Staged Excision (Slow Mohs)
MOHS AND DERMATOLOGICAL SURGERY
UW Health West Clinic UW Health East Clinic
451 Junction Road 5249 East Terrace Drive
Madison, WI 53717 Madison, WI 53718
Staged Excision (Slow Mohs)
Mohs Surgery Clinic evaluates and treats skin cancers and non-cancerous skin growths. There are different kinds of skin cancer. These include basal cell carcinoma, the most common form of skin cancer, squamous cell carcinoma, and melanoma. Most skin cancers can be cured if found and treated early.
Staged Excision is a way of removing shallow melanoma skin cancers that usually takes 2 or more visits. At each visit, the area of skin cancer is surgically removed and sent to our UW pathology lab. This tissue is processed in a special way to allow any melanoma cells to be identified. Results can take from 2 days up to 2 weeks. If there is still melanoma at the edges, this can be re-excised at your next visit. You may have a bandaged wound and multiple visits over a few days or even weeks to ensure that the cancer is completely removed.
Repair of the wound follows once all the cancer cells have been removed. Depending on the size and location on the body, you may need a plastic surgeon.
Though this method has many steps, it preserves as much healthy skin as possible and has the highest cure rate. In comparison to other types of skin cancer, melanoma cannot be identified with faster tissue processing as is done during traditional Mohs surgery. Although it is called ‘Slow’ Mohs, the tissue is actually given high priority in the lab and the special processing is expedited.
Preparing for surgery
On the day of your surgery, wash the area with antibacterial soap before coming to clinic. If the procedure is on your face, do not wear make-up, including eye make-up. Wear comfortable, layered clothing.
You may eat regular meals on the day of surgery, including breakfast. An MP3 player may be used during the surgery. As a courtesy to all patients, we ask that all cell phones and pagers be turned off in the procedure rooms.
Take all routine prescribed medicines, including any prescribed for blood thinning. Medicines that relax you (anti-anxiety) can be taken if given by your referring provider. Bring the medicine with you and take only after you have talked with the surgeon and agreed to the procedure. Do not take them at home. You will need to have a driver if you decide to use these medicines.
If your skin cancer or non-cancerous growth is located around your mouth or lips, you may need to take antibiotics before surgery. Also, if you have had a heart valve replacement, joint replacement, or organ transplant. Please ask your primary doctor about prescriptions before your appointment.
Bring a complete list of current medicines that you take, including dosage. Bring a list of your past and present health problems and surgeries. We need to know of any implanted devices such as a pacemaker or defibrillator.
Relatives or friends may come with you to your appointment. They will need to stay in the waiting room during the procedure. If you are having surgery on the face, especially in the eye area, forehead, or upper cheek, there may be swelling that effects vision. Because of this, or if you plan to take anti-anxiety or prescription pain medicines, you will need a driver.
Day of surgery
When you arrive, you will check in at the registration desk, or a kiosk. In clinic, the staff and the surgeon will discuss your treatment with you. You will be given a local anesthetic to numb the area. The skin cancer will be removed and sent to the pathology lab. The wound may be partially closed with stitches or just bandaged tightly. When the pathology results come back clear, your surgeon will decide what is best to heal your wound. It will depend on the size, location on the body, and what you want.
As with any surgery, there will be instructions to make sure of the best outcome for you. For a few days after surgery, you may have pain, fatigue and swelling which will limit how much you can do. Depending on the body part involved, you will have restrictions for one to several weeks. Your surgeon will talk with you after your surgery.
You will return to the Mohs clinic, a plastic surgeon, or see your local provider to have the stitches removed in usually 1 to 3 weeks. You will need routine follow up skin exams. You may schedule here, with your referring dermatologist, or with your primary doctor. The surgeon will help you decide this. All forms of skin surgery will leave a scar. Most sites heal very well and may take up to a full year. Our clinical staff will answer any future questions or concerns about a scar.
Insurance and billing
If you are being referred under a prepaid insurance program such as Physicians Plus, Dean Care HMO or Group Health Cooperative, please make sure that you have a referral from your regular provider before your appointment here. This will avoid delays.
For UW Health physician billing questions call the UW Medical Foundation at
608-833-6090. For UW Health clinic billing questions you can call
Priceline can give estimates of cost at 608-263-1507.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/05/2013
Copyright © 08/05/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7539
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