Optimal Outcomes May Require a Team Effort
- Posted on: Mar 15 2018
The Mohs surgical technique has been a significant step forward in the area of patient care. This procedure is renowned for its efficacy and long-term results. Because Mohs removes cancerous tissue in layers rather than one substantial piece, there is a much lower risk that patients will need reconstructive surgery to repair scarring from their initial procedure. Even with effective skin cancer treatment using Mohs, there are certain areas and situations that may be more prone to needing reconstruction. Therefore, the Mohs surgeon must be prepared to team with a plastic surgeon on some cases.
Skin cancers on the cheek, lip, eyelid, ear, forehead, and scalp may be more likely to cause cosmetic repercussions. Patients may desire a second surgery to restore an aesthetically pleasing appearance. This is an important need that surgeons need to meet with adequate resources. In some cases, it may be possible to predict the need for reconstruction prior to Mohs surgery, which presents the opportunity to schedule coinciding procedures. It is possible for a Mohs surgeon to also extend clinical training into the area of reconstructive surgery.
Patient Expectations Met with High Standards of Training
The American Society for Mohs Surgery has been established on the principle of standards. Mohs micrographic surgery exists because, decades ago, Dr. Mohs strived to meet that higher standard of patient care. Training and accreditation are what set Mohs surgeons apart from general practitioners who rely on conventional excision techniques for the treatment of skin cancer. The use of this technique is intended to reduce the need for reconstruction, or the degree of reconstruction if it is needed.
Options for Reconstruction
It is possible for reconstruction to occur immediately after the completion of the Mohs procedure. However, if surgery were to occur days or weeks later, this would not translate into a more difficult or less successful reconstruction. The manner of reconstruction is usually discussed after the surgeon has confirmed the complete removal of cancerous tissue. Then, it is possible to understand the nature of reconstruction based on the depth of roots of the cancerous lesion, it’s location on the face or body, and the size of the tumor at the skin’s surface.
Common reconstructive strategies include:
- Allowing time for secondary-intention healing to occur naturally for small wounds.
- Side-to-side stitches may be used to close more substantial incision wounds.
- Skin grafting may be necessary if incisions are larger and more complicated.
The need for reconstruction is an important consideration for Mohs surgeons. If you are a patient, you may search our directory to find a Mohs surgeon near you. If you are a physician interested in Mohs training, call (714) 379-6262 for more information on membership and upcoming courses.
Posted in: MOHS Surgery
