor in the area of ​​the wound.

WHEN TO CONTACT A DOCTOR?

• If pain persists or increases for a long time.
• Bleeding from the hole intensifies or persists for more than 12 hours. In case of severe bleeding of the wound, contact immediately!
• If postoperative edema does not decrease within 5 days.
• There is any doubt or question.

WHAT CANNOT BE DONE AFTER TOOTH EXTRACTION?

• Do not eat or drink for 2 hours.
• Do not injure the place of the extracted tooth, try to “clean” or “rinse” yourself.
• Avoid rinses using hygienic or other solutions, do not use ointments, compresses, etc.
• For 3 days, refuse a bath, hot bath, sauna, solarium, limit physical activity.
• Avoid the use of alcoholic beverages, especially when taking medications.
• Eliminate or drastically limit the number of cigarettes per day.

WHAT DO I NEED TO DO?

• Bite on a gauze pad for 15-20 minutes.
• For the first 3 hours after removal, apply a cold compress (through a towel or napkin) to the operation area: keep the compress for 5 minutes, then remove for 5 minutes.Do it again.
• For 3 days, exclude coarse and hot food from the diet. Optimal nutrition after surgery is food that does not irritate or injure the oral mucosa.
• Observe good oral hygiene. Change your toothbrush. Do not use an irrigator in the area of ​​the extracted tooth.
• If your doctor has prescribed medications for you, then you must take them according to the scheme, observing the dosage.
• The postoperative observation period lasts until the sutures are removed.Stitches are removed by a dentist surgeon during your next scheduled visit.

WHAT TO DO IF THE BLEEDING DOESN’T STOP?

1. Keep Calm! Place a high pillow under your head or sit up straight.
2. Do not spit out saliva – this will only provoke bleeding.
3. Apply cold to the cheek and bite tightly onto a dry tea bag or cotton pad. For bleeding on the palate, press down with your finger. Wait 15 minutes.
4. Measure blood pressure.
5. If ineffective, call an ambulance (112 or 103).

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