Advanced
Mohs micrographic
Surgery in Hyderabad

Mohs micrographic: Pre-Op & Post-Op Care

The procedure for Mohs surgery is divided into three different phases: pre-operative phase, intra-operative phase, and post-operative phase. These phases are designed to make sure of patient safety, accuracy of procedure, and optimal recovery. The pre-operative stage is examining the patient and making them ready for surgery, which is followed by the surgical procedure itself during the intraoperative stage, and finally the post-operative stage, where the patient returns to normal activities after surgery becomes an essential objective.

Pre-operative care: Preparation before the procedure

Mohs surgery begins with careful pre-operative preparation to ensure the patient’s safety, reduce complications, and optimize the results of surgery. The pre-operative phase involves patient education, management of medication, and practical preparations, namely

Discussion of medical history, allergy to medicines, and expectations of surgery with the surgeon.

Medications that increase the risk of bleeding should be avoided 7-14 days before the procedure, for example, aspirin, ibuprofen, naproxen, vitamin E, fish oil, garlic, ginseng, and ginger.

Alcohol and smoking should be avoided to promote healing. The patient should have a light meal on the day, and fasting should generally be avoided.

The surgical area should be washed thoroughly, and wearing loose, comfortable clothing with no makeup or lotions should be a priority.

Transportation and all the necessary documentation should be arranged for the patient. The patient should inform the surgeon of any pre-existing issues.

Intra-operative care: The procedure

In this specialized technique, the skin cancer is removed by taking tissue in thin, layered sections, followed by immediate evaluation under a microscope. This is to achieve complete cancer clearance while preserving the healthy tissue

Local Anesthesia needs to be given to numb the area of surgery

The visible tumor is then debulked and scraped for the removal of any superficial cancer

A thin-layered tissue, with a margin around beneath the tumor, is then excised with a 45-degree beveled edge for processing in the laboratory.

The tissue is then carefully oriented with markings for accurate mapping. The excised specimen is then frozen, sectioned horizontally, and stained for evaluation by microscope.

The surgeon then evaluates 100% of the peripheral and deep margins under a microscope. If cancer cells are found, then additional targeted tissue layers are removed from the affected areas. This process is repeated until all the margins are cancer-free, making sure of complete abnormal tissue removal.

Through the surgical mapping technique, the maximum amount of healthy tissue is actually conserved.

After complete removal, the wound is repaired, which includes primary closure, skin grafts, flaps, or healing by secondary intention based on defect size and location.

The duration of surgery ranges from hours to several hours, depending on the complexity of the tumor and the number of stages.

Post-operative care: The recovery

Recovery after Mohs surgery involves management of wounds, prevention of infection, controlling pain, and healing of wounds. To achieve all this, the following procedures are followed

A pressure bandage is applied as soon as the surgery is completed, and this is to be kept for at least 2-3 days to reduce the risk of bleeding and swelling.

The surgical site should be kept clean and dry. After cleaning wounds, antibiotics should be applied.

Alcohol and smoking should be avoided to promote healing.

The surgical site should be elevated, and ice packs should be used intermittently to reduce the swelling and discomfort.

The patient should expect mild redness, swelling, bruising, and tenderness at the site of surgery, and should monitor for any bleeding or infection.

Pain can be controlled by over-the-counter acetaminophen, and stronger pain medications can be prescribed if needed.
Follow-up visits are scheduled for the removal of sutures and examination of the wounds, typically within 1-4 weeks after the procedure.

The patient receives scar care advice, which includes sun protection to prevent pigmentation changes in the scar. Avoiding any extra activity and wound care duration depends on the method used for wound closure and the patient’s healing.

Benefits of Mohs micrographic at Yashoda Hospitals

Mohs surgery is highly regarded as the most effective method to treat skin cancers, offering unique benefits over other surgical options, namely

• Highest cure rate for skin cancers (99%)
• Maximizes preservation of healthy tissue
• Reduces the risk of recurrence
• Immediate confirmation of clear margins so cancer is completely removed
• Minimizes scarring
• Low surgical risk due to the use of local anesthesia
• Cost-effective procedure
• Helpful in tissue conservation in critical areas like the face, hands, and feet.