Mohs micrographic surgery, a surgical treatment for skin cancer that offers a very high rate of cure, was developed by Frederick E. Mohs, MD, at the University of Wisconsin.
The technique of Mohs surgery is time-consuming and requires highly specialized training and personnel. You were referred to Skin Care Physicians of Georgia because we have the specialized training needed to perform Mohs micrographic surgery, and it has been proven to be a highly successful form of treatment for your type of skin cancer.
There are three primary forms of skin cancer: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Most cases of skin cancer are either basal cell carcinoma or squamous cell carcinoma. Of the two, basal cell carcinoma occurs more frequently and grows more slowly. It rarely spreads through the blood or lymphatic systems to distant parts of the body.
Squamous cell carcinoma is the second most common skin cancer. It is more serious, since it has a greater ability to spread internally to nearby lymph nodes and to other parts of the body.
Malignant melanoma may be life threatening ifnot treated early. It usually appears as a brownish-black spot or bump in the skin that enlarges and sometimes bleeds. Sometimes melanomas arise in moles that have been present for many years.
Mohs micrographic surgery is a specialized technique for the total removal of skin cancers. The procedure is done in several steps:
In most cases, the surgery is done on an outpatient basis; however, in some cases, the doctor may recommend hospital admission. This is especially true for patients with large tumors, but admission is the exception rather than the rule.
Shortly after your arrival, you will be taken to one of the treatment rooms, where the tumor area will be numbed with a needle. The doctor will remove a thin layer of skin surrounding the cancer. After this has been done, any bleeding will be stopped with an electric cautery machine. You will then be bandaged and be able to return to the waiting room or you may stay in the treatment room. By this time, the removed tissue will be in our laboratory. There, it is cut, dyed and made into microscopic slides. It usually takes 20-30 minutes for the layer of tissue to be removed and the bleeding to stop. However, it takes about 1 hour for the tissue to be prepared into microscopic slides for examination. During this time you may chat with the person accompanying you, read a book or step out for fresh air. If examination of the microscopic slides reveals that your tissue still contains tumor cells, the procedure will be repeated. Further tissue is removed only from the areas where tumor cells were found.
The goal is to remove all of the skin cancer while preserving the greatest amount of healthy tissue. However, skin cancers can grow deeply and develop roots extending beyond the area that you actually see. As a result, the final size of the surgical incision will be determined by the extent of the tumor. The average number of surgical sessions required is one to three. However, you may require more before your skin cancer is completely removed. Fortunately, this can usually be done in the course of a single day. When surgery is completed, a decision will be made as to the way to manage your wound.
Pain. Most patients do not have severe pain, but may experience slight discomfort. If this occurs, we suggest you take two tablets of Tylenol every four hours.
Bleeding. Occasionally, bleeding follows surgery. If this happens, do not become alarmed. Lie down and place steady, firm pressure over the wound as close as possible to the bleeding area. Apply the pressure continuously for 20 minutes (timed). Do not lift the bandage to check on the bleeding. If bleeding persists after 20 minutes of steady pressure, apply pressure for an additional 20 minutes. If bleeding still continues, call our office at (478) 742-2180, or go to the nearest hospital emergency room.
Swelling. Swelling is very common following surgery, particularly when it is performed near the eye. All wounds swell a little. Usually this is not a problem, and the swelling diminishes as the wound heals. Ice packs may help to reduce the swelling.
Drainage. All wounds will drain to some extent during the first week or two. This is why frequent dressing changes are necessary.
Infection. Infection of the wound is unusual. However, if you see thick, foul-smelling fluid coming from the wound, call our office immediately. An antibiotic may be necessary.
Redness. All wounds will develop a halo of redness, which disappears gradually. If the area becomes extremely red and itchy you may be allergic to either the ointment or tape. Call our office if this condition develops.
Scarring. All surgeries leave a scar. However, your scar will improve and become less noticeable as time passes.
Stitches and skin grafts. If we close the wound with sutures (stitches) or place a skin graft, you should keep the area clean and dry until the next visit.
Once your surgery is over, periodic follow-up exams by your referring physician are important for at least five years. These visits can help with early detection and treatment of new skin cancers that may develop as well as the rare recurrence of the skin cancer that was treated. If you notice any suspicious areas on your skin between visits, it is best to check with your doctor to see if a biopsy is needed.
Our mission at Skin Care Physicians of Georgia is to provide expert individualized service to each and every patient with skill and compassion. Our board certified physicians and professional staff are highly trained and strive to deliver ethical comprehensive care to all patients and to care for them "just as they would want their family treated."
From treatment of skin conditions such as eczema, psoriasis and rosacea to removal of warts, moles and other lesions, our office provides a full range of medical dermatological services so you can enjoy the healthy skin you deserve.