Patient Information

When you have received the results of your biopsy and it is pathologically proven to be a skin cancer, your referring doctor will forward the necessary paperwork to our office and we will call you to schedule a consultation visit within 3-5 days. Often your referring doctor will not forward the necessary documentation immediately; so when we receive the paperwork, our office will call you.

Consultation Visit:

You will require a consultation visit before surgery can be scheduled. Surgery will not be scheduled on the same day as your consultation visit.

• You will be required to have a consultation visit to:
1. Verify insurance for surgery
2. To be examined by Dr. Walsh
3. To undergo a medical history assessment
4. To ensure Mohs microscopic surgery is the appropriate treatment for your skin cancer.

• You will be required to bring a list of medications, details of your relevant medical history, your medical insurance card and your driver’s license or identification.

• You will be required to verify and sign a demographic form, insurance information and will receive a copy of HIPAA privacy policies.

• The office will verify information and coverage with your insurance carrier. Information will be documented for you to review and sign prior to your consultation with Dr. Walsh. Your insurance may require you to pay a co-pay for each office visit. Please call your insurance if you are unsure if that is a requirement.

• Pre and post operative information and an appointment for surgery will be provided to you before you leave.

PLEASE NOTE: Following Medicare guidelines of January 2008, your insurance carrier may not pay at 100% for Mohs surgery to additional sites on the same day. The office policy is to perform one Mohs surgical site per day. Additionally, your insurance carrier may not pay for reconstructive surgery at 100% on the same day so a repair may be scheduled on a day convenient for you.

This visit will take approximately 30 – 45 minutes.

Day of Surgery:

On the day of your surgery:

• Eat a full breakfast and take any medications as usual. DO NOT omit blood thinning medications unless advised otherwise by Dr. Walsh.
  
  
• Take pre-operative antibiotics if prescribed by Dr. Walsh.
  
  
• Bring a list of medication or medical history changes.
  
  
• You can expect to be in the office for at least 3-4 hours, maybe longer depending on your surgical outcomes so bring a book to read or activities to pass the time. The office provides coffee and cookies/crackers.
  
  
• Please bring a sweater or warm clothing as the office can be chilly.

After your surgery:

• When your surgical site is clear of cancer cells, Dr. Walsh will discuss options regarding your surgical wound. Options may be:
  
  
1. Secondary intention healing – allowing your wound to heal from the bottom up. This option is sometimes slower but in some cases can give a better appearance when healed. You will return in 2 weeks for dressing changes.
   
   
2. Reconstruction – performed in the office by Dr. Walsh. The procedure may be performed on another scheduled day. You will return in 7 – 10 days for suture removal and/or dressing changes.
   
   
3. Refer to a plastic surgeon – this may be a viable option if the surgical site is in a difficult area or is deemed to big or deep to perform reconstructive surgery in the office under a local anesthetic.

All options will be discussed in depth and you will be allowed to make an informed decision regarding your surgical site.

• When you leave the office, you will have a large pressure dressing over your surgical site. Full wound care instructions and dressings will be given to you. You will be required to leave this dressing in place for 24 – 48 hours. There may be some swelling, particularly if your surgical site is around the eye.

• Follow up will be in 7 – 14 days depending on the healing option you choose.

We encourage our patients to call if there are any problems. For calls after hours, please follow the recorded voicemail directions to leave an urgent message and someone will call back as soon as possible.

Follow Up Appointments:

At your 7 – 14 day follow up visit:

• The nurse will change your dressing or remove your sutures. Your wound will not necessarily be healed at this time. You will be required to continue wound care until healed.
  
  
• You will be given detailed wound care instructions and dressings.
  
  
• You will be examined by Dr. Walsh and encouraged to call with any concerns.
  
  
• You will be required to return to the office for a 3 month follow up visit.

At your 3 month follow up visit:

• The nurse will take a photograph of the surgical site for your medical records.
  
  
• Dr. Walsh will examine the healed surgical site for evidence of skin cancer or healing problems.
  
  
• You will not be required to have further follow up with Dr. Walsh but will be advised to proceed with six monthly skin checks with a dermatologist.

We work closely with many dermatologists and plastic surgeons and are happy to refer you on request.