I had MOHS surgery 3 weeks ago and am left with this large hole. Is this normal? (Photo)

Question

I had dissolving stitches put in which dissolved. The hole looks very raw. Something seems off about this?

John Louis Ratz, MD · Answer

When a sutured wound opens up, it's called a dehiscence. You have 2 reasonable choices. One is to return to your Mohs surgeon. The second is to take care of the wound yourself. In order to get this to heal properly, you need to do the following. Clean the wound thoroughly with sterile normal saline until you get down to normal appearing pink tissue. If it starts bleeding, that's not necessarily a bad thing, because bleeding will foster the growth of granulation tissue which is rich in blood vessels and is capable of filling the wound all the way to the surface. Apply Vaseline to the wound and cover the wound with a non-stick bandaid. Clean the wound daily with the saline and Q-tips and do not leave behind any yellowish material. Re-cover the wound as before. When the granulation tissue gets to just below the skin surface, confine your wound care to gentle dabbing of the wound with a gauze pad moistened with the saline and re-cover the wound. This will allow new skin to cover the wound from the outside edges to the central part of the wound and contract the wound at the same time. This should be completed very quickly and the wound will be pink but smaller and level with the rest of the skin in that area. At that point it's OK to keep the wound uncovered.This process will leave you with a normal appearing area once the pinkness fades away. This is called second intention healing and more often then not will result in the area appearing pretty much normal. Most doctors doing Mohs surgery have no training or experience with this. No antibiotic ointment is necessary and is actually warned against by the CDC.Why don't more or even all Mohs surgeons utilize this form of healing?? Well, as one Mohs surgeon once told me: "We repair EVERYTHING! Ya know why? Ya don't get paid for letting it heal"!!Good luck.                     jlr

Amy Y. Paul, DO, FAAD · Answer

Thanks for the photo.  Hopefully by now, things are healing nicely.  If you keep the area clean and moist with plain ointment such as Vaseline or Aquaphor, and covered if it is going to rub on glasses or anything else, you have a high likelihood of having a very good cosmetic outcome.  If you are worried about the wound, I would go back to your surgeon and have them just give it a check.  Best of luck!

F. Victor Rueckl, MD (in memoriam) · Answer

Basically the site wasn't fully healed when the stitches dissolved. Sometimes this happens, which is why I don't personally like only dissolvable stitches, but will nearly always put in a regular stitch or two as well. On the nose it can be very hard to close the site and keep it closed. Some surgeons will opt for healing by secondary intention which is where specific steps are followed and the site will cover over and close up by itself. The key is that you have to keep the area very clean, moist, and well gooped up. You do not want it to get scabs or crusts on it. If you are concerned or don't know what to do, I'd follow up with your surgeon. If you can follow the protocols and cleaning steps it will heal up just fine. "This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

I had MOHS surgery 3 weeks ago and am left with this large hole. Is this normal? (Photo)

Answers (3)

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I had MOHS surgery 3 weeks ago and am left with this large hole. Is this normal? (Photo)

Answers (3)

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Recommended reading

Everything you need to know about Mohs Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.