Pre OPERATIVE INSTRUCTIONS FOR MOHS PATIENTS:
ENSURE YOU READ THESE INSTRUCTIONS 2 WEEKS BEFORE YOUR SURGERY
- Completely avoid aspirin, ibuprofen, or any anti-inflammatory medications for 14 days before your surgery. Aspirin thins the blood and interferes with the clotting process and may cause excessive bleeding. Aspirin is included in many over-the-counter drug products such as Alka Seltzer, Bufferin, Excederin, Dristan, or Bayer Cold Tablets. If you require a painkiller in the pre-operative period, the use of Tylenol (acetaminophen) will not affect your blood clotting and surgical procedure.
- If you are on Coumadin, Plavix, or any other prescription blood thinner for abnormal heart rhythm, prior strokes, valvular heart disease, or previous blood clots, consult your family physician or prescribing physician to determine whether it is safe to stop this medication prior to your surgery. In some cases, these medications may be able to be stopped to allow improved surgery. Although surgery can be performed on a formal blood thinner, the excess uncontrolled bleeding may have very negative effects on the final reconstruction.
- All other normal medications should be taken as prescribed. Stopping other normal medications like anti-hypertensive medications may result in the cancellation of your case.
- Maintain your normal intake of food and fluids. Be sure to eat a normal breakfast on the day of surgery. If your surgery is around the mouth, be prepared to eat food that does not require much chewing for the next 1 to 2 days. In some cases, patients are instructed to chew only bite-size pieces of food for approximately 4 weeks after surgery.
- If you are a smoker, please stop smoking prior to your surgery or reduce you smoking as much as possible for at least 2 weeks prior to surgery and for at least 6 weeks after surgery. It has been well proven that smokers have a much higher rate of post-operative infections and death (necrosis) of tissues moved in the process of reconstruction than that of the non-smoking general population. Due to this fact, all smokers are instructed to stop smoking or dramatically reduce their smoking prior to and after cancer surgery.
- Do not drink alcohol for three days before and after your surgical procedure. Alcohol thins the blood adding additional unrequired complexity to your care and may adversely affect your final results.
- Wash your hair the night before or morning of the day of surgery if your cancer or surgical procedure will be performed within or next to the hair-bearing scalp.
- Please bring a bag lunch. A small refrigerator is available in the patient waiting room. Coffee, tea, and a water cooler are available for patients.
- Wear comfortable clothes, which do not have to be pulled over your head after the operation. Avoid wearing light-colored clothing or fine linens.
- Please do not wear makeup if the planned surgery is on your face.
- Arrange to have someone accompany you home after the procedure as the post-operative swelling and surgical dressings may partially obstruct your field of view and you may be instructed not to drive a vehicle. Additionally, you may require a sedative for anxiety on the day of surgery and you will not be allowed to drive or navigate home independently.
- Parking is available underneath the Skin Care Centre with access from the back lane. Park in a space designated for patients (parking in a 24-hour reserved space may result in your vehicle being towed). Each parking space has a designation number. Once your vehicle is parked, pay at the meter on the first level of the parking garage (P1). You do not need to place your ticket in the vehicle as payment is made for the specific space number. Of course, this prohibits in-and-out privileges. Currently, daily parking rates are the best in the area.
- If you do not live in the lower mainland, you will likely need to stay in Vancouver the night before your surgery given the early start. You may also wish to spend the night after your procedure in Vancouver. Accommodation information can be obtained from our office.
- Expect your surgery to last between 6-10 hours on average. Some surgical cases can be much longer based on the cancer type, tumor size, and complexity of your reconstruction. Much of this time is spent waiting. To alleviate the boredom, please bring reading material, etc.
- You will be required to sign an operative consent form so that surgery can be conducted. This form includes a photographic consent where photos may be included in your chart or used in education of physicians. Dr. Cowan will do everything possible to conceal your identity if your photographs are needed. Your name will never be used in association with the photographs beyond those in an electronic medical record and thanks you for your cooperation.
- You may require the following items for use post-operatively. The specific items required for care of your wound will be discussed at the time of your reconstruction by the nursing staff.
- Polysporin or prescribed Fucidin or Bactroban Ointment
- Normal saline (the nursing staff can instruct you how to make this yourself)
- Dressing materials (you will be advised further on the day of surgery by the discharging nurse)
Preparing for Mohs Surgery
To learn more about preparing for Mohs surgery watch this informational video with Dr. Cowan