Day of Surgery

On the Day of Surgery

    • Eat a good breakfast, unless otherwise instructed.
    • Take your medications as usual, unless otherwise instructed.
    • Wear comfortable clothing, to include a top that can be fully opened from the front.
    • All patients should have an adult accompany them to the procedure and drive them home.
    • Please bring only one person with you.
    • Please do not bring young children.

When you arrive for surgery, the surgical assistant will take you to the surgery suite and prepare the involved area of skin for surgery. If you have any questions, feel free to ask them. The area of skin containing the cancer will be anesthetized. It usually takes about 30 minutes to anesthetize the involved area and to remove the tissue. After the cancerous tissue has been removed, the bleeding will be stopped. The surgical assistant will cover your wound with a bandage. The tissue will be sent to the laboratory for examination. You will then have to wait while the tissue is processed for examination, stained, and examined by the doctor. This process varies from 30 minutes to an hour or more. If examination of the tissue reveals that it still contains cancer cells, the procedure will be repeated as soon as possible, usually right away. Several excisions and microscopic exams may be done in one day. It is occasionally necessary for you to return the following day for additional surgery. The average number of surgical sessions or layers for most skin cancers is two to three, so most patients have their entire skin cancer removed on the same day.

Surgical Wound

When the skin cancer has been completely removed, a decision must be made on the best method for healing the resulting wound. These methods include closing the wound with stitches, allowing the wound to heal by itself, and closing the wound with a skin graft or flap. The doctor will want to achieve the best possible cosmetic and functional result. He will recommend which of these methods is best in your case, and you will decide which option you desire. He is highly experienced in wound repair techniques; repairs may be completed by him or by another surgical specialist. Each patient is unique, and your treatment must be individualized to achieve the best results. After completion of your procedure, you will be given detailed instructions regarding wound care, and arrangements for follow-up will be made. The entire wound healing process may take one year from start to finish. You may experience a sensation of tightness, a tingling or itching as the wound heals. This is normal. As time progresses, you will feel this less and less. Frequently, skin cancers involve nerves and it may be one or two years before your sensation returns to normal. In some cases the numbness may be permanent. Any form of therapy will leave a scar, but the micrographic control provided by the surgery procedure tends to minimize the scar size, as the Mohs surgeon removes only those tissues involved with cancer and preserves as much normal tissue as possible. While the doctor will make every effort to obtain the optimal cosmetic results for you and work in conjunction with other surgical specialists when indicated, the primary goal is complete removal of the tumor. The new skin that grows over the wound contains many more blood vessels than the skin that was removed. This results in a red scar. The area may be sensitive to temperature changes. This sensitivity improves with time and the redness gradually fades. If you are having a lot of discomfort, avoid extreme temperatures. As wounds mature, the skin “settles down” or relaxes, and its appearance tends to become better and better.