Mohs Surgery: Question and Answer

Community Member

One of the topics most asked about by our members here on SkinCancerConnection is about Mohs surgery. Mohs micrographic surgery is a specialized skin surgery which achieves the two goals of ascertaining complete tumor excision while sacrificing a minimal amount of normal surrounding skin. In Mohs surgery, the surgeon excises tumor and immediately evaluates the specimen under the microscope while the patient is still in the office. Mohs surgery is most often done to remove Basal Cell Carcinomas or Squamous Cell Carcinomas, and particularly those lesions on the face. Some experts say the best advantage of Mohs surgery is the cure rate. According to The American Society for Mohs Surgery five-year cure rates approach 99% for new cancers and 95% for recurrent cancers. When you leave your doctor's office after having Moh's surgery you can feel fairly confident that your doctor has removed all of the cancer.

Recently one of our members has asked some specific questions about Mohs surgery and we have asked Dr. Lawrence Green, a practicing dermatologist, and Spokesman for the American Society for Dermatologic Surgery to answer.

Member Dana asks:** Dad(90) w Moh's on chest. open area 5 in diameter. On all of it what shows is fat tissue. Dressing w vaseline,telfa. When will tissue start having a crust?**

Should apply silicone pads now or later? Surgery was 2 PM and review under microscope not finished. Doc will call me Fri to tell about margins, if more resection needed, will do at that time. He said at that time may try reconstruction "string purse like" I am wondering: bc healing already started, what is best? To just leave alone to heal by second intention, or attempt the string purse at a week time interval. Will wound form a scar by then? And if so, is it a good idea to "upset" the scar and interfere w healing at that timepoint by trying to decrease open area w the string purse approach? MANY MANY MANY THANKS!! Dana

Dr. Green: This is a great question, but unfortunately without knowing more details from the Mohs surgeon, I cannot really give you a good answer. But, reconstruction some days after a surgical excision is not necessarily dangerous and actually may be beneficial in some instances-especially after a large procedure. One thing is for sure however; I would recommend trying to close (even a partial closure) such a large (5 inches) excision, because leaving such a large wound open for second intention healing would not only take forever, but could also be at a higher risk for infection.

Thank you Dr. Green for your answer!

We have a lot more information about Mohs Surgery on this site. Please refer to these Health Central articles to learn more: