In the treatment of certain types of skin cancers, Mohs surgery is thought to be the gold standard. It is vital for patients to work with an experienced and skilled Mohs surgeon for best outcomes.
At the time of the pre-operative consultation, the Mohs surgeon will explain the steps involved in the procedure.
Depending on the location of their skin cancer, the patient may be able to wear their normal clothes or put on a hospital gown.
The Mohs surgeon will assess the site where the patient had their biopsy and may use a pen to mark it for reference. The surgeon will position the patient to gain the best access to the treatment site, which may include lying down or sitting up.
A surgical drape will be placed over the treatment area. However, the patient will not be able to view the proceedings if skin cancer is present on the face. But the surgeon will talk them through it. They will numb the area completely by injecting a local anesthetic.
The patient will remain conscious during the procedure.
The surgeon will remove a thin layer of visible cancerous tissue using a scalpel. For some skin cancers, this may be the “the tip of the iceberg,” which means that they have roots ore extensions that cannot be seen from the surface.
The ensuing lab analysis will establish whether this is the case. Then the surgeon will temporarily bandage the wound, and the patient can relax as the lab investigation commences.
The surgeon dissects the tissue in multiple sections, color codes them using dyes, and develops a map of the surgical site. Following this, the lab technician freezes the dissected tissue and cuts extremely thin horizontal slices similar to a layer of cake.
These slices are then mounted on microscopic slides, stained, and covered. This is quite a detailed and time-consuming process.
The surgeon will assess all the sides as well as the underside of the tissue placed on the slides. If any cancer cells remain, they will mark the area on the map. The surgeon will then let the patient know whether they will need another layer of tissue to be eliminated.
The surgeon will administer more anesthetic in the operating room, if necessary. They will then remove another layer of skin in the area where the cancer cells are located on the basis of the map.
The patient will then wait as the lab work will commence. This process will be repeated until the surgeon attains cancer-free margins.
When no more cancer cells remain, the surgeon may leave the wound open or suture it, depending on its location and size. At times, the wound may require reconstruction using the flap technique. The surgeon will move the adjacent tissue into the wound or use a skin graft.
For most patients, the Mohs surgeon will repair the wound immediately after achieving clear margins. But sometimes they may repair the wound working with another specialist.
Board certified dermatologist Dr. Jamie McGinness and Jackie McGinness, FNP (Nurse Practitioner) receive patients from Shiloh, IL; St. Louis, MO, and nearby areas for skin care procedures.
If you would like to learn more about procedures and treatments at Metro East Dermatology & Skin Cancer Center by Board Certified Dermatologist Dr. Jamie L. McGinness please contact us here or call (618) 622-SKIN (7546)
Taking new patients in and around the greater St. Louis, Missouri and Illinois area: East St. Louis Missouri, Shiloh Illinois, Belleville, Millstadt, Saint Clair County, Madison County and more.