Wound Closure 10 Days After Mohs Surgery?

The beauty of Mohs surgery is that there is confidence that all of the skin cancer was removed at the time of surgery without waiting. My own personal experience is that I coordinate with the Mohs surgeon to send the patient to my plastic surgery office immediately following the Mohs surgery for me to do the reconstruction.

You might want to ask the specific reasons why this answer was given.

I am not sure why you are waiting 10 days. The only reason I can see is the final pathology report. The wound can be closed and if the margins are positive again then you will need more surgey to remove the remaining part of the tumor.

I would agree with Dr. Hruza. Best option is to ask your doctor exactly why he is delaying repair of the defect. If the defect is particularly deep or there is exposed bone, he may want to wait for sufficient granulation tissue to develop before placing a graft. The possibility that he is waiting for a final pathology report before repairing is less of a possibility as generally the surgical margins are determined on the same date (exceptions perhaps being some unusual types of skin cancer). Good luck.

the value of Mohs surgery is that when the margins are clear and the surgery is completed then you can be closed in the office.  There are times when you may need to heal before closure but these are few specific cases.

Step #1 Find out if your dermatologist is a fellowship-trained Mohs surgeon. If not , I would recommend you seek a second opinion by a fellowship-trained Mohs surgeon. Got to mohscollege.org to see who in the area is certified. They will be able to examine your case , your notes and see what is going on. If your surgeon is fellowship-trained then you need to get a better understanding of what they are thinking and what they see that concerns them that their margins were not clear. In any event some clarification is needed since you seem to be confused and possibly rightfully so.

 

There are a couple of possible reasons to delay repair: 1. The surgeon sent the final specimen to a pathologist for permanent sections to confirm the negative margin, 2. The surgeons wants to repair the Mohs defect with a delayed skin graft. Waiting for 10-14 days before graft placement improves the wound bed to enhance the chance for graft take and allows for some filling in of the wound bed to improve the final contour.