Pre Op and Post Op Mohs Surgery Instructions

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I was very satisfied with my experience at Fresno Dermatology Specialists. Dr. Paz performed surgery on me to remove skin cancer from my face. I was pleased with the results. The staff members at this office are friendly and helpful.
-Mr. Gomez, Fresno

We’re Here to Help Every Step of the Way

We have provided the information below to help our patients understand what they should do and not do before and after Mohs Surgery. You may review these materials online and/or download and print them. During your initial consultation at our office, Dr. Paz and a medical assistant will discuss with you the benefits and side effects of the surgery. After Dr. Paz completes the surgery, a medical assistant will review the post-operative instructions with you. Dr. Paz also provides his personal cell phone to his surgical patients to respond to any questions or complications post-surgery.

Mohs Surgery Pre-Operation Instructions

  1. Eat a meal before your surgery and help yourself to the refreshments our office provides.
  2. Take regularly prescribed medications the morning of the surgery, although aspirin and aspirin containing medications should not be taken 14 days prior to surgery unless you are a cardiac or stroke patient and your doctor prescribed the aspirin. Please advise Dr. Paz at least one week before surgery if you are on any blood thinners. Advise Dr. Paz if you are taking any over-the-counter medications.
  3. If you smoke tobacco, please stop for 2 days before the surgery and 7 days after the surgery.
  4. If you consume alcoholic beverages, please stop 14 days before and 2 days after surgery. These will help prevent complications of bleeding.
  5. We recommend a shower the evening or morning before surgery and freshly laundered clothes to help reduce the chance of getting an infection. Wear a t-shirt or blouse that buttons up in the front.
  6. A container for contact lenses or dentures should be brought if the surgical site is around your eyes or mouth.
  7. Please realize that you will probably be in our office for an extended period of time on your surgery day. For this reason, please bring any medications with you so that you can take them throughout the day.
  8. On the day of your surgery, you should be accompanied by a family member or friend. We ask that you limit it to two people due to the limited space in our waiting room.
  9. Remember to start antibiotics on time if you were instructed to do so.
  10. If you are allergic to any medications, or have any sensitivities, please notify us immediately.
  11. There will be a bulky pressure bandage in place for 24 to 48 hours after the surgery. These pressure bandages may obscure your vision. This is another reason you should have a driver. Please consider this when scheduling your surgery.
  12. For the first 48 to 72 hours activity will be limited. Restrictions include avoidance of strenuous exercise, heavy lifting and bending over (if your surgery is on the head or neck)

Mohs Surgery Post-Operation Instructions

How to Care for Mohs Surgery Site:

  1. Leave the initial dressing in place for the first 24 to 48 hours.
  2. Apply an ice pack to the affected area for 15 minutes of every hour for the first day. The ice pack should also be used every 3 to 4 hours on the day following the surgery. It is often helpful to elevate the affected area for the first day after surgery. Ice packs and elevation decrease swelling and tenderness in the surgical site.

Wound Care After Surgery:  Supplies needed: Aquaphor or Vaseline, Telfa dressing, and paper tape.

Wound Care (with stiches):

  1. Avoid getting post-operative bandage wet during the first 48 hours.
  2. Before showering, remove the bandage and discard it the trash.
  3. Cleanse the incision with soap & water (not hydrogen peroxide) to remove any drainage and crusting.
  4. Pat the wound dry and apply a generous layer of Aquaphor or Vaseline ointment to the incision.
    Cover the wound with a Telfa dressing cut into the shape of the incision.
  5. Tape the Telfa dressing in place with paper tape.
  6. Repeat this process every day until your post-op visit.

Care for Wounds Healing by Secondary Intention (without stiches):

  1. Site should be cleansed with Hydrogen Peroxide. Apply Vaseline or Aquaphor to the wound.
  2. Cover the wound with Telfa dressing or a non-stick bandage, tape edges.
  3. Repeat this process every day until your post-op visit.

What to Expect and General Instructions for Your Recovery

  1. Pain is usually minimal. If discomfort occurs, you may take Extra Strength Tylenol. We will prescribe pain medication for you if necessary.
  2. Minimal bleeding is expected. If you see blood at the edge of your dressing, leave it in place and apply firm pressure to the area directly over the dressing for 15 minutes. If this does not stop the bleeding, you may not be pressing hard enough. Repeat this process once if the bleeding continues. If there is still bleeding after 30 minutes of pressure call Dr. Paz’s cell phone at: 559-575-2233 or (559) 575-2232.
  3. Continue to avoid aspirin and aspirin containing products for one week after surgery.
  4. No strenuous activity for a week after surgery. If you drop something, bend your knees to get it.
  5. To minimize swelling of areas on the head try sleeping with your head elevated on several pillows.
  6. Alcoholic beverages should be avoided at least 48 hours post surgery to prevent bleeding.
  7. Smoking should be avoided at least until the sutures are removed.
  8. Please avoid directly rubbing the site of the surgery and avoid trauma to the surgical site.
  9. Your follow up visit for removal of sutures will be scheduled on the day of the surgery.
  10. Please call if any signs of infection occur (e.g. increasing tenderness over several days, fever, & yellow drainage).