Mohs Preoperative Instructions
Anytime you are considering a surgical procedure it can be anxiety-provoking. We hope that by having detailed instructions prior to arriving you can feel better prepared and have the best possible outcome.
Mohs Surgery is unique in that it is performed under local anesthesia. We believe that this is a great advantage, not undergoing the implicit risks associated with General Anesthesia, as well as keeping the cost of the overall procedure down.
Because we prepare the slides and examine the tissue specimen while you are here, there is a waiting period with every specimen taken. This is largely where the time commitment comes from.
Dr. Smith will come to greet you on the day of surgery and ensure that you understand what is planned for your Skin Cancer and what can be expected. She will then clean the area and use a local anesthetic, most commonly lidocaine, to numb the area. We will take our time and ensure that you are numb before proceeding. We will then take a small perimeter both below and around your skin cancer to process. This layer of tissue is frozen and cut very thinly before staining so that we can see more clearly if there is any residual cancer. If there is, we will repeat this process around where we see the remaining tumor.
When we are confident that the tumor has been removed, we will proceed to repair the skin. We will do this with every effort towards a pleasing cosmetic result.
In preparation we would ask that you do the following:
Refrain from any alcohol in the 24 hours preceding surgery as it can increase bleeding and bruising from your surgery.
Avoid any supplements that you take that may thin the blood, such as Ginger, Gingko, garlic and fish oil at least 7 days prior to surgery.
All prescribed blood thinners (such as Warfarin, Eliquis, Pradaxa, etc) you should CONTINUE. DO NOT STOP these without express direction from your primary care physician or cardiologist.
If you take Aspirin ONLY for preventive reasons you may stop this for 7 days prior to your surgery. However, if you take Aspirin for a current condition such as a previous stroke, or atrial fibrillation or known heart disease please CONTINUE this medication or discuss it with your primary care physician or cardiologist.
Please ensure that you take all your regular medications on the day of surgery, with special attention to your blood pressure and diabetic medications. If these conditions are uncontrolled on the day of surgery, your procedure may be delayed for your own safety until they are better controlled.
Please eat normally on the morning of surgery. Local anesthetic is generally better tolerated with some food in the stomach. At the very least ensure that you are well hydrated. We can help you with some snacks if you don’t feel like eating until later.
Please let us know if you have a Pacemaker or Implanted Defibrillator, this does not stop us from doing your procedure, however, we will use methods that are safer for your device.
If you have had a joint replacement within the last 2 years, a history of Infective Endocarditis, a murmur that causes you symptoms, or a history of valve replacement or repair please ensure that we know this history. We may need input from your specialist regarding pre and post-operative antibiotics.
If you have a condition that increases your chance of an infection such as history of Organ Transplant please let us know this as well.
If you have any questions about the above, please don’t hesitate to bring them up at your consultation or prior to beginning Mohs Surgery. In addition, always consult your prescribing physician before you stop or change how you are taking a particular medication.