How to Prepare For Your Surgery Day
· Ensure that you have completed the Health History form and sent in a photo of your lesion(s) at least one (1) week prior to the date of your surgery. If you require assistance with this, please call our office at (403) 700-0110 or send an email to info@calgaryskincancer.com. Please note that you are welcome to walk in anytime during our business hours, Monday – Friday between 8:00 AM – 4:00 PM and we will take your photo for you and you can fill out the Health History form at reception.
· Please arrange for a ride to and from your surgery. The College of Physicians and Surgeons of Alberta’s guidelines for Non-Hospital Surgical Facilities state that patients are NOT to drive themselves to and from any surgical procedure.
· We strongly encourage you to eat breakfast on the morning of your surgery and to bring snacks/lunch with you, unless you have been instructed otherwise.
· Wear clean, comfortable, loose-fitting, low-linting clothing that is washable; please avoid wearing white if you can. Ensure that you wear layers that can be added or removed should you feel too warm/too cold.
· Plan to be at Calgary Skin Cancer Centre for approximately 6-8 hours when you are here for your surgery. We recommend bringing books/magazines, a laptop/tablet, crossword puzzles, etc. to help pass the time.
· Do not smoke or use tobacco for one (1) day prior to your surgery and for three (3) days after surgery.
· You can take all of your regular medications that are prescribed to you. The only medication that we ask you to stop is Aspirin (including Baby Aspirin); if you are taking Aspirin or Baby Aspirin on a daily basis, please stop taking it for five (5) days prior to your surgery. If you are on blood-thinners (such as Warfarin, Coumadin, Plavix, Pradaxa and Xarelto), you can continue taking them as directed by your regular doctor.
· If you are on oxygen therapy, please bring enough supply for a minimum of eight (8) hours.
· If there has been any change in your medical status, medications, or if you have been hospitalized within the week prior to your surgery, please let us know as soon as possible.
· Please do not leave Calgary Skin Cancer Centre until you have been discharged by Dr. Guillemaud and/or one of our nurses.
· We require a minimum for 48 hours’ notice if you wish to cancel or reschedule your surgery.
What To Expect When You Arrive For Your Surgery
You will arrive at your scheduled appointment time for check-in and will be greeted by our surgical coordinator and asked to review the consent form.
You will also be asked to provide the contact information for your ride.
Then you will be taken back to our surgical waiting area where you will be provided with coffee, water and tea.
One of our nurses will bring you into a surgical suite where you will be prepped for your surgery. This will include a discussion of your diagnosis and the planned treatment, and details of the surgery and expected outcomes. You will have the opportunity to ask any questions as this time.
After you consent to surgery, local anesthetic will be injected so that you are comfortable during the procedure. The first layer will be taken, and you will be sent back to the surgical waiting area.
While you wait, Dr. Guillemaud will analyze the tissue that she removed and determine whether or not you will need to have another layer of skin removed. This takes approximately 90 minutes each time. Most patients require an average of 2-3 layers of excision.
Once all of the cancer has been removed, Dr. Guillemaud will then complete the repair (reconstruction) of your surgical defect. This takes approximately one (1) hour.
You can expect to be at Calgary Skin Cancer Centre for approximately 6-8 hours on the date of your surgery.
CLICK HERE to learn more about the Mohs Procedure.
Reconstruction
Our primary goal with Mohs Micrographic Surgery is to clear your skin cancer. Once this has been achieved, Dr. Guillemaud will assess the defect and determine the options available to you for reconstruction of the area. While Dr. Guillemaud is the expert, it is a collaborate decision between the Surgeon and Patient as to the type of repair that is done.
Some types of repairs require more care on the patient’s end and may not be suitable options. Dr. Guillemaud has extensive training in facial reconstruction but may look to another surgeon for help with a more complex repair that would require sedation or general anesthetic.
Sometimes this is planned prior to the Mohs Surgery, but other times, it is not determined that another Specialist is required until the removal of the tumor when the extent of the tumour is more than predicted.
Depending on the size, depth and location of the defect, one of the following options for reconstruction are chosen:
· A small wound may be allowed to heal on its own (secondary intention). This requires a fair amount of wound care on the patient’s part for several weeks after the removal.
· Simple wounds can generally be closed with sutures by advancing the two sides of the incision together either on the surface of the skin or underneath using dissolving sutures.
· Larger wounds may require loosening and rotating tissue from a near by area to cover the wound. This is called a rotation flap. Skin may be borrowed from somewhere else on the body to cover the wound, which is known as a skin graft. Generally, the donor tissue is harvested from behind an ear, lower abdomen or collarbone area, depending on the size of graft required.
· If the defect is anticipated to be large or if the tumour is found to be much more extensive then expected, the patient may be referred offsite to another Specialist for reconstruction (Plastic Surgeon). This may be arranged beforehand but sometimes may have to be arranged at the time of Mohs or shortly thereafter. All information regarding this will be communicated to you.