Mohs surgery

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How you prepare

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Selecting a Mohs surgeon
Mohs surgery can be technically challenging. Any dermatologist can perform Mohs surgery, since dermatologists learn about Mohs surgery in their medical training. Some Mohs surgeons have undergone specialized training — called a fellowship — to learn more about Mohs surgery.

Selecting an experienced Mohs surgeon who has completed a fellowship may reduce your risk of complications or errors during surgery. Ask your doctor about his or her qualifications and experience performing Mohs surgery.

Preparing for surgery
Your surgeon may recommend ways you can prepare for your surgery. You may be asked to:

  • Stop taking certain medications. Let your surgeon know of any medications or supplements you're taking, including any blood-thinning medications, such as warfarin (Coumadin), clopidogrel (Plavix) or aspirin. Some supplements — vitamin E, ginkgo, ginger and others — may affect your chances of bleeding after surgery, so make sure your surgeon knows about those, too. Continue taking any prescription medications as instructed unless your surgeon tells you otherwise.
  • Clear your schedule for the day. It's not possible to predict how long Mohs surgery will take. For most people, the procedure takes less than four hours. But your surgeon may advise you to plan as though surgery will take all day, since there's a very small chance it could take that long.
  • Wear comfortable clothing. Wear casual clothes that are comfortable. Dress in layers so you can easily adapt if the room is warm or cold.
  • Bring something to help pass the time. Expect some waiting time during your Mohs surgery. Plan ahead by bringing a book, magazine or other activity to help you pass the time.
References
  1. Robinson JK, et al. Surgery of the Skin: Procedural Dermatology. 2nd ed. Philadelphia, Pa.: Mosby Elsevier; 2010:711.
  2. Benedetto PX, et al. Mohs micrographic surgery technique. Dermatologic Clinics. 2011;29:141.
  3. Nehal K, et al. Mohs surgery. http://www.uptodate.com/index. Accessed July 6, 2012.
  4. Mosterd K, et al. Surgical excision versus Mohs' micrographic surgery for primary and recurrent basal-cell carcinoma of the face: A prospective randomised controlled trial with 5-years' follow-up. Lancet Oncology. 2008;9:1149.
  5. Tierney EP, et al. Recent changes in the workforce and practice of dermatologic surgery. Dermatologic Surgery. 2009;35:413.
  6. Murphy ME, et al. Errors in the interpretation of Mohs histopathology sections over a 1-year fellowship. Dermatologic Surgery. 2008;34:1637.
  7. Basal cell and squamous cell skin cancers. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed July 11, 2012.
  8. Important patient information regarding Mohs micrographic surgery in the treatment of skin cancer. American Society for Mohs Surgery. http://www.mohssurgery.org/i4a/pages/index.cfm?pageid=3335. Accessed July 6, 2012.
  9. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. July 19, 2012.
MY01304 Aug. 25, 2012

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