Mohs Surgery Post-Operative Care

Hi, my name is Jessica Dorsey and I’m a board-certified dermatologist and fellowship-trained Mohs surgeon at U.S. Dermatology Partners and today I’m going to be talking to you about post-operative care for surgery.
So, with Mohs surgery what that involves is numbing the skin similar to when the biopsy was performed with a local anesthetic and then the doctor will take a thin sliver of the skin and take it to the lab and process it while the patient is waiting. Once we determine that we get clear margins then the doctor will take a look at the defect size and location and determine what the best closure type will be. Sometimes that can be allowing the wound to heal by mother nature where no stitches are required, or it can be a simple line closure, or it may require the use of a flap or a graft.
Usually, the wound care is very simple whether you have an open wound or a wound with stitches or a wound where there is a layer of skin glue on top and all of the stitch work is done underneath the skin. Most of the time wounds will heal faster if you keep them greasy, if you keep them moist, and covered with Vaseline and a band-aid. What we ask the patient to do after they have surgery on their skin is to take it easy. Don't do any strenuous activity, don't run a marathon or climb a mountain. You just want to go home and rest and take it easy. In addition to keeping the wound moist and greasy with Vaseline in a band-aid, you want to do daily to twice daily cleansing of the wound as instructed by your doctor.
Most of the time scarring is minimal with Mohs surgery because it is a tissue-sparing technique where we are able to take more narrow margins and follow the skin cancer exactly where it's tracking and leaving as much normal skin behind. That allows for a much smaller defect and therefore a smaller scar as a result. If you have a skin graft that is placed, then you may have a little circular patch where the skin graft is healing that will gradually fade to a skin tone after it has finished healing. If you have a skin flap, for instance, if you have to do a flap on the nose you can expect to have a little bit of redness and swelling maybe for a few weeks or even up to a few months but that will gradually fade and then there are other procedures that your doctor can do such as dermabrasion to smooth the edges of the scar and provide a better cosmetic appearance.
The best thing that you can do at home to take care of your scar and provide the best cosmetic outcome for the scar is to take it easy, keep it greasy and covered with a band-aid at the instruction of your doctor. Refrain from smoking. If you're a smoker, you'll want to stop smoking for at least one week prior to the surgery and for at least two weeks after the surgery. Stay out of the sun. Try to minimize your sun exposure as much as possible and if you do have to be out in the sun make sure you put on your sunscreen. There are some scar gels that we recommend, some of them do have sunscreen already within it and so that can be something that you can discuss with your doctor. If you have any questions regarding skin cancer, dermatologic surgery, Mohs surgery, or any other skin-related concern, please reach out to the U.S. Dermatology Partners location nearest to you.

[@ronwedge6171]

Very helpful ! Much better than the post op care sheet I was issued.
Thanks !

[@jeanne819]

I have had several skin cancer surgeries including malignant melanomas 1980 and I’m grateful to be alive today. I had a Mohs surgery three weeks ago on my leg and it is still oozing today and I have to continue wearing Band-Aids I’m unable to go swimming and it’s very concerning. 4 inches away from this site they did a biopsy three weeks ago as well and I’m still awaiting the results which is ridiculous. I’m in New York and I don’t understand this. I need to know what to do about this oozing I don’t have a red infection going on like I did a year ago with another surgery on my ankle cancerous

[@tiazadobbs7475]

Mine is on my lower leg as well. I'm concerned about wound healing and pain as I have neuropathy and nerve damage.