Management of lymph node metastases

Curing Melanoma with Surgery

A wide local excision of a melanoma will minimise recurrence and will assist with determining the need for additional surgery and ongoing management.

Recovery and Rehabilitation

After surgery you may have stitches until the wound heals. One to three weeks is an average healing time, however if the wound is larger or you had a skin graft it may take longer to heal.

After your wound heals you may have a scar, which should fade with time.

You may experience some pain around the site of the wound after surgery and your surgeon may recommend some over-the-counter medication or prescribe you some pain medication.

It is common to have one or more surgical drains after lymph node surgery (except sentinel lymph node biopsy) and advice will be given to you as to how long these will be in place and how they are to be managed in the post-operative setting. If you need to go home with drains in place, then at-home nursing visits may be part of your post-operative management to make the recovery process easier.

You will receive post-operative instructions outlining when you can get back to normal activities and how to care for the wound.

More information

What else you should know

The Difference Between Melanoma and Other Skin Cancers

Melanoma is more serious and less common than basal cell carcinoma (BCC) or squamous cell carcinoma (SCC).

In most cases (95%) melanomas are shades of brown. In 30% of cases they begin in previously ‘normal’ moles and in 70% of cases they begin as new moles.

Identifying and treating melanomas early is vital as they are dangerous and can be life threatening.

How do I care for myself at home?

After returning home from surgery you should follow the post-operative instructions provided by the Reconstructive Plastic Surgery Melbourne team.

Remember, everyone recovers differently, but you can follow these general steps to optimise your healing.

Medicine

Always speak with your surgeon to find out when you can recommence taking your existing medication and before starting any new medicine they have prescribed.
Always consult your surgeon before taking new medication, even if it’s over-the-counter.
Always follow the instructions provided with the medication.

Activity

When you have stitches, always check with your surgeon before returning to your normal activities.
After a skin graft, any exercise that stretches the skin should be avoided for at least three weeks.

Caring for your wound

Your wound will have a dressing covering it to help it heal and protect it from outside elements. If you had a skin graft you may need to change your bandages. Your post-operative instructions will outline how to care for your wound.
If you have stitches, your surgeon will let you know when or if you have to return to have them removed.
Wash the area daily with warm, soapy water and pat it dry. Ensure you don’t use any alcohol or hydrogen peroxide which can slow down the healing process.
After 24 to 48 hours you may shower, try to keep the wound as dry as possible. If it gets wet, always pat dry the wound. Baths shouldn’t be taken for at least two weeks or until your surgeon advises it’s safe.
If you have a surgical drain (or drains), you will be advised about how to care for them and it is common to have at-home nursing visits every 1-2 days to help manage the drains until they are ready to be removed.

If you had a skin graft, be sure not to rub over the wound for at least three to four weeks.

Follow-up appointments

Follow-up appointments are essential after having a melanoma removed.

What are some of the risks?

Like any surgery, there are risks and complications associated with removing melanoma.

Risks of surgery to remove melanoma include:

infection
scarring
bleeding
rejection of the skin graft.

When should I call for help?

Notify your health care team immediately if you experience any of the following symptoms:

nausea, vomiting or diarrhoea
fever/high temperature – 38°C or higher
your stitches become loose or your wound opens
increasing pain that doesn’t improve with medication
increasing warmth, swelling or redness around incision site
pus coming from the incision site
heavy bleeding from incision site
red streaks leading to the incision site
you can’t pass stools or gas
signs of a blood clot including pain in your calf, back of the knee, groin or thigh, redness or swelling in your leg.

If you pass out or are short of breath call 000 for emergency care.