๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
POSTOPERATIVE CARE
In addition to those given preoperatively (see Table 151.3), antibiotics may be given postoperatively for wound infection prophylaxis if surgery is extensive as well as for any debilitated patient for whom proper wound care is a concern. Additionally, surgical reconstruction on highly sebaceous noses and distal lower extremities (below the knee) plus those near the nares and mouth may require prophylactic antibiotics. Pain control is assessed on a case-by-case basis. Substantial pain following MMS is uncommon. Acetaminophen is usually sufficient for postoperative discomfort, especially for smaller defects and simple repairs. Oral narcotic analgesics may be prescribed for patients with low pain thresholds, large tumors, complex reconstruction, or wounds in anatomic locations of high tension (e.g. scalp) or sensitivity (e.g. lip, nose, ear). One randomized controlled trial found the combination of acetaminophen and ibuprofen superior in controlling postoperative pain compared to acetaminophen with codeine and acetaminophen alone.
Ongoing surveillance at least annually for new primary and recurrent cancer is recommended for all patients, given that 50% of patients with keratinocyte carcinomas will experience another skin cancer during the subsequent 5 years.