Mohs surgery, developed in by a general surgeon, Frederic E. Mohs, is microscopically controlled surgery used to treat common types of skin cancer. If you've been diagnosed with skin cancer, your doctor might recommend a type of procedure called Mohs surgery. Learn what to expect before. Mohs micrographic surgery is considered the most effective technique for treating many basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs), the two most common types of skin cancer. In the mid s, Perry Robins, MD, became the first dermatologist to study the.
After your wound has healed, please return to your referring doctor for regular skin exams. We recommend six-month follow-up visits for two years and yearly thereafter if no additional cancers are detected.
If any areas of your skin change in any way, fail to heal or cause concern, please let your doctor know immediately. The surgery is generally well tolerated with few side effects but you may experience the following:. You will experience little discomfort after your surgery.
Patients who do experience pain take Tylenol. Due to its potential to cause bleeding, please don't take aspirin or ibuprofen for pain control. In some cases, you may be prescribed a stronger pain medication.
A few patients experience some bleeding, which usually is controlled by the use of pressure. Take a gauze pad and apply constant pressure over the bleeding area for 15 minutes. Do not lift up or relieve the pressure during this period of time. If bleeding persists after continued pressure for 15 minutes, repeat the pressure for another 15 minutes. If this fails, call your doctor. A doctor can be reached 24 hours a day by calling the answering service. This phone number will be given to you when you leave.
Please don't drink alcohol the first night after surgery as this may stimulate bleeding. Please notify us if you have an increase in your temperature, chills, increasing redness, swelling, drainage or escalating pain.
Scarring can be minimized by the proper care of your wound. We will discuss wound care in detail with you. After having skin cancer, you are at a higher risk of developing it in the future. Skin damage from the sun cannot be reversed. This saves as much normal, healthy skin as possible. Once the cancer has been removed, the Mohs surgeon will explain options for repair of the wound, including natural healing granulation , suturing the wound together by a side to side closure, or using a skin flap or graft.
Mohs surgeons who are members of the American College of Mohs Surgery have undergone at least one year of fellowship training beyond dermatology residency, which allows for additional experience in all these specialized processes and techniques. The Mohs micrographic procedure was named after Dr. Frederic Mohs who discovered and developed it at the University of Wisconsin Medical Center in the s. It has since been refined to the state-of-the-art treatment that it is today.
When advising a patient about their surgery, a Mohs surgeon will tell the patient to anticipate that the procedure will take at least half a day, if not the better part of a day.
Because the Mohs procedure involves removing the entire cancer in one visit, and saving as much of the healthy surrounding tissue as possible, the surgeon will remove a small piece of tissue, then immediately analyze the tissue. The surgeon will repeat this process several times, if necessary, until all the cancer has been removed. While the process is time consuming, it ensures that the entire tumor is removed.
The largest portion of your day having Mohs surgery will be spent waiting as the surgeon processes and examines the tissue they have removed. Another time consuming period is the meticulous reconstructive surgery following the complete removal of the cancer, to ensure the best cosmetic result.
The cure rate for Mohs surgery is as high as 99 percent for the removal of a basal cell skin cancer, and 95 percent for squamous cell skin cancer and recurrent cancers. Any treatment for skin cancer will leave a scar. Mohs surgery preserves as much normal skin as possible and maximizes options for repairing the area where the skin cancer had been.
Once the Mohs College surgeon has completely removed your skin cancer, optimizing the final cosmetic result of your surgery becomes our highest priority. Generally, a post-surgical scar improves with time and can take up to one year or more to fully mature. It is different from the standard bread loafing technique of sectioning, where random samples of the surgical margin are examined.
The procedure is usually performed in a physician's office under local anesthetic. A small scalpel is utilized to cut around the visible tumor. A very small surgical margin is utilized, usually with 1 to 1.
If cancer is found, its location is marked on the map drawing of the tissue and the surgeon removes the indicated cancerous tissue from the patient. This procedure is repeated until no further cancer is found. The vast majority of cases are then reconstructed by the Mohs surgeon. Some surgeons utilize micrometres between each section, and some utilize micrometres between the first two sections, and micrometres between subsequent sections 10 crank of tissue set at 6 to 10 micrometre is roughly equal to micrometres if one allows for physical compression due to the blade.
The trend in skin surgery over the last 10 years has been to continue anticoagulants while performing skin surgery. Most cutaneous bleeding can be controlled with electrocautery, especially bipolar forceps. The benefit gained by ease of hemostasis is weighed against the risk of stopping anticoagulants; and it is generally preferred to continue anticoagulants. Few specialists dispute the cure rate for Mohs, especially pathologists familiar with the procedure. These are only a small number of cases reported by Mohs, and numerous other articles by other authors have shown tremendous cure rates for primary basal-cell carcinoma.
Studies by Smeet, et al. Mohs surgery is not the answer for all skin cancers. In reality, Mohs micrographic surgery is nothing more than frozen section histology using a unique peripheral margin control tissue processing technique. There is nothing magical about its cure rate or why years of training is required.
The method is unique only in that it is a simple way to handle soft, hard-to-cut tissue. Once learned, any pathologist currently performing frozen section histology would realize how simple the technique is.
It is better than performing serial bread loafing at a 0. Once mounted as tangential or horizontal sections , the pathologist simply has to relearn how to visualize skin structure on a tangential to horizontal view.
Mohs Micrographic Skin Cancer Surgery is a specialized technique, designed to remove skin cancers, most commonly basal cell carcinomas. Also called Mohs micrographic surgery. Used to treat skin cancer, this surgery has a unique benefit. During surgery, the surgeon can see where the cancer stops. Overview. Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin.