HOW DO I PREPARE FOR THE DAY OF SURGERY?
Since you can expect to be with us for several hours, we recommend bringing a book or magazine. Also, because the day may prove to be tiring, it is wise to have someone accompany you on the day of the surgery to provide companionship and a ride home.
The best preparation for Mohs surgery is a good night's rest followed by a normal breakfast. Please do not consume any aspirin or aspirin-containing products, ibuprofen, onions, garlic, vitamin E or liquor (including beer or wine) two weeks prior to your appointment. All of the above cause thinning of the blood. If you are taking aspirin per your doctor's orders, please check with him or her before discontinuing any of your medications. If you are taking any over-the-counter medications, please check with your pharmacist to see if they contain aspirin or aspirin derivatives.
Take your daily medications as usual on the morning of your surgery, and please bring a list of all the medications you are taking.
WHAT HAPPENS ON THE DAY OF SURGERY?
Appointments for surgery usually are scheduled early in the day to allow us to finish the same day.
You will be placed on the surgical table, and the area around your skin cancer will be anesthetized (numbed) with a local anesthetic. This step may be slightly uncomfortable for a few seconds, but usually this is the only discomfort felt during the procedure. Once the area is numbed, a thin layer of tissue is removed and the bleeding controlled. The tissue is mapped, color-coded, and sent to the on-site Mohs laboratory to be processed into microscope slides.
A pressure dressing will be placed over the area, and you will be free to leave the surgical suite. On the average, it takes an hour for the slides to be prepared and studied. The nursing personnel will tell you when you leave the surgery room how long before you need to return. During this time you may wait in the waiting room and read your book or magazine. Please plan to be available in the waiting area at the time the nursing personnel tell you so we can serve you as efficiently as possible. For snacks and/or lunch, there are restaurants on the opposite side of Meridian Street across from St. Vincent Carmel Hospital. Please remember that the time the nurse will tell you is only an estimate. Occasionally, tissue requires special attention and will take longer for the technician to process.
Most Mohs surgery cases are completed in two or three stages. Each stage involves the removal and microscopic examination of your skin for cancer. Therefore, the majority of cases are finished before noon. Once Dr. Hanke is confident the skin cancer has been completely removed, he will discuss with you his recommendations for dealing with the surgical site.
WHAT CAN I EXPECT AFTER THE SURGERY?
Pain:
You will experience very little, if any, discomfort after surgery. Again, we request that you do not take aspirin or ibuprofen, but use Tylenol or a Tylenol-like painkiller (Datril). Rarely will it be necessary for the physician to prescribe a stronger pain medicine.
Bleeding:
Rarely does bleeding occur following surgery. If this should happen, the bleeding can usually be controlled through pressure. You should lie down, and apply constant pressure on a gauze pad placed over the bleeding point for 20 minutes; do not lift up or release the pressure at all during that period of time. If bleeding persists after continued pressure for 20 minutes (timed), repeat the pressure for another 20 minutes. If this fails, call Dr. Hanke or proceed to the nearest hospital emergency room.
Complications:
There are some minor complications which may occur after Mohs surgery. Infection is rare. A small, red area may develop surrounding your wound. This is normal, and does not usually indicate infection. However, if the redness does not subside in two days or if the wound begins to drain pus, you should notify our office immediately. Itching and redness around the wound, especially in an area where adhesive tape has been applied, are common. When this occurs, ask your druggist for a non-allergenic tape, and inform us on your return visit.
Swelling and slight bruising are common following Mohs surgery, especially when it is performed around the eyes. These conditions usually subside within four to five days after surgery, and may be reduced by sleeping with your head slightly elevated and by using an ice pack for short periods of time during the first 24 hours.
At times, the area surrounding the operative site will be numb to touch. This area of anesthesia (numbness) may persist for several months or longer. In rare instances, it may be permanent. If this occurs, please discuss it with your physician at the follow-up visit.
Restrictions:
Depending on the size and location of the wound, Dr. Hanke may recommend restricted physical activity for a day or more. Details will be discussed with you.æ
