Mohs Skin Cancer Surgery Chelmsford

Mohs surgery, developed in the 1930s by Frederic E. Mohs, is a microscopically controlled surgery used to treat both common and rare types of skin cancer. During the surgery, after each removal of tissue and while the patient waits, the tissue is examined for cancer cells. That examination dictates the decision for additional tissue removal for any residual cancer cells. Mohs surgery is used for high risk selected facial skin cancers, basal cell carcinoma (BCC) being the most common, and is the gold standard that has the lowest recurrence rate and the significant advantage of confirming the tumour is removed before the reconstruction (usually done on the same day). It may also simplify the reconstruction and potentially reduce the amount of scarring.

The Mohs process examines 100 percent of the tissue margins under the microscope, whereas in standard surgical excision only assesses cross-sections through the removed tissue (which is about 1 percent of the margins, from which clearance of the tumour is estimated). Mohs surgery also conserves healthy tissue, giving you the smallest scar possible

The local anaesthesia injection is generally the most painful part of the experience. Once the area is numb, you may feel some touch or pressure sensations as the surgeon works, but removing the first specimen takes only a few minutes. Tissue processing usually takes an hour or two, though, so you may want to bring a book or magazine to pass the time, and make sure your phone is fully charged.

Mohs surgery is a complex procedure with significant infrastructural and staffing requirements. Not only the relevant out-patient  & in-patient surgical suites, but also a Mohs laboratory are required. Staff included in the procedure would include the Mohs surgeon, and when required other specialists such as Plastic, Oculoplastic or Maxillofacial Surgeons, the nursing staff and specialist Mohs laboratory biomedical sicentists and technicians.

It can take a full day for the procedure, where the skin cancer is removed in stages, with reconstruction being performed later, possibly after a long break. Because some tumours are  much larger than they first appear, it can take many stages to fully remove the tumour, in which case the reconstruction may not be completed until late afternoon, or even later. Rarely, the procedure has to be continued on a subsequent day.

There will be a follow up appointment a week later for wound care. Exertional physical activity (such as exercise, swimming, etc) should be avoided  until wound review to minimise the risk of post-operative complications and poor wound healing.

You can use your private medical insurance. We would always recommend that you check with them regarding your cover and please note that some insurance companies will not renumerate more than one lesion per day, for those patients that have more than one lesion needing Mohs surgery.