Mohs Surgery on my Scalp, Multiple Questions?

1. will the quarter size hole heal by itself? i do not want a skin graft. 2. should i use a rx ointment r is vaseline or an antibiotic just as good. 3. can i leave the contry on sept 27th? i asked my doc all these questions but he was not very helpful.

Doctor Answers 3

Mohs surgery wound care and healing

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Following removing the cancer with Mohs surgery, patients can heal either with stitching (a closure, flap or graft) or by letting it heal on its own, which sounds like what was selected in your situation. Generally, I make this decision with a patient and discuss the pros and cons of each and then we select what seems the most appropriate for the patient. Healing on its own is a good option for the scalp if the patient does not want to limit their activity afterwards which stitching would require. The downside to healing on its own, is that it takes a very long time to heal. Generally speaking, I have my own patients who choose this option, keep the wound covered with vaseline or any ointment as studies show no difference between healing with vaseline versus a topical antibiotic. As to whether you can leave the country, generally, I advise my patients to make sure they are not traveling in the post-operative period because if they have any issues, I like to see them right away. I would discuss this with your Mohs surgeon. 

Stamford Dermatologic Surgeon
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Healing after Mohs on scalp

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1. Quarter-sized defects from Mohs can be left to heal on their own or they can be sewn up.  If left to heal by secondary intent (on its own) it will take longer to heal (typically many weeks) but no sutures will be needed.  If it is sewn back together, those sutures can be removed typically within two weeks and ideally no further wound care will be needed.  2. Using Vaseline is fine and it's less costly and less likely to result in an allergic response.  3.  Leaving the country....I would ask your doctor if the site has healed enough for this to happen.  Ideally you want to be healed up before you travel especially if travelling abroad. 

Mohs surgery on my scalp, many questions

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Most often I would say I leave Mohs sites on the scalp to heal on their own, which is called by secondary intention. There's not a lot of give in the scalp, so stitching can be rather difficult, making secondary intention usually the preferred method with Mohs. I prefer my patients use either Vaseline or Polysporin on the site post surgery. I ask patients to clean the site with 1/2 water and 1/2 peroxide a few times a day, goop up the site well, and cover it as needed. Don't let the area scab up. I don't know why you are leaving the country, how long you will be gone, or where you plan to go. I would be worried if you are, like traveling to a third world country, or hiking mountains, but as long as you are going somewhere civilized where you could get care if you needed it, I wouldn't necessarily restrict travel.

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