MOHS Patient Instructions
1. Avoid aspirin and aspirin products for at least 10 days before your surgery is scheduled or as instructed by the nurse or physician.
2. Avoid Ibuprofen (Motrin, Advil), Aleve and other arthritis medications and any other herbal supplements for at least 4 days before your surgery is scheduled, or as instructed by the nurse or physician.
3. Take all your other prescribed medications unless instructed otherwise.
4. Tylenol is ok to take before your surgery.
5. Avoid alcohol for at least 48 hours before your surgery is scheduled.
6. We suggest that you eat meals as normal, but minimize the amount of caffeine you drink.
7. We suggest that you bring someone with you who would be able to drive if you are not able.
8. If your surgery will be done on your face, head or neck:
- Wear a shirt that buttons so that bandages are not disrupted when removing the shirt.
- Do not wear any makeup on your face, eyes, or lips.
- Do not shave your face for at least 24 hours before your surgery.
9. If your surgery will be done on your arms, hand or fingers:
- Wear a loose fitting shirt that is easy to remove and will not rub on bandages.
- Do not wear jewelry on the hand or arm.
10. If your surgery will be on your leg, foot or toes:
- Wear loose fitting pants that are easy to remove and will not rub on bandages.
- For foot and toes bring or wear loose/oversized shoes that will fit over bandages.
11. Due to the nature of the MOHS procedure you will be required to do a lot of waiting. Our goal is to take care of you and have you on your way as soon as possible, however you should be prepared for the following:
- Plan on the process taking 3-4 hours, and sometimes all day, until 5 p.m. or later.
- Avoid making other appointments / engagements on your surgery day if possible.
- Bring a good book, laptop computer, tablet or something else to keep yourself busy.
12. Plan on having an appointment 7 to 10 days following surgery to have sutures removed.
Please call our office at (801) 475-5210 if you have any questions or concerns
MOHS MICROGRAPHIC SURGERY
Mohs micrographic surgery is the most effective method for removing certain skin cancers, particularly those that spread deep and wide with finger-like or root-like projections. Basal cell carcinoma and Squamous cell carcinoma of the skin spread in this fashion.
Mohs surgery is named for Frederick Mohs, the physician who developed the technique in the 1930’s and first published his results in 1941.
This outpatient surgery is done under local anesthesia. The obvious skin cancer and a margin of surrounding normal tissue are removed. This tissue is then processed on slides for microscopic review by the doctor. After the tissue is examined under the microscope, it is determined if cancer cells remain and, if so, their exact location. At this point a second layer of tissue is removed and the process repeated, layer by layer, until the excised tissue is free of cancer. Once the area is cancer free, the wound is repaired. The options for repair include second intention healing, simple closure with sutures, a skin graft or flap.
Every surgical procedure has its own potential risks. Mohs surgery complications may include pain, bruising. swelling, wound infection, bleeding or hematoma formation, a larger than anticipated wound, or loss of sensation in the area of skin treated.
After surgery, you will be instructed on how to care for your wound. Strict adherence to the wound care protocol is important to promote proper healing.
Occasionally, the scar may need to be revised to achieve a better appearance or hotter function of the affected area. This is optional and is discussed with the doctor.
Please refrain from taking aspirin for two weeks prior to your surgical procedure. Please refrain from taking Motrin, Advil, ibuprofen, Alleve, naproxen or other NSAIDs 4 days prior to your procedure. Please read all medical labels closely, even those that are over-the-counter, so you can avoid all of these agents prior to your procedure. Avoid alcoholic beverages for 3 days prior to the procedure and 2 days after. Please avoid smoking as much as possible before and after the procedure. On the day of your surgery, eat your meals as you usually would. Take your normal prescribed medications. If the cancer is on the upper nose or near the eyes, you may want to have someone accompany you. Plan on spending several hours with us. Some cases take all day.
After the procedure, you will have a dressing in place. Go home, rest and limit your activity. No lifting, bending or stooping. Any special post-op instructions will be given to you. Follow-up visits will depend on the repair done.
Dr. Brad Draper is a Board Certified Dermatologist and a fellowship trained Mohs and facial reconstructive surgeon. He is a fellow of the American Academy of Dermatology and the American College of Mohs Surgery. Dr. Draper obtained his undergraduate degree at the University of Utah and went to St. Louis University Medical School. He completed dermatology residency at Vanderbilt University and Mohs Surgery fellowship at Billings Clinic, which is home to the first and only advanced surgical training program in Montana/Wyoming. He also has a Ph.D. in cell biology from Vanderbilt University.