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Risk and Important Reminders

Risks of Surgery

As with any type of surgery there are possible complications and risks which may occur. Because each patient is unique, it is impossible to discuss all the potential complications and risks in this format. The usual risks are discussed below. Dr. O’Donnell will discuss any additional risks associated with your particular case. Please understand that these occurrences are the exception and not the rule.

The defect or wound created by the removal of the skin cancer and it’s underlying roots will be larger than anticipated. This is due to the fact that a skin cancer seen on the surface is actually on the “tip of the iceberg” and frequently more of the tumor is underneath the surface where only the microscope can see. There is no way to predict the final size of the wound prior to surgery.

There will be a scar at the site of the removal. There is no such thing as scarless surgery. We will make our best efforts to obtain optimal cosmetic results. Again, Mohs surgery will leave you with the smallest possible wound, thus creating the best opportunity for optimal cosmetic results. Rarely, an additional revision surgery is needed after Mohs surgery to optimize the cosmetic or functional outcome.

There may be poor wound healing. At times, despite our best efforts, for various reasons (such as bleeding, poor physical condition, smoking, diabetes, or other diseases), healing is slow or the wound may reopen. Flaps and grafts utilized to repair the defect may sometimes fail. Under these circumstances, the wound will usually be left to heal on its own and you will need close follow-up care.

There may be a loss of motor (muscle) or sensory (feeling) nerve function. Rarely, the tumor invades or wraps around nerve fibers. When this is the case, the nerves must be removed along with the tumor. Prior to surgery, Dr. O’Donnell will discuss with you any major nerves which might be near your tumor.

The tumor may involve an important structure. Many are near or on vital structures such as the eyelids, nose or lips. If the tumor involves these structures, portions of them may have to be removed with resulting cosmetic or functional deformities. Furthermore, repairing the resulting defect may involve some of these structures.

Wounds rarely become infected (fewer than 1%), requiring antibiotic treatment. The typical signs of infection are increasing pain, swelling and drainage. If you are at particular risk for infection, you may be given an antibiotic prior to surgery.

There may be excessive bleeding from the wound. Such bleeding will be controlled during surgery. There may also be bleeding after surgery. If you experience bleeding after surgery,
apply firm pressure over the wound with a clean dry cloth or towel for 30 minutes. You will be given detailed written instructions concerning any bleeding after the surgery. Significant blood loss is very rare, but bleeding into a sutured graft or flap may inhibit good wound healing and thus increase the chance for the graft or flap to fail or not “take”.

There may be an adverse reaction to medications used. We will carefully screen you for any history of problems with medications; however, new reactions to medications may occur.

There is a small chance that your tumor may recur after surgery. Previously treated tumors and large, longstanding tumors have an increased chance for recurrence.

Important Reminders

-DO advise us as soon as possible if you must cancel or change your appointment. We do have a waiting list of skin cancer patients. The sooner you notify us of a change in your scheduled appointment the more time we have to schedule someone in your place.

-DO get a good night’s sleep prior to surgery.

-DO stop smoking or decrease as much as possible two weeks before and after surgery.

-DO eat a good breakfast.

-DO take all your usual medications on schedule unless otherwise instructed.

-DO arrive on time for your appointment allowing time for A.M. traffic and parking.

-DO dress comfortably.

-DO ask any questions you might have.

-DO let us know if you take Coumadin, other blood thinners, aspirin or antibiotics prior to surgery.

-DO NOT take aspirin or any other aspirin products two weeks prior to surgery unless otherwise directed.

-DO NOT drink alcohol 24 hours prior or 48 hours after surgery.