Skin Graft After Mohs Surgery Split Open About 4-5mm the Day After Stitches Came Out

I had Mohs surgery near the corner of my eye for basal cell lesion 9 days ago. The nurse took stitches yesterday. She warned that if I rubbed it too much, the skin might come of. That got my attention! I've been VERY careful but I was washing my face this morning with just my hands as gently as possible and avoiding getting near my eye. I felt a bit of pain and looked in the mirror. The front edge of the graft is split 4-5 mm and I can see down into it. It looks grayish. Should I worry?

Doctor Answers 6

Skin graft healing after Mohs Surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Always contact your surgeon if there is any question about wound healing. Sounds like you may experience a minor wound dehiscence or partial graft necrosis. This is typically fine and should healed with decent cosmetic outcome, particularly along eyelids. Your surgeon may choose to apply steri-strip along the edge that may be partially split for a peace of mind.

Bay Area Dermatologic Surgeon
4.5 out of 5 stars 14 reviews

Skin grafts may develop different colors

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If you have a concern about the skin graft, you can see your doctor for reassurance. If part of the graft is not doing as well as the other, it will need time to declare itself and there's not much that can be done, aside from having the doctor follow with you, avoid smoking and second-hand smoke, and use an appropriate ointment of the doctor's preference. Some grafts turn quite dark and do well, but some grafts turn very dark and hard and eventually slough away, part or all of the graft. In that event, the residual wound is allowed to heal with ointment and then determine the outcome several months after, provided there is no more immediate concern because of eyelid function. So see your doctor for an accurate evaluation of your condition.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Graft is gray

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

First let your surgeon know- and go back and show them if possible. Second do not worry- if the rest of the graft is pink and only that area is "gray" then it should heal in by itself over time. Keep everything clean.

Call your Mohs surgeon....

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I would call your Mohs surgeon and let him/her know.  If this were my graft, I would want to see it if it is gray.  It may just be some superificial epidermal slough (not to uncommon with grafts), but worst-case scenario, the graft may not be taking.  The good news in the area in question tends to heal in very well by second intention (i.e. doing nothing); therefore, you may be ok. 

Nevertheless, call your Mohs surgeon, and get him/her to look at it.

Brent Spencer, MD
Frisco Dermatologic Surgeon

Skin graft care after Mohs surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

If there is a change in your skin graft or loss of sutures you should show this to your surgeon. In is not uncommon for certain areas of a graft to not take and still get an excellent cosmetic result.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

Best to call your doctor

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Grafts can be tricky, but nature has a great way of healing wounds.  It is possible that the wound will still end up healing well, but it is important to show your concern to your surgeon.

Jeffrey Ellis, MD
Long Island Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.