England's failure in their first innings is of concern

England needed all the determination so evident under the guidance of Flower and captain Andrew Strauss since the start of last year, to leave the Gabba unbeaten.

For their coach, though, the stakes suddenly became much higher than the outcome of a mere cricket match – albeit the all-important first Ashes Test – when doctors informed him he needed surgery urgently to remove a melanoma on his face.

It was England's much-respected security expert Reg Dickason who convinced Flower he should have a mole just below his right eye checked over again.

The result was local-anaesthetic surgery, once the medics realised there was a danger of skin cancer.

Flower therefore had a new reason to thank the man so trusted by England to keep them safe around the world.

"Reg has saved so many lives over the years," he said, on arrival yesterday in Adelaide to prepare for the second Test.

"He had been to see this dermatologist just recently himself and had a few things taken off."

Flower addressed the press at the team hotel, still wearing the stitches which will heal the skin graft on his upper cheek. "I was a bit worried about one particular area – which is pretty obvious to see – and he urged me to go and see this bloke as well. Yet again, it was another piece of good advice from Reg."

After his scare, Flower was told on Monday that the surgeons have managed to remove all the dangerous cells and he can therefore consider himself in good health.

England's players, and other backroom staff, can nonetheless expect another check-up while in Australia.

"They are regularly screened," added Flower. "More than likely, there will be another screening on this tour. Cricketers are in the sun all the time, so it's a real risk, and we want to make sure everything is okay with everyone."

A relieved Flower was able to smile through any remaining discomfort as he reflected on his players' remarkable second-innings revival on the final two days of the first Test. Alastair Cook batted throughout 10-and-a-half hours and 152 overs for a maiden double-century, and Andrew Strauss and Jonathan Trott also made hundreds in an astounding 517-1.

"I think our batsmen showed they can handle the attack," said Flower. "But that is only one Test we've just played, and the real test is over the long term – and that is five Test matches."

England did not fare nearly so well at their first attempt with the bat, having won the toss, and conceded a first-innings deficit of 221.

Flower added: "The first-innings batting is always a focus, because if you do get first-innings runs you put the opposition under pressure.

"We didn't do that in this last Test, so we'll obviously be looking to target that area.

"Even though we bowled outstandingly well, they still scored 480 so we need to put them under pressure and create chances."

Graeme Swann, touted as one of the keys to the outcome of the Ashes, found himself under attack in Brisbane on his way to match figures of 2-161.

Flower expects him to have conditions a little more in his favour at the Adelaide Oval, and knows the off-spinner will relish the challenge of opposition batsmen trying to unsettle him.

"Graeme Swann is a really experienced campaigner and, if anything, I think that fires him up and will give him chances. Historically, it turns here and does give the spinners a little bit of help."

England's survival at the Gabba did not come down to the last-ditch heroics they have pulled off three times in the last 16 months – starting at Cardiff on their way to 2009 Ashes success.

Many will nonetheless draw parallels with that great escape from the SWALEC, and Flower can see where they are coming from.

He knows England have won nothing yet this winter but, by stretching Australia's resources in the first of two back-to-back Tests, they could reap the rewards soon.

"The bottom line is the scoreline is 0-0, and we'll be starting that battle again on Friday," he said. "But obviously there's fatigue for some of the bowlers after long spells, and confidence, or lack of, is passed from one match to the next. So there is definitely a connection there."

Informed of England's interpretation of events so far, Flower's opposite number Tim Nielsen was moved to an early bout of sarcasm which may or may not calm any Australian nerves.

"We're going terribly; we're going awfully!" he said. "I can't believe they said that – and I'm not sure we're going to turn up on Friday!"

It is a safe bet they will, and highly likely too that Mitchell Johnson will be involved again despite his miserable experience on what used to be his home ground.

The left-armer finished with 0-170, made a 19-ball duck and dropped an important catch.

Nielsen said: "He didn't have his best game, but he's not on his own there. There were only 11 wickets for both 'groups'. That says it was hard work to me.

"He didn't bowl as well as he would like, so that's our job in the next couple of days – to make sure we get him back up and going.

"At different times there have been a lot of players who didn't perform in one Test match and then have been able to up the ante and come out and do as well as they need to to have an impact in the next."

"He's taken 160 Test match wickets. He's good at this game."