About Mohs Surgery - What To Expect

As noted before, Mohs surgery does require some time. The main reason for this is that the tissue is processed in our onsite lab while the patient waits. Most Mohs surgeries take 2-4 hours to complete, but more complicated cases can take a good portion of the day, multiple Mohs stages take time to complete. That is why Mohs surgery is often referred to as an "all-day" technique, though this is rarely the case. As a result, the procedure is scheduled in the morning or early afternoon.

Once the patient arrives, he or she is prepared for surgery. The site is identified, local anesthetic is administered and the tissues are removed. Before the patient leaves the room, the area is bandaged. The tissue is then taken to our laboratory while the patient waits in the appropriate area. The laboratory portion of the process can range from 30 minutes to an hour or more. This depends on the size and complexity of your tumor. If the removed tissue is found to still contain skin cancer, at the examined margins, the procedure will be repeated as soon as possible. In fact, several excisions and microscopic examinations may be done in one day. Rarely, it is necessary for the patient to return the next day for further surgery.

It is important to be prepared for the aforementioned waiting that is involved with the procedure. Our facility has two waiting areas to help make this period more comfortable. One room has a television and the other room is a quiet room with recliners where patients can read or just relax.

After the skin cancer has been completely removed by the Mohs technique, a decision is made to determine the best method for treating the wound created by the surgery. These methods include letting the wound heal on its own, or closing the wound through a variety of suturing techniques. The repair is usually performed on the same day as the removal. In some instances, you may need to return to have the wound repaired on a different day, if it is advantageous to do so. The Mohs technique is strictly outpatient. However, on rare occasions, patients may require hospitalization. This possibility will be considered during your consultation.

You may also elect to have the wound repaired by your referring physician or another physician. There are certain instances where this may be preferable. This will also be discussed during your consultation.

After surgery, you will need to care for your surgical site. Printed instructions will be available in the office after your surgery is complete. You should plan on wearing a bandage for at least 7 days after your surgery. Also, you should plan to avoid strenuous physical activity for at least 48 hours after surgery. You should not plan athletic or exercise activities for 2-3 weeks after surgery. Refraining from these activities will facilitate proper healing, which will improve your outcome.

The following are a few things to consider when preparing for your Mohs surgery:
1. Bring something to do. You will have a lot of free time while you are waiting for your Mohs stages to be prepared. Bring books, puzzles, paperwork or anything that you like to do to pass the time.

2. Eat a full breakfast or lunch (depending on when your Mohs surgery is scheduled). Also, bring a lunch or a snack, as you may get hungry while you are waiting.

3. Dress comfortably and bring something warm to wear. The building is kept on the cooler side while we are doing Mohs to facilitiate the frozen tissue processing. It is a good idea to bring a light jacket or a light blanket if you are cold natured. Also, wear casual clothing as your clothing may be stained by blood or surgical preps.

4. Take all of your prescribed medications. Bring your medications with you as you may need to take them during the course of the day. If you are diabetic, bring your testing items with you. If you are taking blood thinners, we will discuss options to help manage this during the perioperative period.


Avoid taking medications, that will promote free bleeding. If you are on these medications under the direction of a physician, you may continue to take them. This will be determined during your preoperative consultation. The following list of drugs includes many, but not all, drugs that can impair normal clotting mechanisms. For example Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as aspirin and ibuprofen, bind to blood platelets and impair platelet during blood coagulation. Alcohol and vitamin E also impair clotting. Coumadin (warfarin), which impairs clotting by competing with vitamin K, is given to patients who have a illness that causes excessive clotting.

Advil
Aleve
Alcohol
Alka Seltzer
Amigesic
Anacin
Anaprox
Anaproxin
Ansaid
APC
Apixaban (Eliquis®)
Argesic
Arthra G
Arthropan
A.S.A.
Ascodeen
Ascriptin
Aspergum
Aspirin
BC Powder
Baby Aspirin
Bayer
Brufen
Bufferin
Butazolidin
Cephalgesic
Cheracol Caps
Children's Aspirin
choline salicylate
Cilostazol (Pletal®)
Clinoril
Congesprin
Cope
Coricidin
corticosteroids
Coumadin
Dalteparin (Fragmin®)
Dabigatran (Pradaxa®)
Darvon ASA
Darvon Compound

Daypro
Depakote
dexamethasone
diclofenac
dipyridamole
Disalcid
divalproex
Doan's Pills
Dolobid
Dristan
Easprin
Ecotrin
Empirin
Emprazil
Endodan
Enoxaparin (Lovenox®)
Excedrin
Feldene
fenoprofen
feverfew
Fiorinal
flurbiprofen
Froben
4-Way Cold Tabs
Garlic Capsules
Gelpirin
Genpril
Genprin
Ginko Biloba
Goody's Body
Pain
Haltran
Halfprin
Ibuprin
ibuprofen
Ibuprohm
Indameth
Indocin
indomethacin
ketoprofen
ketorolac
Lortab ASA
Magan
Mg sallicylate
meclofenamate
Meclofen
Medipren
mefenamic
Menadob
Midol
Mobidin
Monogesic
Motrin
nabumetone
Nalfon
Naprosyn
naproxen
Norgesic
Norwich Ex.Str.
Nuprin
Ocufen
Orudis
Oruvail
oxyphenbutazone
Oxybutazone
oxyprozin
Pamprin
Pepto-bismal
Percodan
Persantine
Phenaphen
Phenylbutazone
piroxicam
Ponstel
Prasugrel (Effient®)
Prednisone
Quagesic
Red Wine
Relafen
Rexolate
Robasissal
Roxiprin
Rivaroxaban (Xarelto®)
Rufin
Saleto
Salflex
salsalate
Salsitab
Sine Off
Sine Aid
Na thiosalicylate
Soma Compound
sulindac
Synalgos DC
Tanacetum
parthenium=
(feverfew)
Ticagrelor (Brillinta®)
Tolectin
tolmetin
Toradol
Trandate
Trendan
Trental
Trigesic
Trilisate
Tusal
Vanquish
Vitamin E
Voltaren
Warfarin
willow bark
Zactrin
Zorprin

To get more information on what to expect preoperatively,
be sure to check out the preoperative checklist in the “For Patients” section of the website.



 
 
 

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