Video Production by Josh Melendez

This video covers the potential complications involved when undergoing a dermatology procedure.

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Video Transcript:

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So, today we’re going to be giving a brief overview of the potential complications that could happen during your procedure at your local dermatologist’s office.

Now, none of these talks or none of these consents that you will sign can possibly cover everything that could happen. Our goal is to talk about the things that are most likely to happen or could happen reasonably. You know, every day when you get in your car and you drive down the road, there’s a whole host of things that could happen.

And nobody is ever going to tell you all the things that could happen when you’re driving a car. And I can’t tell you everything that could happen during a surgical procedure. But these are the basics, these are what you need to be made aware of. And with everything, if you have any questions or any concerns or any individual circumstances that affect you, please let your dermatologist know prior to any procedure.

Now, these general complications are true for a biopsy, they’re true for a surgery, they’re true for most surgery, in fact they’re true for most procedures that happen in a dermatologist’s office. And if you do not have a consent form prior to your surgical procedure, you’re welcome to look at my practice’s consent so you can get an idea of what the potential complications could be.

The first is an allergic reaction to either the numbing or the cleaning or the bandaging. You know, everybody is a little bit different with allergies, and so the best thing for you to do is let us know beforehand if you’ve had problems in the past. The next is bleeding around the surgical site. And this is fairly common for the first 24 to 48 hours.

And if that happens, all I need you to do is elevate the area above the level of your heart, and hold five minutes of firm pressure to the area without peeking. Every time you peek the clock restarts. Almost all bleeding will stop if you elevate it and hold five minutes of firm pressure.

It might start again an hour or two later, all you do is repeat the procedure. If the bleeding is uncontrollable, that’s when you need to contact your local doctor and let them know what is going on. Next is bruising around the site. Any time we cause trauma to an area, we can cause bruising. It’s especially true if we’re working anywhere around the eyes, those will bruise very easily.

Scar formation. Any time we do any type of procedure there will be a scar that forms. Now, whether you can see that scar or not, it doesn’t really matter because you will have a scar that forms, that’s the most important thing. So, there are some things that you can do to help the scar not be as noticeable when it is fully healed, and the most important is not to put any pull or tension on the wound, or any pressure or rubbing on the wound for six weeks after the surgery.

If we can give the surgical site time to heal, it will heal much better with a much better scar. Wound infection. Wounds can get infected, sometimes those infections can be serious, most of the time they’re not. If you start to experience increased redness that goes beyond a centimeter beyond the wound edge, increased tenderness, oozing from the area, fevers, chills or night sweats, you need to let your dermatologist know.

So, you can have chronic wounds that develop, whether those wounds are ulcers, whether the wound splits open, whether the skin around the wound dies, all of these things are possible, and they’re especially true on the lower extremities. When you get to below the knee, those areas take a long time to heal, and so you need to be prepared for that.

And those areas, if we do anything to them, could form chronic wounds that you might need wound care for. Now, it’s very rare, but it is a possibility. Postoperative discomfort or pain. Usually that’s fairly minimal with the vast majority of procedures that dermatologists do in office. But if you do have some discomfort, you can try a couple of things.

You can try some Tylenol, if you’re allowed to take Tylenol. You can elevate the wound above the level of your heart to try to decrease some of the swelling in the area. You can apply ice to the area for five minutes an hour, and if you do that you just put it right over the surgical dressing. So, for five minutes an hour while you’re awake for the first day or two, that will help decrease the pain. Now, we do not want you taking the NSAIDs, and the NSAIDs are the Motrins, the aspirins, the Aleves, for the first 24 to 48 hours, because that will increase your chance of bleeding, and then we’re just going to have more of a mess on our hands.

So if possible, take Tylenol, elevate, ice when needed. Now, you can always get skin color changes, those skin color changes can be lighter, they can be darker than the surrounding skin, or they can be pink. And those color changes could last forever, they could be permanent, so you need to be prepared for that.

You can get recurrence or regrowth of the lesion that was removed. So,it’s always important to look at the operative site once a month in the mirror for the rest your life to see if you think the lesion is coming back. So, if there’s anything that’s new, changing, growing or something different about the surgical scar, please let us know. You can always get loss of sensation in the area or the area distal to the spot we worked on.

So, let’s say for example we worked on your forearm, you could get local numbness that could be permanent, and you could also get numbness that travels down your hand and be permanent that way. It’s pretty unusual but it could happen. And the same thing could happen with decreased motor movement, decrease of the ability to move a muscle, not only around the surgical site, but distal to it. Again, those are very rare, but you need to be aware of those.

Please remember that with anything in life there are potential complications. Our job is to help you understand those complications before the procedure is performed so that you can take control of your health and the situation and the procedure that you’re about to undergo. As always, it’s our privilege to help you become comfortable in your skin.

After watching this video please also watch the pre-operation video, the procedure video, and the post-operation video, so that you can achieve the best outcomes possible.

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About the author

Dr. Anderson with Doctors Quarterly Magazine - Cropped
Dr. Reagan Anderson

Dr. Anderson is a Board Certified Dermatologist and Mohs Micrographic Surgeon. He serves as a Clinical Professor of Dermatology and is actively involved in patient and healthcare provider education on dermatology conditions and treatment.

Colorado Dermatology Institute
8580 Scarborough Drive / 1220 Lake Plaza Drive
Colorado Springs, Colorado