Is It Okay for a PA to Do Facial Repair After Mohs?

asked 1 year ago by 221641anon in SC
Latest answer by Andrew Kaufman, MD
Question viewed 418 times
Tags: qualifications, repair, stitches

The dermatologist/Mohs surgeon did the surgery, harvested the graft, and left his PA to do the rest. I know that many PA's may be good at stitching. However, I have a hard time comparing a PA to a dermatologist or plastic surgeon. If this is the routine procedure at this office, would I be better off seeking a surgeon who does his/her own stitching on the face? It seems to me to be more intricate than stitching up any other wound. My graft separated and migrated upward after stitches came out.

7 answers to Is It Okay for a PA to Do Facial Repair After Mohs?

Can a PA do Repair After Mohs Surgery

It is o.k. for a physician's assistant to do the repair after Mohs surgery,... but only if it's o.k. with you. Some physician's assistants probably do very good work, but I would agree with your comment that it's difficult to compare an MD with a PA. Everybody has preferences as to who should do the repair... plastic surgeon, dermatologist, facial plastic surgeon, etc. My own preference is that I would prefer that a fellowship-trained Mohs surgeon (i.e. from the ACMS) or a... more

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon

www.dermatology-center.com

Sewing a skin graft can be done by a P.A. or M.D.

Although I do not have a P.A. in my office, they certainly could do the sewing of a skin graft. P.A.s have been utilized by plastic surgeons to sew the skin after a facelift is done! Experience is a crucial component of the ability for a P.A. to peform excellent work, and the physician is responsible to supervise their work and is responsible for the outcome.

Ronald Shelton, MD
Manhattan Dermatologist

Facial repair after mohs surgery

In my practice, I do not have a PA treat any patient with cancer. This approach is individualized not standardized. If your surgeon has confidence in his or her PA and you have confidence in your surgeon, then that is the key issue.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

www.palmbeachdermasurgery.com

In our office Surgery including stitching is done by MDs

Dermatologists, particularly Mohs surgeons, as well as plastic surgeons have typically both extensive training and experience in all of the issues related to removing a skin cancer surgically and repairing any resulting "defects". This may add up to years of training and experience, even for young practitioners just beginning. It is worthwhile exploring the background, training and experience of any one you choose to allow to do surgery on your face and make sure you... more

Daniel Berg, MD
Seattle Dermatologic Surgeon

Repair after Mohs Micrographic Surgery

Defects after Mohs Micrographic Surgery are typically repaired with sutures which involve buried sutures that are meant to provide strength and hold wounds together and self-dissolving followed by top epidermal sutures that are meant to line up wound edges evenly and should be removed 5-14 days depending on location. While some Physician Assistants or Nurse Practitioners may be well-trained and qualified to perform suturing, dermal/buried suturing particularly on the face and... more

William Ting, MD
Bay Area Dermatologic Surgeon

It may be okay, but....

The PA may do a fine job at your repair, but I would never let a PA do repairs in my office. The level of training is just not there. Now there may be some PAs out there that do good work, but I know that they do not get a lot of training in suturing in their training programs (disclosure: my wife is a PA). In my opinion, I would find someone who does the sewing his/herself. If the doctor is delegating a task as important as facial reconstruction... more

Brent Spencer, MD
Frisco Dermatologic Surgeon

Mohs suturing should be done by a qualified surgeon

221641 anon, A Mohs surgeon is responsible for the surgical removal of tumor and the interpretation of slides to ensure complete margin control. It is possible for other surgeons to perform the repair however if you are going to a Mohs surgeon, you typically expect them to be the ones doing the stitching. While grafts can be placed by a PA, there is some finesse that take place in sewing them precisely into place. I do not have any PAs employed in my practice. The key thing is... more

Kavita Mariwalla, MD
New Haven Dermatologic Surgeon

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