Mohs surgery involves a surgical technique that is used for the treatment of skin cancer. With this procedure, a specially trained dermatologist removes thin layers of cancerous skin and examines the tissue until only cancer-free skin remains. MOHS Reconstruction is also called Mohs micrographic surgery.
What is the purpose of the MOHS Reconstruction?
The goal of Mohs surgery is to eliminate as much of the skin cancer as possible while avoiding damage to any healthy surrounding skin tissue. This procedure is done on an outpatient basis with local anesthesia. With Mohs surgery, the surgeon can verify that all cancer cells are removed during the procedure, which increases the chance of a cure and reduces a need for more treatments or another surgery.
What types of cancer are treated with Mohs surgery?
The MOHS Reconstruction is used for skin lesions that have hard to define borders, are large and aggressive, and have a high risk of recurrence or have recurred after previous therapy. In addition, this surgery is used to treat cancers that are located in areas where the surgeon wants to preserve healthy tissue, such as around the ears, eyes, nose, mouth, hands, feet, or genitals. Mohs surgery is usually used for:
Basal cell carcinoma (BCC)
Squamous cell carcinoma (SCC)
How do I prepare for Mohs surgery?
To prepare for your Mohs procedure, you will be asked to:
Stop taking certain medicines – Be sure to make the doctor aware of all medications and supplements you take. Certain anti-inflammatory drugs and blood-thinning agents should be held for several days before the procedure.
Take time off from work/school – The procedure may take up to four hours, and you will want time to recover. It is best that you plan to not return to work or school for a day or two.
Dress comfortably – Wear casual clothes, and dress in layers so you can adapt to the room temperature. You may have to change into a gown if the location of the lesion requires it.
What is the procedure like?
When you arrive at the surgical center, you will be taken to the procedure room. A nurse will discuss the surgery risks and benefits and have you sign a consent form. After being positioned on the procedure table, the doctor will inject the area with a local anesthetic. After the anesthetic takes effect, the surgeon uses a scalpel to remove the top skin layers of the skin cancer. The surgeon then takes the tissues to the laboratory for analysis.
Expect to wait around 30-60 minutes. Bring a magazine or book to pass the time. After the surgeon gets results from the lab, he will either remove more tissues or close the wound. If cancer cells remain, the Mohs procedure will continue. The surgeon removes an additional layer of skin from the area, which must be analyzed in the lab. The process is repeated until the last tissue sample is cancer-free.
What can I expect after the procedure?
After the surgeon removes all cancer, the wound must be repaired. Depending on the size and extent of the wound, this may include:
Letting the wound heal without sutures.
Closing the wound with sutures.
Using a skin flap to shift skin from an adjacent area to cover the wound.
Using a skin graft from another region of the body to cover the wound.
The surgeon will have you return for a follow-up in 3-7 days, at which time your wound will be reassessed. Mohs surgery has a high cancer cure rate, but there is always a small chance that the cancer will recur. Therefore, you must return for periodic office visits for the surgeon to assess the area.
See comment in PubMed Commons belowBobotsis R & Guenther L (2016). How Mohs Surgery Transformed Into a First-Line Treatment of Skin Cancer. J Cutan Med Surg.