North Pacific Dermatology PS
















Welcome to North Pacific Dermatology

Mohs surgery offers the highest cure rate of all treatment options (99% cure rate for basal cell carcinoma).  It allows the least amount of healthy skin removed, thereby minimizing the final surgical scar.  It is a one day outpatient surgery only requiring local anesthesia, not general anesthesia.

How is Mohs Surgery Done?                             

The patient is taken to a surgical suite and prepped.  The surgical area is anesthetized with local anesthetic (numbing injections).  The tumor along with a thin surrounding layer of skin is excised.  The removed specimen is then processed in the lab and examined under a microscope.  If any residual tumor remain at the edge of the specimen the patient will be taken back to the surgical suite for another layer removal.  This is done until the area is free of tumor.

On average it takes approximately 1 hour to process and examine each specimen, less time for small specimens and more time for larger ones.  Also on average it takes 2-3 attempts to clear the tumor.  The size of the surgical defect cannot be determined until the tumor is completely removed.  Typically patients will be in the office for 3-4 hours, but be prepared to spend the day for surgery.

After complete removal of the cancer, typically reconstructive surgery is performed to repair the surgical wound.  Sometimes the wound will be allowed to heal in for 1-2 weeks before it is repaired.  Depending on the size and location of the wound, it may be allowed to heal in by itself.  The repair method cannot be determined until the tumor is completely removed.

Do you take Aspirin, Coumadin, Plavix or other blood thinners (ibuprofen and other anti-inflammatory medications)?                        

●If you take aspirin or ibuprofen please discontinue these medications at least 7 days before surgery.  If your aspirin is prescribed, please check with your physician before stopping it.

●If you take coumadin (warfarin) or Plavix please continue the medication.  Please check your levels a few days before the surgery.

●Please continue all other regular daily medications unless specified.

Do you have any artificial joints or heart valves?

●If you do, you may require antibiotics before the surgery.  Please let us know so we may prescribe some antibiotics prior to surgery.

Do you require antibiotics before dental procedures?

●Please let us know so we may prescribe some antibiotics before surgery.

Absolutely no Alcohol, fish oils (omega-3 fatty acid), Vit E, or gingko 7 days prior to surgery.  They cause more bleeding.

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