What is Mohs surgery?
Mohs surgery is a special method for removing skin cancer. Mohs surgery is the safest method to remove skin cancer. The operation is always done with local anesthesia. The visible skin cancer and a smaller fringe of about 1 – 2 mm of the surrounding healthy tissue is removed. The sample is examined in a microscope immediately. In this way, the presence of skin cancer is visualized, both on the edges and in depth. Under the microscope you can find remaining tumors, and repeat the procedure until all cancer is removed. Then the wound can be closed using plastic surgery techniques. The patient is seen after 5 – 7 days for a check and removal of sutures (thread).
Why Mohs surgery?
Skin cancer often spreads (up to 1-2 cm) outside of the visible area, and therefore, you cannot know in advance how far it has spread. In contrast to other methods, through Mohs surgery you can continually investigate the tissue you remove under the operation. This is a big advantage, since the surgeon can be sure that the surgery is removed completely with only one operation. In addition, up to 40 % less tissue is removed with Mohs surgery compared with a conventional excision. Therefore, Mohs surgery is the most effective method for treatment of skin cancer, and the result is the safest both regarding the removal of skin cancer and the least possible scar formation.
What is the success rate?
The recurrence after Mohs surgery is between 1% (cases where there was no prior treatment) and 5% (cases where there was prior treatment).
Will I be admitted to a hospital?
Mohs surgery is performed with local anesthesia and does not require an admission. Therefore you can go home the same day that you had the operation.
How long does the operation take?
The first part of the operation most often takes 20 minutes, while it take 1-2 hours to investigate the removed tissue microscopically. Typically, tissue is removed and examined in 1 -3 rounds, but it varies from patient to patient. The time for one operation and the waiting room will normally be about 3 – 4 hours in a single day.
Will the operation leave a scar?
Unfortunately, ll operations cause scars, but with Mohs surgery you are assured an optimal cosmetic result.
What should I take note of with respect to the operation?
You should inform your doctor in advance, if you take the following medications:
- Acetyl salicylic acid
- Other blood thinning medicine
Alcohol can increase the tendency for bleeding, therefore you should avoid alcohol the days before the operation.
Smoking delays wound healing. We therefore recommend stopping smoking at least 1 day before the operation and for at least 14 days afterwards.
Before the operation
- To prevent infections, you should take a bath the day of the operation. It is important that your hear is newly washed.
- It is important that you have eaten and drunk, as you would usually to to avoid feeling unwell on the day of the operation.
- Bring along something to read/entertainment and something to eat, to make the waiting time pleasant. We will provide juice and water.
- It is a good idea to clear the calendar on the operation day, since we do not know in advance how long the operation will take.
- Remember to bring the results of any biopsy from your doctor/skin doctor/hospital both to the first consultation and on the operation day.
The operation day
After the operation
- Movement after the operation can provoke bleeding from the wound. Therefore, it is important that you keep yourself well rested in the first days after the operation.
- In the same way, exercise and hard physical work should be avoid until the sutures are removed (7-10 days after the operation).
- It is a good idea to have a family member or a friend with you for the night after the operation, since there is always a slight risk for bleeding because of the operation.
- The first day the wound can cause mild pain. For pain, we recommend 1 gram of Paracetamol (for example Panodil, Pinex or Pamol), though at most four times a day.
- The sutures are removed 5-7 days after the operation.
- You will come for a check up 3 months and 1 year after the operation.
- The first day the wound can be tender and there can be slight bleeding. The wound edge will be dark red the first days or weeks and be slightly numb in the weeks to months after the operation.
- Do not expose the skin to sunlight after the operation. This will worsen the result of the treatment. Protect yourself against sunlight for at least a year after treatment is finished. It is advantageous to protect your skin every day from April to October with sun factor 50, a sun hat or other clothing (except for rainy days).
Should you expose the wound to sun after the operation?
No. Do not expose the skin to sunlight after the operation. This will worsen the treatment results. Protect yourself from sunlight for at least a year after the treatment is finished. It is advantageous to protect your skin every day from April to October with sun factor 50, a sun hat or other clothing (except for rainy days).
What are the normal symptoms when a wound heals?
The first days, the wound can be tender and it can bleed slightly. The edges of the wound will be dark red for the first days or weeks and it can be a little numb from weeks to months after the operation.
What kinds of complications can occur?
With an operation, there is a risk for complications such as:
- Bleeding from the wound
- Sensitivity in the area of the operation
- Unsightly scar formation
In rare cases the skin that has been used to cover the wound can die. In that case it will be removed.
Symptoms of infection, that you should watch for:
- Redness outside of the treated area
- Yellow or unclear fluid from the wound
- Skin feeling hot
- Any fever
Normal and abnormal bleeding
The day after the operation there can be slight bleeding, which is normal. If bleeding increases and the dressing becomes saturated, press hard on the dressing for 15 minutes (e.g. with a piece of paper towel or a clean cloth). If the bleeding does not stop, you can try to press a bag of ice on the wound for 15 minutes. Contact us if the bleeding doesn’t stop.