Preparing for Surgery
It has been shown that washing the entire body from your neck down with Hibiclens (chlorhexidine 4%) for two days before the surgery reduces post-operative infections. Even if the lesion is on your face or scalp, cleansing the body will reduce the chance of spreading bacteria. PLEASE take care to avoid the eyes and ears when washing as it can cause permanent damage to the eyes and ears. This can be purchased at your local pharmacy in the First Aid Aisle.
On the day of surgery, you may eat a normal breakfast and continue taking your medications including Coumadin, Plavix, and aspirin, as prescribed.
Please dress in comfortable clothing that you do not pull over your head (e.g. shirt with buttons) because clothing could interfere with post-operative bandaging. Please do not wear make-up.
Mohs Micrographic surgery can take several hours. For this reason, we ask patients not to make any other plans the day of surgery.
If you have a cold, flu, or a temperature greater than 100.4 F, please notify our medical staff. It may be necessary to reschedule your surgery.
Due to space restrictions, we ask that only one family member or support person comes with you to your appointment.
During Surgery
We strive to make your surgical experience as comfortable as possible. Before the procedure, you will have the opportunity to ask the doctor any questions you may have.
The surgical process begins with removal of the visible cancer tissue and the first layer of skin. A bandage is then applied to the wound. This initial stages usually lasts less than 15 minutes.
After removal, the sample tissue is processed and then studied under a microscope. The skin cells are color-coded and charted on a map that corresponds with the cancer site. Tissue examination generally takes about 45 minutes to an hour.
If cancer cells remain, the procedure of cancer cell removal and microscopic examination is repeated until the margins of the tissue are clear of cancer cells.
Once the margins of skin are cancer-free, the wound is normally closed with sutures. This is required for optimal cosmetic results. The sutures may require removal at a follow-up appointment 1-2 weeks after your procedure.
We recommend that you schedule your follow-up appointment for suture removal before you leave the office on the day of your procedure.
Please understand that our day is unpredictable. You will experience waiting sometimes before and/or between stages of your procedure, so we ask that you provide some form of entertainment (i.e. books, laptop, iPad). We do provide Wi-Fi internet access. We appreciate your patience. Our goal is to have the entirety of your procedure completed as quickly as possible.
After surgery
After surgery, a pressure bandage is applied to the wound site that must be kept there for 24 hours. Further wound care instructions will be given to you before you leave the office. Suture removal and follow-up appointments are usually required as a means to provide optimal results and monitor the healing process. For this reason, we do not recommend travel at this time.
Extra-Strength Tylenol is recommended for any pain after surgery. Bruising, swelling, aching, and soreness are typical symptoms that occur after surgery. You may also experience loss of sensation surrounding the wound.
A small amount of blood on the bandages during changing may occur.