When possible, we request that you stop any blood thinners prior to surgery. You should always get the OK from your prescribing physician before stopping any potentially necessary medications. The following medications are considered blood thinners and ideally should be stopped for the number of days listed below:
- Aspirin - 7 days
- Plavix (Clopidogrel) - 7 days
- Warfarin (Coumadin) - 5 days
- Pradaxa - 3 days
- Vitamin E - 7 days
- Fish oil - 7 days
When you arrive on the day of your surgery, you will be brought into the procedure room. Dr. Ellerbroek will mark the area where the skin cancer is present. The area will then be cleaned and numbed with a local anesthetic. A layer of skin with the cancer will then be removed, attempting to keep the size of removal as small as possible. A temporary bandage will be placed on the wound while the tissue is sent to the lab and is marked, frozen, stained, and sectioned for viewing under the microscope to check tumor margins. Although Mohs surgery has an extremely high cure rate and leaves the smallest scar, the tissue processing does take some time...usually around 30 minutes. We recommend that you bring a book or something to do to occupy your time while you are waiting.
Once the microscope slides are prepared, Dr. Ellerbroek will look at them under the microscope. The cancer will be marked on a map, and if the margins are not clear, another layer will need to be taken from the area where the cancer is still present. This will lead to another wait time of around 30 minutes while the slides are prepared. This process is repeated until the cancer is clear. Typical cases are usually clear in 1-2 stages, although there is always a possibility of extra stages, which will lead to a longer day in the office.
Once the cancer margins are completely clear, the area will be repaired with sutures. This can involve the possibility of a simple repair, skin flaps, or skin grafts, depending on how large of a repair is necessary.