Mohs Microscopic Surgery - Dr. Patrick
Walsh
Mohs Micrographic Surgery is an advanced surgical procedure originally
developed in the 1930s by Dr. Frederic Mohs and has been refined
and perfected since. Mohs surgery relies upon the accuracy of a microscope
to trace and ensure the removal of skin cancers such as basal cell
carcinomas, squamous cell carcinomas, and some melanomas. Mohs surgery
allows Dr. Walsh to see beyond the visible disease, and to precisely
identify and remove the entire tumor, leaving healthy tissue unharmed,
thus lessening the potential for re-growth, scarring or disfigurement.
The cure rate for Mohs Microscopic Surgery is the highest of all
treatments for skin cancer; up to 99 percent even if other forms
of treatment have previously failed.
If a biopsy has been taken from your skin lesion and the pathology
report states the lesion has been diagnosed as a skin cancer (BCC,
SCC, melanoma), your doctor may suggest Mohs surgery as the most
effective and recommended treatment.
If your doctor refers you for Mohs surgery with Dr. Walsh, an appointment
will be scheduled for a consultation visit. The consultation visit
allows Dr. Walsh to examine your past medical history and current
medications. Some conditions or medications may be contra-indicated
with your surgery. You may be required to discontinue certain medications
prior to surgery and we may be required to call your treating physician
regarding any necessary precautions we need to undertake. Therefore,
a consultation visit is considered necessary prior to your surgery
to ensure your safety; the visit will also give you an opportunity
to receive information and meet the surgical staff.
Surgery is usually scheduled early in the day and is performed as
an outpatient. We suggest you try to get a good night's rest prior
to surgery and eat a good breakfast. It is a good idea to bring some
snacks/food (coffee and cookies will be provided), a warm layer of
clothing, books or magazines. We recommend you have someone to drive
you home.
Mohs Microscopic Surgery Procedure
(1).
The biopsy site of your skin cancer will be marked out by Dr. Walsh and
injected with a local anesthetic to numb the area. |
 |
(2)
. Photographs will be taken pre, during and post surgery. The photographs
will be filed in your medical records and may be used for teaching purposes. |
(3). Dr. Walsh will
surgically remove the biopsy site and the visible portion of the skin
cancer. |
 |
(4). The removed tissue
is marked with colored dye to distinguish top from bottom, right from
left and a map of the excised tissue is made. |
|
(5). Dr. Walsh
will microscopically examine the removed tissue (which takes approximately
45 minutes – 1 hour), to check for evidence of remaining cancer cells. |
 |
(6.) If any
of the sections of removed tissue contain cancer, Dr. Walsh will return
to the surgery site and remove another layer of tissue only from the
specific area within each section where the cancer cells were detected
(Stage II Mohs Surgery).
Positive Map (positive areas shown in red). |
 |
(7). Dr.
Walsh will microscopically examine the removed tissue (taking less time
than Stage I) for evidence of additional cancer cells.
(8). If the microscope still shows evidence
of disease, the process will continue layer-by-layer until the cancer
is completely gone.
(9). When the microscopic examination is negative, (there are no remaining
cancer cells), Dr. Walsh will discuss the options available to you
for the reconstruction of your wound site.
(10). Dr. Walsh is trained in reconstructive
procedures and will perform the reconstructive procedure necessary
to repair the wound. Some wounds may be left to heal on their own;
the wound may be closed with stitches, a skin graft or flap. Dr. Walsh
will also discuss the option of a surgical specialist to complete the
reconstructive surgery as necessary.
(11). You will be required to perform wound
care for your surgical site. The nurse will discuss wound care with
you and provide an instruction sheet. The office number will be provided
if you have any problems.
(12). You will return to the office in approximately
seven days for removal of your stitches. If your wound is to heal by
itself (second intention healing), you may return to the office for a
dressing change in 7 - 14 days.
(13). Following the removal of your stitches, you will return to the office for
a three month follow up visit. After this visit, you will follow up with your
referring dermatologist/physician for regular skin checks. |
The new skin that grows over the wound contains many more blood vessels
than the skin that was removed. This results in a red scar and an area
which may be sensitive to temperature changes.
This sensitivity improves with time and the redness will gradually fade.
You may experience itching after your wound is healed. Moisturizers help
relieve the itching.
The healing process may take 6 to 18 months to be complete.
Dr. Walsh recommends that you take adequate protection from the sun,
avoid burning and use discretion. Sunlight is probably the main contributing
factor in the development of skin cancer, and patients who have developed
one skin cancer will often develop more at a later time. You are advised
to liberally apply a sun screen with SPF 15 to all exposed areas, including
the tops of your ears. It is best to apply the sun-screen about 15-30
minutes before going outdoors. Be sure to re-apply as necessary (at least
every 2 hours) and wear protective clothing when possible.
Please contact our office for any further information you
may require - 817.923.8220
BACK TO TOP»
|
|
