Managing Lip Wounds: Care Tips and Treatment Options for Healing

Lip wound

Dear Dr.
Chen,
A few days ago, my father had a small tumor on his lower lip removed by a dermatologist, resulting in a wound measuring 0.5 x 0.3 cm (it wasn't this large initially).
However, it became slightly red and swollen after possibly coming into contact with water, which may have caused it to enlarge.
The dermatologist initially advised applying tetracycline ointment and, after three days when the wound is drier, to use a hydrocolloid dressing.

1.
Due to the location of the wound on the lip, it is difficult to keep it covered while eating, as it tends to get moist and the dressing falls off.
Even if I apply a tight dressing, it comes off after eating in the morning.
As a result, there was some redness and swelling around the wound on the first day.
However, I have used silver-containing dressings twice, which have reduced the redness and swelling.
I forgot to ask if silver ointment or dressings can be used on lip wounds?
2.
The dermatologist mentioned that once the wound is drier, we can use a hydrocolloid dressing.
However, I noticed that the wound is about 0.1 cm deep.
Will using a hydrocolloid dressing help the wound heal from the bottom up? Currently, the wound is less red and swollen, and there is no pain, but it is somewhat moist with a thin white necrotic membrane in the center.
Is it appropriate to use a hydrocolloid dressing at this stage, even though it is difficult to keep it on? I can manage to keep it on at night.
3.
Given that maintaining a dressing on the lip is challenging (due to eating), can I apply an oral ointment or tetracycline in the morning without a dressing? And then use a hydrocolloid dressing at night? The elderly complain that the dressing falls off every time they eat, and I am unsure how to properly apply medication to facilitate healing.
4.
This is a separate issue: I need to undergo a fecal test for colorectal screening, but I am currently taking orlistat (Xenical).
Do I need to stop taking it, and if so, how many days before I can collect the sample? This is quite concerning for me.
Thank you for your continued assistance.

Xiao Xin, 40~49 year old female. Ask Date: 2019/01/12

Dr. Chen Jiaming reply Surgery

1.
Lip wounds are difficult to bandage, but silver-containing compounds can inhibit bacteria, so they can be used!
2.
Since the wound has white necrotic tissue, while artificial skin can absorb secretions or block external saliva, it is uncertain whether the internal wound will heal.

3.
Most lip wounds are simply bandaged on the first day to absorb blood and fluid, and after the second day, they are managed with an open approach.
After meals or exposure to water, a little ointment can be reapplied.

4.
Xenical increases the fat content in stool; after inquiry, it was found that it does not affect occult blood tests, so there is no need to discontinue its use specifically.

Reply Date: 2019/01/12

More Info

Managing lip wounds, especially after a surgical procedure like the removal of a skin lesion, requires careful attention to promote healing while minimizing discomfort. Here are some tips and treatment options based on your questions and the current medical understanding of wound care.

1. Use of Silver Dressings on Lip Wounds: Silver-containing dressings can be beneficial due to their antimicrobial properties, which help prevent infection. However, when it comes to sensitive areas like the lips, caution is advised. While silver dressings can be used on the lips, they should be applied carefully to avoid irritation. If the wound is not showing signs of infection (such as increased redness, warmth, or pus), it may be safe to continue using the silver dressing. However, if irritation occurs, it may be best to switch to a more gentle option, such as a hydrogel dressing, which can provide moisture and promote healing without the potential irritation from silver.

2. Artificial Skin for Deeper Wounds: Artificial skin or occlusive dressings can indeed help in the healing process by providing a moist environment that promotes epithelialization. For a wound that is approximately 0.1 cm deep, using an artificial skin dressing can be appropriate once the wound has dried out sufficiently. The presence of a white, necrotic film indicates that the wound is in the healing phase, but it is essential to ensure that the wound is not overly moist, as this can lead to maceration. If the wound is still exuding fluid, it may be better to allow it to dry out a bit more before applying the artificial skin. If you find that the dressing does not stay in place due to eating, consider using a smaller piece of artificial skin that can be applied just before meals and removed afterward.

3. Medication Application: It is understandable that maintaining a dressing on the lips can be challenging due to eating and drinking. Applying topical antibiotics like tetracycline ointment during the day without a dressing can be a good strategy, as it will help prevent infection while allowing the wound to breathe. At night, when the patient is less likely to eat, applying an artificial skin dressing can provide a protective barrier that promotes healing. This alternating approach can help manage moisture levels and protect the wound from external irritants.

4. Considerations for Colorectal Screening: Regarding the use of orlistat (Xenical) and its impact on stool collection for a colorectal screening, it is generally recommended to stop taking orlistat a few days before the test. This is because orlistat can affect the absorption of fats and potentially alter the stool consistency, which may interfere with the test results. It is advisable to consult with your healthcare provider for specific recommendations on when to stop taking the medication before the test.

In summary, managing lip wounds requires a balance between protecting the wound and allowing it to heal. Using silver dressings can be beneficial, but monitor for irritation. Artificial skin can be applied when the wound is dry enough, and alternating between topical antibiotics and dressings can help manage moisture and protect the wound. Lastly, consult with your healthcare provider regarding the timing of medications in relation to your upcoming tests. Always prioritize comfort and healing, and do not hesitate to reach out to a healthcare professional for personalized advice.

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