How is Mohs surgery performed?
There are 3 distinct steps:
- Curettage of the visible part of the tumor
- Excision to a certain depth
- Microscopic study of the excised piece during the operation.
All the excised pieces are marked with dyes to know the exact location of the tumor, in case it is not completely excised. If cancerous cells remain, the procedure is repeated but only in the affected area, called stages.
How many stages will I need?
It depends on the location, depth and extent of the tumor. Unfortunately it is impossible to know before the procedure.
How long does it last?
It usually takes half a day, depending on the stages needed to eliminate all the cancerous cells. Each stage usually lasts between 15-20 minutes.
It is a good idea to bring a book or magazine since you will have to wait one hour between stages in the waiting room during the microscopic study in the laboratory. You do not need to be hospitalized afterwards.
What are the advantages of Mohs surgery?
It is the most effective technique to completely remove skin cancer, with a lower rate of recurrence. In addition, by means of microscopic control during the intervention, we eliminate the minimum amount of tissue not affected by the tumor.
Does it hurt?
It only hurts when the local anesthesia (mepivacaine) is applied. If you have pain after surgery is recommended to use paracetamol one gram every 8 hours. It is important to avoid acetylsalicylic acid (aspirin).
What is the next step after completing Mohs surgery?
After completely removing the skin cancer, we have 3 options to repair the defect created in the skin:
- Simple stitch closure
- Covering the wound with a skin graft or flap
- Let the wound heal on its own (closure by secondary intention).
Will I have a scar?
Yes, any therapeutic technique will leave a scar. However, with Mohs surgery only the strictly necessary tissue is removed, minimizing the scar.
What follow-up care will I need?
In one or two weeks you will have to come back to check the scar and remove the stitches. During the first months the scar should be protected from sun exposure to avoid poor healing and residual pigmentation.
After the healing period, dermatological controls should be performed every 6 to 12 months for 5 years to control possible recurrences or appearance of new skin cancers.