Mohs Skin Cancer Surgery

Pre-Operative Instructions

We will call you to schedule your surgery. For some patients, we ask that you come in for a surgical evaluation before the day of your Mohs surgery. Also, if you feel more comfortable with meeting Dr. Reichel prior to the day of your surgery, we welcome the opportunity for a preoperative consultation. Otherwise, one of our Registered Nurses will call you prior to your surgery to provide you with additional information and to answer any questions you may have.

The preoperative consultation with Dr. Reichel is important. This may be done before your surgery, or on the same day as your surgery. A consultation will allow evaluation of the cancer and an assessment of your general health. Any medical conditions should be disclosed and discussed with Dr. Reichel and her nursing staff. Any questions you have will be answered and discussed in detail.

Avoid non-prescribed anti-inflammatory containing products for two weeks prior to surgery. This includes Aspirin, Ibuprofen, and Aleve. Also stop taking Vitamin E and Ginkgo Biloba.

If you take Coumadin, Plavix, aspirin or another blood thinner, we might contact your primary care physician to determine whether you may stop the medicine before surgery. We will contact you with further directions, so please do not stop these medications on your own.

The Day of Mohs Surgery

The length of the procedure varies depending on the size and location of the skin cancer and the type of reconstruction to be done. Although the average time is 5-7 hours, you should plan on spending much of the day in our office.

Eat a light breakfast. Bring snacks or lunch, as, on occasion, Mohs surgery can take several hours.
Take your daily medications (unless otherwise directed by us).
Wear comfortable, loose-fitting clothing that can be removed by unbuttoning rather than having to be pulled over the head. This will reduce irritation to the dressing site.
If surgery involves your face, do not wear any cosmetics/makeup.
Shower and shampoo before surgery, as your wound and dressing site need to remain dry for 24-48 hours after surgery.

Please arrive 15 minutes prior to your scheduled surgery time.

Dr. Reichel and her staff look forward to taking great care of you. Call with any questions (206) 859-5777.

The Surgery:

After the intake, the skin cancer will be marked with a surgical pen, and the area surrounding the skin cancer will be cleaned with an anti-bacterial soap. Local anesthesia will then be injected into the area of skin containing the cancer. This injection will probably be similar to the one you received for your biopsy. The cancer will then be removed with the special Mohs technique. This is further described above.

Post-Operative Instructions After Mohs Surgery

Care: Your surgical wound will require care during the weeks following surgery. Detailed written instructions will be provided. You should plan on wearing a bandage and avoiding strenuous physical activity for at least one week.

Pain: Most of our patients report minimal post-operative pain. We will give you a prescription for pain medicine. If your pain is not controlled with this medicine, please call the office.

Work: Some patients may not feel comfortable returning to work for up to one week after surgery. Others may return sooner. We usually recommend that patients make arrangements to be away from work for one to two days.

Healing: Bruising and crusting of the wound usually subsides in the first 2-3 weeks. You may have itching as the wound heals. Extreme itching is rare. If this happens, please call us. You may have numbness around the surgical site. In rare instances, the numbness may be permanent. It is important to know that complete healing of the surgical scar takes place over 12-18 months. Especially during the first few months, the site may feel thick, swollen, or lumpy, and there may be some redness. Gentle massage of the area (starting about 1 month after the surgery) will speed the healing process.

Future appointments: For most patients, Dr. Reichel would like to see you back 6-8 weeks after your surgery to evaluate the scar and answer any questions. We will recommend that you continue to have close follow-up with your dermatologist.

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