MINOR SURGERY PATIENT INFORMATION LEAFLET
(Removal of minor skin lesions, lumps and bumps)
Both Dr Higgie and Dr Nelson are qualified and experienced practitioners able carry out Minor Surgery procedures here in the surgery. Minor surgery is a relatively painless and fairly quick procedure generally taking 15-20 minutes.
Most procedures are carried out using a local anaesthetic (an injection at the sight of the lesion which numbs the area, similar to that used by dentists). The local anaesthetic lasts for about 2 hours. You should not feel any pain during the procedure but you may feel a sensation of pressure. If you do feel any pain during the procedure you should tell the Doctor immediately.
Minor surgery is a safe and effective treatment, however there are some risks associated with minor surgery:
All minor surgery can leave some degree of scarring. This varies from person to person and cannot be predicted. If you have concerns about scarring it is important that you discuss this with the Doctor before your procedure.
Some lesions are surgically removed from the skin and will require skin closure with sutures. Other lesions may be removed from the skin by cautery (burning the area), this will not require any sutures. The Doctor will advise you which method of removal is required. All lesions surgically removed from the skin will be sent to the laboratory for analysis.
Once your minor surgery has been completed the Nurse will apply a dressing to your wound and you will be allowed to go home.
You may notice once the local anaesthetic has worn off that your wound is a little painful, you can take simple pain killers such as Paracetamol. The wound may remain painful for 24-48 hours, if the pain is not improving after 48 hours please contact the surgery for advice. Likewise, if the wound becomes red, swollen or starts discharging pus, please contact the practice for advice.
The wound dressing should be left in place for at least 24 hours, or longer as specified by the Doctor or Nurse. It is important that the wound is kept clean and dry and that you don’t use any creams or lotions on the wound.
If you have required stiches to your wound you will need to make an appointment in 7 – 10 days time with the Nurse to have them removed.
Please note if patients under the age of 16 years must be accompanied by a parent or guardian
Joint and Soft Tissue Injections Information for Patients
Why have an injection?
Joint injections can be an effective way of treating some problems of joints and ligaments that are caused by inflammation. Examples of conditions we sometimes treat with injections include:
What is injected?
We normally use a corticosteroid called Methylprednisolone (Depo-medroneTM). Steroids are very potent anti-inflammatory drugs. They can be associated with lots of side effects if used long term, but the amount we use in an injection is small and highly unlikely to cause problems.
With some injections, we also include a local anaesthetic called lidocaine.
Are there any problems associated with these injections?
Complications are rare, but can occur:
Care after the injection
If you do have any pain following the injection, we would recommend simply taking 2 paracetamol 500mg tablets up to four times a day as required.
Avoid activities that may increase pain in the injected area for 48-72 hours after the injection: For example, avoid carrying shopping if you have had a tennis elbow injection. This may require some people needing to take 2-3 days off work if their occupation has a direct impact on the injected site.
Don't try any of the painful movements for a couple of days, after which a slowly increase the amount of movement.
Liquid Nitrogen Treatment – Cryo Therapy
Liquid nitrogen is extremely cold. It will freeze any living tissue it comes into contact with. Applying small amounts of liquid nitrogen to various skin problems is now a standard treatment.
What can it treat?
Warts and verrucas, skin tags, small fleshy growths and similar small 'lumps and bumps' on the skin are ideal for liquid nitrogen treatment.
Is it painful?
Applications usually last about 10-30 seconds. Try holding a cube of ice against your skin for 10-30 seconds. It is uncomfortable but usually not too painful. Liquid nitrogen applied to skin is similar but colder and most people find the discomfort quite bearable.
What can I expect?
After a treatment, the lump, wart or whatever is being treated will gradually discolour and fall off. The surrounding skin will sometimes become red and swollen and be sore for a day or so. It is similar to a mild burn. Occasionally a blister (sometimes a 'blood blister') forms. If this happens, it is best to pop it with a clean pin and apply a plaster. New skin quickly forms and any scab or blister will soon disappear. The cosmetic result is usually good, however a small number of patients experience some skin discolouration.
Does it always work?
Usually it does. However, sometimes thicker warts or verrucas need two or more sessions of liquid nitrogen treatment over a period of a few weeks to get to the root. Compared with other treatments, most people find liquid nitrogen the most effective and the least time-consuming way of removing these skin blemishes.
The common cold and most upper respiratory infections are caused by infection with germs (viral infections). They usually get better in a few days. This leaflet gives some tips on what to do, and what symptoms to look out for which may indicate a more serious illness.
A cold is an infection of the nose and upper airways caused by a germ (virus). They are extremely common. An adult can expect 2-4 colds a year, and a young child about 3-8 colds a year. Many different viruses can cause a cold. This is why colds come back (recur), and immunisation against colds is not possible.
Infections of the throat (larynx), or the main airway (trachea), or the airways going into the lungs (bronchi) are also common. These infections are sometimes called laryngitis, tracheitis, or bronchitis. Doctors often just use the term upper respiratory tract infection (URTI) to include any, or all, of these infections. Most URTIs are due to a viral infection.
The diagram above shows the sites of a range of respiratory infections. This leaflet just deals with the common cold and URTIs. See separate leaflets about other infections of the respiratory tract and related structures, called Bronchiolitis, Pneumonia, Tonsillitis, Sore Throat, Acute Sinusitis, and Pleurisy. See also the separate leaflet called Coughs and Colds in Children.
The common symptoms of a cold are a blocked (congested) nose, a runny nose, and sneezing. At first there is a clear discharge (mucus) from the nose. This often becomes thick and yellow/green after 2-3 days. It may be difficult to sleep due to a blocked nose.You may feel generally unwell and tired, and you may develop a mildly high temperature (a mild fever).
In other upper respiratory infections, cough is usually the main symptom. Other symptoms include fever, headache, aches and pains.
Symptoms are typically at their worst after 2-3 days, and then gradually clear. However, the cough may carry on after the infection has gone. This is because swelling (inflammation) in the airways, caused by the infection, can take a while to settle. It may take 2-3 weeks, after other symptoms have gone, for a cough to clear completely.
A main aim of treatment is to ease symptoms whilst your immune system clears the infection. The most useful treatments are:
You can buy many other cold and cough remedies at pharmacies. There is little evidence that they help fight the infection, but they may be useful for certain symptoms. For example, a decongestant nasal spray may help to clear a blocked nose.
But remember, cold and cough remedies often contain several ingredients. Some may make you drowsy. This may be welcome at bedtime if you have difficulty sleeping because of your cold. However, do not drive if you are drowsy. Some contain paracetamol. Be careful not to take more than the maximum safe dose of paracetamol if you are already taking paracetamol tablets.
If you use a decongestant nasal spray, do not use it for more than a few days. It can have an immediate effect to clear a blocked nose. However, the effect does not last very long. If you use a nasal spray for more than 5-7 days, you may feel that your nose is becoming more blocked. This is called a rebound effect.
In March 2009 an important statement was issued by the Medicines and Healthcare products Regulatory Agency (MHRA) which says:
"The new advice is that parents and carers should no longer use over-the-counter (OTC) cough and cold medicines in children under 6. There is no evidence that they work and can cause side effects, such as allergic reactions, effects on sleep or hallucinations.
"For 6 to 12 year olds these medicines will continue to be available but will only be sold in pharmacies, with clearer advice on the packaging and from the pharmacist. This is because the risk of side effects is reduced in older children because they weigh more, get fewer colds and can say if the medicine is doing any good. More research is being done by industry on how well these medicines work in children aged 6-12 years."
Note: paracetamol and ibuprofen are not classed as cough and cold medicines and can still be given to children.
Antibiotics are not usually advised if you are normally in good health. Your immune system can usually clear the infection. Antibiotics do not kill germs which are viruses. Even if a different type of germ (called a bacterium) is the cause, antibiotics usually do little to speed up recovery from a URTI.
Antibiotics may even make symptoms worse, as some people develop side-effects such as diarrhoea, feeling sick or a rash. Antibiotics may be prescribed if you become more unwell, or if you already have an underlying (chronic) lung disease. They may also be prescribed if a complication develops, such as pneumonia - but this is unlikely to occur if you are otherwise healthy.
Research studies suggest that:
Most URTIs do not cause complications. A URTI may trigger coughing, wheezing and shortness of breath in people with asthma or other lung diseases. Sometimes the infection travels to the lung tissue, sinuses, or ears. Germs (bacteria) may thrive in the mucus so some people develop a secondary bacterial infection of the lung tissue (pneumonia), ears or sinuses. Therefore, see a doctor if symptoms do not start to ease within a few days, or if you suspect that a complication is developing. In particular, symptoms to look out for that may mean more than just an URTI include:
Prevention is difficult. Many germs (viruses) can cause a URTI. Also, many viruses that cause URTIs are in the air, which you cannot avoid. However, the following are suggestions that may reduce the risk of catching a URTI or of passing one on, if you have one:
Basically, common sense and good hygiene may prevent the passing on of some viruses that cause URTIs.
An interesting research study (link provided in 'Further reading & references', below) showed that people who exercise regularly are less likely to get URTIs. The study was on 1,002 people over 12 weeks during the winter. It found that the people who exercised on five or more days a week had a much lower chance of developing a URTI compared with those who did little exercise. And, if someone who exercised regularly developed a URTI, there was a good chance that symptoms would be less severe than someone (with a URTI) who did little exercise. The researchers thought this may be because exercise boosted the immune system and this may help us fight infections.
Many common infections of the nose, throat, sinuses, ears, and chest are caused by germs called viruses. Flu-like illnesses are also caused by viruses. Diarrhoea and/or being sick (vomiting) are often due to a viral infection of the gut. If you are normally well, your defence (immune) system is good at fighting off many types of viral infection. An antibiotic medicine is not needed if a virus is causing an infection. This is because:
See the separate leaflet called Health Protection Agency Antibiotic Leaflet.
You may feel unwell for several days or more until a viral infection clears. Treatment aims to ease symptoms. Treatments that are commonly advised for viral infections include the following:
The immune system can clear most infections with germs called bacteria. For example, antibiotic medicines usually do little to speed up recovery of bronchitis, or most ear, nose, and throat infections that are caused by bacteria. However, you do need antibiotics if you have certain serious infections caused by bacteria, such as meningitis or pneumonia. When you are ill, doctors are skilled at checking you over to rule out serious illness, and to advise if an antibiotic is needed.
Occasionally, mild infections caused by germs (viral or bacterial) develop into more serious infections. See a doctor to review the situation if the illness appears to change, becomes worse, does not go after a few days, or if you are worried about any new symptom that develops.
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