Most patients are initially surprised that the size of their surgical wound is larger than they expected. The cancerous tumor is often well beyond its obvious external margins with nests of cells growing in unpredictable areas.
Please keep in mind that our major goal was to completely remove the skin cancer. After this has been achieved, our next goal is to provide you with the best possible functional and cosmetic results. There are several options for repairing your surgical wound including:
- Healing by granulation — This simply means letting the wound heal by itself. Experience has taught us that there are certain areas of the body where nature will heal a wound as nicely as a surgical procedure. There are also times when a wound will be left to heal knowing that if the resultant scar is unacceptable, some form of reconstructive surgery can be performed at a later date.
- Closing the wound side-to-side with stitches — This involves sewing the skin edges together. This procedure speeds the healing and typically offers an excellent cosmetic result.
- Skin flaps — This involves movement of adjacent healthy tissue to cover a surgical site. When practical, flaps are chosen because of the excellent cosmetic match of nearby skin.
- Skin grafts — There are two types of skin grafts, which are used to cover a surgical site with skin from another area of the body:
- A split thickness graft is a thin shave of skin usually taken from the thigh.
- A full thickness graft provides a thicker layer of skin to achieve the desired results. This skin is usually removed from around the ear or collarbone and then stitched to cover the wound. The donor site is also sutured together to provide good healing.
If your Mohs Surgery is extensive, we may recommend that you see one of our consultant physicians, usually a plastic or facial-plastic surgeon. If a reconstructive surgeon referred you to us, he or she will care for you after your cancer has been removed. Your referring physician will usually let us know ahead of time whether you will be seeing them for closure of the wound.