Treatments: Mohs Micrographic Surgery

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What is Mohs Micrographic Surgery?

Mohs surgery is a highly specialised surgical technique to remove certain skin tumours. It offers the following advantages:

 

	A morphoeic basal cell carcinoma at the medial canthus		The appearance immediately following a Mohs micrographic excision of the tumour showing that the margins of the tumour were poorly defined by clinical examination alone.		The appearance 3 months following oculoplastic reconstruction using a skin graft from the upper inner arm.

Why is it necessary to travel to another hospital in Manchester for this treatment?

The Mohs surgeon for this region is Dr. Nick Telfer who is a Consultant Dermatologist based at the Dermatology Department of Hope Hospital, Salford. He is one of very few doctors in this country who have received specialist training in Mohs surgery. His role in your management is to remove the tumour. Once this has been done you will transfer to the Face & Eye Clinic Manchester (or to Manchester Royal Eye Hospital depending on arrangements made in your particular case) where you will undergo surgery for the reconstruction of the defect left by the Mohs surgery. This will normally take place the same day.

What will Dr. Telfer do?

Dr. Telfer will inform you of when and where your Mohs surgery will take place. This procedure is performed under a local anaesthetic and the removal of the tumour takes place in stages. There is a waiting period between each stage of approximately 1 hour during which time you will be resting in a waiting area, with a temporary bandage in place. Do not eat or drink anything from 9.00 a.m. (at least 6 hours before your planned reconstructive surgery at the Face & Eye Clinic Manchester where your reconstructive surgery will be performed under local anaesthesia with intravenous sedation by an anaesthetist).

The procedure may take anything from 1 hour to most of the morning to perform, and once the procedure has been completed you will transfer to the Face & Eye Clinic Manchester.

We would like you to be as comfortable as possible while you are waiting in between stages, so you might like to:

a) Bring something to read b) Bring a friend (but not the whole family!)

What will happen when I arrive at the Face & Eye Clinic?

You will be seen by the nursing staff initially. The surgical wound will be carefully examined by your surgeon to determine precisely what type of reconstructive surgery will be required. This will be discussed with you. This will usually be performed under a local anaesthestic in the operating theatre. If you wish, the anaesthetist who will be monitoring you during the surgery will give you some sedation to help you relax. Very occasionally, if the defect is very large, this surgery will be performed under general anaesthesia at a local private hospital instead. This will be discussed with you. Admission to hospital is not necessary if local anaesthesia only is required but if admission to hospital is required because you live some distance away, or you live alone, or because you would prefer to, please bring an overnight bag so that you are prepared to stay with us if necessary.

What will happen following the surgery at the Face & Eye Clinic?

You will be discharged home within an hour of the completion of the surgery. Pressure dressings over the eye along with a bandage around the head may be kept in place for a few days and arrangements will be made for you to attend the clinic a few days to a week later for the dressings to be removed and sutures to be removed if required. If you have any queries about the reconstructive surgery arrangements at the Face & Eye Clinic please leave a message for Mr. Leatherbarrow's secretary at the contact address below:

Spire Manchester Hospital Russell Road Whalley Range Manchester M16 8AJ Tel: 0161 232 2435 Fax: 07092 016718 E-mail: info@eyelidsurgery.co.uk Or at: The Face & Eye Clinic 2 Gibwood Road Northenden Manchester M22 4BT Tel: 08458 332233 E-mail: enquiries@faceandeye.co.uk

Unless you have been told otherwise please do not use aspirin or any aspirin containing medications for at least 3 weeks prior to the surgery. This may include a number of arthritis medications. If in doubt please ask.

Please Note:

If you are insured it is important that you clarify in advance with your insurance company the level of reimbursement they will allow for this surgery. Unfortunately, some insurance companies grossly under-estimate the expertise and time required for this type of treatment and leave patients with a shortfall. We will be happy to provide your insurance company with details of your proposed treatment along with a quote of the costs.

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