Mohs Surgery: Overview, Preparation, Procedure, Recovery, Risks, and Aftercare
The Mohs surgery, also known as Mohs micrographic surgery, is a type of surgery used to remove skin cancer, mainly basal cell carcinomas and squamous cell carcinomas. Some types of skin cancer benefit from its high cure rates and tissue-sparing approach, making it a preferred treatment choice.
Preparation
In preparation for Mohs surgery, patients typically complete the following steps:
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Surgery patients undergo a thorough medical evaluation to assess their overall health and suitability for surgery. Surgeons may review the patient's medical history and conduct a physical examination.
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Mapping of the skin cancer lesion and surrounding tissues: This ensures precise removal of cancerous cells while minimizing damage to healthy tissue.
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Patients and healthcare providers discuss the Mohs surgery procedure in detail, including its benefits, risks, and expected outcomes. Alternative treatment options may also be discussed.
Procedure
The following steps are involved in Mohs surgery:
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In most cases, the surgical area is numbed using local anesthesia to ensure the patient remains comfortable during the procedure. General anesthesia is not usually required.
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Surgical removal and mapping of skin cancer lesions: The surgeon removes the visible portion of the lesion, along with a thin layer of surrounding tissue. The tissue is then mapped and divided into sections for examination under a microscope.
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For the purpose of assessing whether cancer cells are present in each tissue section, the surgeon carefully examines it under a microscope. In the event that cancer cells are detected at the surgical margin, additional layers of tissue are removed from the corresponding area and examined until cancer-free margins are achieved.
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In some cases, reconstructive surgery may be required to restore the appearance and function of the treated area after cancerous tissue has been removed.
Recovery
Patients typically experience the following recovery process after Mohs surgery:
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Surgical wound care: Patients receive instructions on how to minimize infection risk and promote wound healing. To promote healing, the wound needs to be kept clean and dry, topical medications should be applied, and strenuous activities should be avoided.
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During follow-up visits, patients are monitored for healing progress and checked for complications. Additional treatments, such as scar revision or skin grafting, may be recommended if necessary.
Risks
There are potential risks and complications associated with Mohs surgery, including:
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During and after surgery, patients who take blood-thinning medications or have underlying bleeding disorders are at risk of bleeding.
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Surgical wounds are susceptible to infection, which can delay healing and cause complications. Infection can be reduced by keeping the wound clean and following wound care instructions.
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It is possible that Mohs surgery will result in scarring, particularly in areas where larger tissue excisions are required. However, the degree of scarring can vary depending on the location and size of the lesion as well as the patient's skin type and healing ability.
Aftercare
The following aftercare recommendations should be followed by patients following Mohs surgery:
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Wearing sunscreen, wearing protective clothing, and seeking shade when outdoors are the most effective ways to prevent sun damage and reduce the risk of skin cancer recurrence.
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The early detection and treatment of skin cancer recurrence are crucial for optimal outcomes. Patients should regularly self-examine their skin and schedule routine follow-up appointments with their dermatologist.
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A healthy lifestyle, including a balanced diet, regular exercise, and avoiding tobacco use, can improve skin health and reduce skin cancer risk.
