In 1938 Dr. Frederic Mohs developed a technique to remove skin cancers, which provided patients with an excellent chance for cure. The term MOHS Surgery refers to a highly specialized procedure for the total removal of skin cancers. MOHS, as an acronym, stands for Microscopically Oriented Histographic Surgery.
Mohs micrographic surgery is the most effective and advanced treatment for skin cancer. It is performed on an outpatient basis using a highly specialized and precise technique that removes the cancer in stages, one tissue layer at a time. This technique allows physicians to precisely identify and remove a tumor while leaving the surrounding healthy tissue intact and unharmed. Mohs surgery offers the highest potential for cure, even if the skin cancer has been previously treated by another method.
Dr. David Byrd is an American College of Mohs Surgery (ACMS) fellowship-trained Mohs surgeon to ensure that your skin cancer treatment is performed to the highest standards of quality and competency.
We answer some of the questions you may have as a patient. If you have any more questions, please do not hesitate to ask us.
Appointments for surgery are scheduled early in the day. This allows us to continue the surgical steps throughout the entire day if necessary.
The nurse will escort you to an operating room where a local anesthetic will be used to numb the skin so that you will feel little discomfort.
The next step is for the surgeon to remove a layer of skin involved by the cancer. After this tissue has been carefully removed, bleeding is stopped with a machine called cautery, which generates heat. You may feel this slightly. Before you leave the treatment room the nurse will dress your wound, and by the time you get to the waiting room the removed tissue will be in the laboratory where it is being prepared for microscopic examination.
If examination of the slide reveals that your tissue still contains cells of skin cancer, the procedure will be repeated as soon as possible. Several surgical excisions and microscopic examinations may have to be done in one day. Seldom is it necessary to have a patient return the following day for additional surgery.
When we have determined that the skin cancer has been completely removed, a decision is made about how to repair the wound created by the surgery:
• The wound may be allowed to heal by itself.
• For small post-surgical sites, direct closure by suturing the sides of the wound together may be possible.
• In certain areas of the body, there is very little tissue that can be stretched for coverage of a wound. In this case either a skin graft or a skin flap must be used.
Dr. Byrd will recommend which of these options will be best for your individual case. You will be given written care instructions upon discharge. Avoid making travel plans for 2 weeks following surgery.
Each step (or stage) of the surgical procedure takes an average of 2 to 3 hours. The initial surgical procedure is approximately 30 minutes; the time may be longer in extensive cases. However, after the tissue removal it takes approximately 2 hours for the slides to be prepared for the physician to complete microscopic examination. If several surgical excisions are required, the time involved will be more extensive. The average number of surgical sessions is two or three per skin cancer. Once the skin cancer is removed, if repair of the wound is required this will add time to your day. Reserve the ENTIRE DAY for this surgical procedure, we cannot predict how long you will be in the office for.
Yes. It is recommended that you have someone that can at least drive you home, and it may be pleasant to have company!
A local anesthetic is injected around the skin cancer to numb the area. A burning sensation is felt during the injection of the anesthetic. The surgery may cause slight discomfort. There may be moderate discomfort later in the day or during the first night following surgery. If you’re uncomfortable we recommend taking Extra Strength Tylenol. Avoid aspirin-containing compounds (such as Excedrin or Ibuprofen) as these may produce bleeding. We also recommend stopping Vitamin E and garlic supplements.
Try to get a good night rest and eat a light breakfast. If you’re taking any medications, take them as usual unless we direct you otherwise. Wear casual clothes that are comfortable. Dress in layers so you can easily adapt if the room is warm or cold. You may wish to bring a book or tablet with you on the day of surgery, we have Wi-Fi. Most of your day will be spent in the waiting room. You should bring a lunch or snack with you.
