Author Archives: diminiko

Post Extraction Instructions

Modern oral surgery may involve the teeth themselves, their supporting tissues and bone, or any of the soft tissue within the mouth.

Healing occurs quickly in most cases without any complication, although problems may arise as the mouth must still function while healing is taking place. Additionally, the mouth cannot be sterilised and there is always a risk of infection of the oral wound. The most common complications are pain, swelling, infection and bleeding.

Please do not place fingers, pencils or any object unnecessarily in the mouth (to avoid injury or infection). A soft toothbrush should still be used to carefully clean your teeth. Be careful not to chew or bite your lip or tongue during the initial hours after your surgery, as they may still be numb from the anaesthetic.

PAIN

Moderate pain can be controlled by the medications prescribed. Remember to take these medicines in the usual way and DO NOT apply the drug directly to the wound itself. Warm packs applied after day 3 will help control any remaining pain or muscle fatigue. If the pain persists you should contact your surgeon.

SWELLING

Some swelling and/or difficulty in opening your mouth is common but it should begin to subside after 2—5 days.

Apply an ice pack immediately following theatre and at home for the next 24­48 hours, as this will limit the amount of swelling and pain. Do not apply the ice pack directly to your face – always wrap them in a face washer or cloth first.

INFECTION

Continued pain, swelling or a raised temperature may indicate an infection. Infection may spread or at least seriously delay healing. If you experience any of these symptoms you should contact your surgeon immediately for further care.

Avoid infection by strict oral hygiene:

  1. Rinse your mouth gently after every meal to dislodge any remaining food particles. You may use mouthwash or a salty­water mouthwash made by using a teaspoon of salt mixed into a glass of lukewarm water.
  2. Maintain your regular brushing habits with a soft toothbrush and extra caution.
  3. If given antibiotics (not all patients need them) it is important that you finish the whole script of antibiotics provided to you by your surgeon.

BLEEDING

Slight ooze during the initial days after your surgery is quite normal but if bleeding increases it requires attention.

The action to take is:

  • Remove any excess blood clots from the mouth.
  • Apply one piece of rolled gauze, a bandage or a clean handkerchief to the wound and keep it under moderate pressure. The cloth must be clean and should be dampened. The pack must be placed over the surgical site; if you feel it in between your teeth it has been incorrectly placed.
  • Sit down and maintain the pressure for at least 20 minutes. If doing this cannot stop bleeding contact your surgeon immediately.
  • Avoid the risk of bleeding by avoiding excessive activity for about 24 hours. Do not lie down flat as this increases the venous pressure in the face and thus the tendency to bleed and swell. Relax, but keep your head elevated (on at least two pillows).
  • Avoid hot foods or fluids for the first three days as the heat may predispose to bleeding.

NUTRITION

Avoid dehydration by keeping your fluid intake up. Ideally use an electrolyte replacement drink (e.g. Sports drink). Water based ice blocks are also a good method of providing a degree of fluid intake. The electrolyte ice blocks provided can be consumed as is or frozen, and can be purchased from most retail pharmacies.

Eat soft nutritious foods such as soft-boiled eggs, soup, mashed potato or fruit juices, even if you don’t feel particularly hungry, as regular meals are vital to your recovery. It is normal to experience some nausea or lack of appetite following your surgery.

POST OPERATIVE REVIEW

We realise that everybody has different post-operative needs. Our practice will be in touch during your recovery. Our practice nurse will contact you 4­5 days following the surgery and will tailor a postoperative plan to suit your needs. If required, we will organise a post-operative review. Many patients may not even require a follow­up appointment.

This advice is to help you achieve a smooth post­operative recovery. Should any problems arise or you have any questions following your surgery please do not hesitate to contact our practice.

EMERGENCY AFTER HOURS CONTACT- 0402828048

Skin Cancer Post-Surgery Instructions

TYPICAL POST-OPERATIVE SYMPTOMS

Typical symptoms and signs to watch for following surgery include the following:

Tingling, burning, redness, tightness at the surgical site. These are normal experiences as the skin, tissues and sensory nerves heal. Pain medication will help you cope with any discomfort. Consistent sharp pain should be reported to our office immediately. You may also feel minor discomfort at the graft donor site, if you had your own skin grafted to repair the defect.

Shiny skin or any itchy feeling: Swelling can cause the skin to appear shiny. As the healing process advances, you may also find a mild to severe itchy feeling at the scar revision or any graft donor site. An antihistamine can help to alleviate severe, constant itchiness. If the skin becomes red and hot to the touch, contact our office immediately.

CALL THE OFFICE IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING:

  • A high fever over 38.5 degrees centigrade.
  • Any pain that cannot be controlled by your pain medication.
  • Bright red skin that is hot to the touch.
  • Excessive bleeding or fluid seeping through the incisions.
  • A severely misshapen or swollen appearance at the wound site.

To alleviate any discomfort, and to reduce swelling, you may apply cool, not cold compresses to the wound site. Crushed ice or ice packs must be wrapped in a towel before being applied to the skin. Do not apply ice or anything frozen directly to the skin. Apply cool compresses for no longer than 20-minute intervals.

TWO TO SEVEN DAYS FOLLOWING SURGERY

During this time you will feel better with each day that passes. Ease into your daily activities.

  • Continue to cleanse wounds as directed; you may shower. Take a warm, not hot shower. Do not take a bath. Do not remove any steri-strips. Do not rub your incisions. Apply any compression as directed.
  • Take medications as directed. Pain medication such as paracetamol should ease your discomfort.
  • Proper sun protection is vital. You must not allow direct or indirect sun exposure to your wounds. Wear protective clothing, a wide-brimmed hat and at least an SPF 30 if you must be outdoors.
  • Do not resume any exercise other than regular walking.
  • Maintain a healthy diet. Do not smoke. Do not consume alcohol.

ONE TO FOUR WEEKS FOLLOWING SURGERY

  • As you resume your normal daily activities, you must continue proper care.
  • Discomfort or tightness and tingling will resolve.
  • Continue wound care as directed. Any dressings were removed at your first post-operative visit. You may now start using chloramphenicol ointment or paraffin on the incision 2 times daily, and start some gentle scar massage.
  • Ease into your fitness routine. Avoid aerobic exercise that may stress or stretch the skin in the area of your scar revision.
  • Do not smoke. While incisions may have sealed, smoking deprives your body of necessary oxygen that can result in poorly healed, wide, raised scars. For your long-term health, there is no need to resume smoking.
  • Practice good sun protection. Do not expose your skin to direct sunlight. If you are outdoors, apply at least an SPF 30 at least 30 minutes prior to sun exposure and wear protective clothing. Your skin is highly susceptible to sunburn or the formation or irregular, darkened pigmentation.

YOUR FIRST YEAR

  • Continue healthy nutrition, fitness, and sun protection.
  • Your scars will continue to refine. You may massage the scars with hand lotion (e.g. Vitamin E cream or Bio-oil) or scar treatments (e.g. Dermatex), starting at 3 weeks after the procedure. This should be performed 3 times daily for several minutes each time for the first year after the surgery. If the scars become raised, red or thickened, or appear to widen, contact our office. Scars are generally refined to fine lines one year after surgery.

Head and Neck Cancer Surgery

Cancers of the head and neck include cancers that occur in any of the tissues or organs in the head and neck. Most head and neck cancers are the type of cancer called squamous cell carcinoma. These cancers begin in the cells that line the nose, mouth or throat, or cover the surface of the tongue. Skin cancer arises from similar calls found in the skin.

Our bodies are made of millions of cells, many of which wear out and die and need to be replaced. Sometimes, the process that creates replacement cells gets out of control, so that too many cells are produced, creating a lump or ‘tumour’. If the cells remain in the tumour, they are not ‘cancerous’, and the tumour is called ‘benign’. However, if the cells can leave the tumour and spread into other tissues, the cells are described as ‘cancerous’ and the tumour is called ‘malignant’.

A small sample of cells, called a biopsy, may be taken from a tumour and examined under a microscope to find out whether the tumour is benign or malignant.

We know that cancers are not infectious – cancer of the head or neck cannot be caught from someone like a cold or cough. However, we do not know very much about what does cause cancer.

There are some things, however, that we know do to increase the chance of developing cancer of the head and neck, including:

Smoking tobacco
Chewing tobacco, betel or pan
Heavy consumption of alcohol
Some viruses

Only taking a biopsy –a sample of cells from the abnormal area – and examining it under a microscope can make a definite diagnosis. A CT scan or MRI scan may be performed before taking a biopsy to help identify the affected areas.

The different types of treatment may be given alone, or in combination with each other. They include:

Radiotherapy
Surgery
Chemotherapy
Photodynamic therapy

Your surgeon is specially trained to guide you through the steps of diagnosis and treatment. He works in a multidisciplinary team to ensure that the highest standard of care is made available and to co-ordinate the many allied health specialties vital in rehabilitation following treatment.