At the time of the pre-operative consultation, the Mohs surgeon will discuss the steps involved in the procedure.
Suncoast Skin Solutions, led by board certified dermatologist Dr. Christopher Ewanowski, provides cosmetic and medical skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, Sarasota, Central Florida, Florida, and surrounding communities.
Depending on the site of their skin cancer, the patient may be able to wear their regular clothes or may need to put on a hospital gown.
The Mohs surgeon will assess the site where the patient had their biopsy and may use a pen to mark it for reference. Subsequently, the surgeon will position the patient to get the best access to the treatment site, which may include lying down or sitting up.
A surgical drape will be placed over the treatment area. If skin cancer is on the face, the patient may not be able to view the proceedings. But the surgeon will talk them through it. They will numb the treated area completely by administering a local anesthetic. The patient will remain awake throughout the procedure.
The surgeon will eliminate a thin layer of cancerous tissue using a scalpel. This may only be the “the tip of the iceberg” in some cases of skin cancers, which means that they have roots or extensions that are not visible from the surface.
The lab analysis that follows this process will establish whether this is the case. The surgeon will then bandage the wound temporarily, and the patient can relax as the lab work initiates.
The surgeon will dissect the tissue into multiple sections, color code them using dyes and develop a map of the surgical site. Subsequently, the lab technician will freeze the dissected tissue and cut it into very thin horizontal slices similar to a layer of cake.
These slices are then mounted on microscopic slides, stained, and covered. This is a very detailed and time-consuming process.
The surgeon will assess all sides as well as the underside of the tissue placed on the slides. If any cancer cells remain, they will demarcate the location on the map. The surgeon will now let the patient know whether they will need another tissue layer to be removed.
The surgeon will administer more anesthetic in the operating room, if necessary. They will then remove another layer of skin at the location where the cancer cells still remain based on the map.
The patient will then wait as the lab work commences. This process will be repeated until the location is free of cancer cells.
When there are no more cancer cells remaining, the surgeon may leave the wound open to heal or use stitches to seal it, depending on its location and size. At times, the wound may warrant reconstruction using a skin flap. The surgeon will move the adjacent tissue into the wound or use a skin graft.
The surgeon will repair the wound immediately in most cases, after achieving clear margins. But sometimes they may repair the wound working along with another specialist.
Dr. Ewanowski’s skin care clinic receives patients from Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, Sarasota, Central Florida, Florida, and nearby areas for cosmetic and medical skin care procedures.
SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.