Pre-Operative Instructions | Post-Operative Instructions
- What is skin cancer?
- What is Mohs surgery?
- What happens the day of surgery?
- What can I expect after the surgery is complete?
What is skin cancer?
Cancer is characterized by the uncontrollable growth of cells, often at a pace that is not easily regulated. Specifically within the skin, basal cell carcinoma and squamous cell carcinoma are the most prevalent forms of cancer, originating from specific cells within the skin. At the Mohs Surgery Princeton, NJ Unit, we specialize in treating basal cell carcinomas, squamous cell carcinomas, as well as rarer skin tumors, such as early melanomas. Among these, malignant melanoma, also known as a “cancerous mole,” presents as a dark spot or bump on the skin, gradually increasing in size. Skin cancer can be effectively treated through procedures like Mohs surgery, which ensures the precise removal of cancerous tissue while preserving healthy skin. This meticulous approach is crucial for successful skin cancer treatment.
What is Mohs surgery?
In the 1940s, Dr. Frederick Mohs, a surgery professor at the University of Wisconsin, pioneered a skin cancer treatment method known as chemosurgery. This technique, now referred to as Mohs micrographic surgery or Mohs surgery, involves the precise removal of skin cancers with a team of specialized medical professionals, including physicians, nurses, and technicians. Mohs surgery is a highly specialized procedure aimed at removing cancerous tissue layer by layer until all cancer cells are eradicated, minimizing damage to healthy tissue and optimizing cosmetic outcomes. Patients undergoing Mohs surgery benefit from the expertise of trained professionals who ensure thorough treatment and follow-up care to promote healing and recovery.
The lead Mohs surgeon overseeing the team is extensively trained in this technique and accredited by the American College of Mohs Micrographic Surgery and Cutaneous Oncology. Other team members may include fellows and residents who assist in the procedure. The nurse plays a crucial role in addressing patient concerns, aiding during surgery, and providing post-operative care instructions. Additionally, a technician prepares tissue samples for microscopic examination, a pivotal step in the surgery process. Collaboration among the medical team ensures a comprehensive and effective approach to skin cancer treatment through Mohs surgery.
Initially utilizing a chemical paste to fix tissues before removal, modern Mohs surgery has evolved since 1974 to primarily use fresh tissue samples, omitting the chemical application. This evolution reflects advancements in dermatologic surgery techniques, enhancing the precision and efficacy of Mohs surgery. By leveraging cutting-edge technology and best practices, Mohs surgeons can deliver optimal results for patients undergoing skin cancer treatment. The continuous refinement of Mohs surgery protocols underscores the commitment to innovation and excellence in dermatologic care.
Each tissue layer removal and evaluation cycle typically takes about an hour, with the surgical procedure itself lasting around 20 to 30 minutes per stage. Mohs surgery’s meticulous approach involves a thorough examination of tissue samples under a microscope, ensuring the complete removal of cancerous cells. The use of local anesthesia enhances patient comfort during the procedure, allowing for a focused and efficient treatment process. Patients can expect personalized care and attention at every stage of Mohs surgery, from initial consultation to post-operative care, ensuring a smooth and successful treatment journey.
Following the Mohs surgery, the patient is left with a surgical wound that can be treated in various ways to optimize cosmetic outcomes. Options may include natural healing, wound closure with stitches, skin grafts from other body areas, or skin flaps to cover the surgical site, depending on individual circumstances. Mohs reconstruction techniques aim to restore both function and aesthetics, enabling patients to recover from skin cancer treatment with minimal scarring and optimal results. By tailoring wound closure approaches to each patient’s needs, Mohs surgeons can achieve favorable cosmetic outcomes while ensuring comprehensive cancer removal.
In complex cases, referrals to specialized consultants may be recommended. The collaborative nature of Mohs surgery allows for multidisciplinary care, involving experts from various fields to address unique patient needs. By consulting with specialized providers, Mohs surgeons can offer comprehensive treatment plans that encompass all aspects of skin cancer care. This holistic approach underscores the commitment to patient-centric care and ensures that individuals receive the highest standard of treatment for their skin cancer.
The goal of Mohs surgery is to meticulously remove cancerous tissue while preserving healthy skin, offering patients the possibility of a favorable cosmetic outcome despite the inevitable presence of some scarring. By prioritizing tissue conservation and optimal aesthetic results, Mohs surgeons strive to achieve the best possible outcome for each patient. The emphasis on precision, expertise, and individualized care sets Mohs surgery apart as a leading treatment option for skin cancer, providing patients with effective and tailored solutions for their skin cancer needs.
What happens on the day of surgery?
Your appointment has purposely been scheduled early in the day, and upon your arrival you should check in at the registration window. When the surgical suite becomes available, you will be escorted in by our surgical nurse. If you have not had a consultation visit, she will go through the procedure with you, examine the questionnaire you have answered, and answer any questions you have. The Mohs surgeon will also be available to answer questions.
After preliminary preparation of the skin, you will be placed on the surgical table and the area around your skin cancer will be anesthetized (numbed) using a local anesthetic. This may be uncomfortable, but usually this is the only pain you will feel during the procedure. Once the area is numbed, a layer of tissue will be removed and the bleeding controlled. The removed tissue will be carefully handled by the surgeon, diagrammed, and sent to the technician to be processed into microscopic slides. A pressure dressing will be over your surgical wound, and you will be free to leave the surgical suite. On the average, it takes an hour for the slides to be prepared and studied. During this time you will rest in the waiting room, read your book or magazine, and enjoy some hot tea, coffee or cookies.
Most Mohs surgery cases are completed in two or three stages. Each stage involves the removal and microscopic examination of your skin for cancer. Therefore, the majority of cases are finished in one day. Once we are sure that we have totally removed your skin cancer, we will discuss with you our recommendations for dealing with your surgical wound. Usually, the wound will be closed the same day.
What happens on the day of surgery?
Upon your early appointment arrival, please proceed to the registration window. A surgical nurse will guide you to the surgical suite when it’s ready. If you haven’t had a prior consultation, the nurse will brief you on the procedure, review your questionnaire, and address any queries you may have. The Mohs surgeon will also be on hand to address any concerns you might have. This personalized approach ensures that patients feel informed and supported throughout their surgical experience, promoting a sense of comfort and confidence in the care they receive.
Following the initial skin preparation, you will be positioned on the surgical table, and the area surrounding the skin cancer will be numbed with a local anesthetic. While this may cause some discomfort, it is generally the only sensation you will experience during the procedure. Once numbed, a layer of tissue will be excised, and any bleeding will be managed. The excised tissue will be meticulously handled by the surgeon, documented, and forwarded to the technician for processing into microscopic slides. A pressure dressing will be applied to the surgical wound, after which you will be able to leave the surgical suite. This step-by-step process ensures a systematic and thorough approach to skin cancer removal, with a focus on patient comfort and safety throughout the procedure.
The majority of Mohs surgery instances are conducted in two or three stages, with each stage involving the removal and microscopic inspection of your skin for cancerous cells. As a result, most cases are wrapped up within a single day. Once we are certain that all traces of the skin cancer have been eliminated, we will outline our recommendations for addressing your surgical wound. Typically, the wound will be closed on the same day for your convenience. The efficient and comprehensive nature of Mohs surgery allows for prompt treatment completion and wound closure, enabling patients to undergo skin cancer removal without prolonged hospital stays or multiple procedures.
What can I expect after the surgery is complete?
After Mohs Microplastic Surgery, here are important things to consider:
Pain Management and Recovery: Post-surgery discomfort is typically minimal and can be managed with over-the-counter pain relievers. Avoid taking Advil or Motrin due to their potential to increase bleeding. Stronger pain medication will be provided if necessary, ensuring that you remain comfortable during your recovery period.
Managing Bleeding: In rare cases, some patients may experience post-operative bleeding. Applying pressure with a gauze pad on the bleeding area for 15 minutes without interruption usually controls it. If bleeding persists, repeat the pressure or contact your healthcare provider promptly for further guidance. Immediate attention to post-operative bleeding can help prevent complications and promote healing.
Potential Complications: Minor issues such as redness and swelling around the wound may occur post-surgery, which are generally normal and expected. However, if these symptoms persist or if the wound shows signs of infection, inform your physician promptly. Timely communication with your healthcare provider can address any concerns and ensure proper management of post-operative complications.
Addressing Itching and Redness: Itching and redness, especially where adhesive tape was used, are common side effects of surgery. If you experience discomfort, consult your pharmacist for non-allergenic tape and inform your healthcare provider during your follow-up appointment. Managing itching and redness effectively can enhance your comfort and promote optimal wound healing.
Dealing with Swelling and Bruising: Swelling and bruising, particularly around the surgical site, are common after Mohs surgery. In most cases, these symptoms subside within a few days, especially with the use of ice packs during the initial recovery period. Understanding how to manage swelling and bruising can help expedite your recovery and minimize discomfort post-surgery.
Numbness Sensation: Temporary or long-lasting numbness around the surgical site is normal after Mohs surgery. While some patients may experience permanent numbness, it is essential to discuss any concerns with your physician during your follow-up visit. Open communication with your healthcare provider can address any lingering numbness and ensure appropriate follow-up care.
Scar Management: While scarring is inevitable after surgery, proper wound care is essential for minimizing its appearance. Detailed wound care instructions provided by your healthcare team will guide you on post-operative care, ensuring that you follow best practices for scar management. By adhering to scar management protocols, you can promote optimal healing and achieve the best possible cosmetic outcomes post-surgery.
Choose Dr. John Vine’s Dermatology & Skin Care Center of Princeton for Your Mohs Micrographic Surgery Needs
When it comes to Mohs micrographic surgery for skin cancer treatment, trust in the expertise and dedication of Dr. John Vine’s Dermatology & Skin Care Center of Princeton. Led by a team of skilled professionals accredited by the American College of Mohs Micrographic Surgery and Cutaneous Oncology, our center offers meticulous and personalized care to ensure optimal outcomes for each patient.
Contact us today to schedule your consultation and take the first step towards comprehensive and effective skin cancer treatment with Mohs surgery. Your skin deserves the best care – choose Dr. John Vine, located in Princeton, NJ, for expert Mohs micrographic surgery tailored to your unique needs.
