To make an appointment, call us Monday through Friday, 8:00 am to 16:30 pm on 012 346 4202 or 083 822 6601.

Preparing for your skin surgery

PREPARING FOR YOUR SKIN SURGERY

Dear patient

DO:

  • Do book off the remainder of your day from admission onwards. Due to the variables
    involved your Mohs excision and the reconstruction that follows can be completed as early
    as lunch time or as late as early evening.
  • Do bring something to read or occupy you while you are in the ward.
  • Do always eat a hearty breakfast before 07:00 on the morning of the surgery.
  • Do bring clear fruit juice (apple/grape) to take as sips (alternatively sips of water) until 11:00 or 2 hours before reconstruction in the afternoon. If reconstruction is under local anaesthezia you can eat lunch and drink any fluids as normal.
  • Do BRING ALL your medications in their bottles to show the doctor. Take ALL your regular medicines unless the doctor tells you not to.
  • WEAR ABSOLUTELY NO JEWELLERY. If you're having face surgery WEAR ABSOLUTELY NO MAKE-UP and have your hair pulled back away from the surgery site.
  • Do WEAR slip-on shoes to wear when you walk between the ward and procedure room.
  • Do tell your doctor if you have a cold or don't feel well.
  • Do have someone drive you home from the doctor’s office after the surgery if possible. We can call your ride to pick you up a half hour before you're ready to leave.
  • It's a good idea to use the restroom before surgery. Ask the receptionist to show you the way.

DON'T:

  • Don't consume ALCOHOL (wine, beer, whiskey, ciders) from 5 days before until 3 days after surgery, if possible. Alcohol may cause bleeding.
  • Don't take herbs, vitamin E, niacin, fish oil tablets (omega-3 fatty acids), or non-steroidal
  • anti-inflammatory medicines (Myprodol, Neurofen, Coxflam, Cold medicines, Cataflam-D etc.) as far as possible, for one week before surgery. They can cause bleeding.
  • Don't apply lotions near the surgery site on the day of surgery or the bandages will not stick to your skin.
  • If your doctor has prescribed Aspirin for your heart TAKE THE ASPIRIN AS YOUR DOCTOR SUGGESTED UNLESS YOUR DOCTOR SAYS YOU CAN STOP ASPIRIN FOR 1 WEEK BEFORE SURGERY. Ask your doctor BEFORE stopping aspirin. Over-the-counter Panado can be taken any time when it's needed for pain and/or headaches before or after the surgery because it does not cause bleeding.
  • Don't stop warfarin before surgery but ask your doctor to verify that your INR level is less than 2.5.
  • Don't smoke excessively (it slows healing). It's best not to smoke at all. DO NOT smoke within 2 hours before surgery.

Please ask if you have ANY questions before, during or after surgery.

Except in case of genuine emergency or illness, we require 72 hour notice to reschedule your Mohs appointment, to allow the hospital and other role players to do appropriate scheduling.

Surgery to be performed:
Insignificant, serious, or life threatening reactions may occur to any medicine.

Anaesthesia will be performed using:

  • Lignocaine with/without adrenaline.
  • Bupivacaine (Maicaine) may also be used.
  • Antibiotics may be prescribed post-operatively.
  • Analgesics may be prescribed post-operatively.
    Please inform your doctor on the day of surgery about any prior reactions to any of these medications, or any other relevant allergies.
  • Infection or bleeding can occur after surgery.
  • Sometimes more than one surgical procedure is necessary to remove a large lesion, to remove a lesion in a difficult area, or to obtain the best possible repair of the surgical
    wound and the best possible cosmetic result.
  • When necessary Dr du Plessis will request a specialist reconstructive surgeon to close the defect after the successful removal of the skin cancer with Mohs micrographic Surgery.

Post surgery:
There will be need for a post-operative follow-up for suture removal and wound evaluation. It is best to remain in the local area (if possible) for 10-14 days post-op.

Let the doctor know if you cannot do this. Please phone the rooms following the surgery to set up the suture removal follow-up appointment. If the reconstruction was performed by the reconstructive surgeon, make these arrangements with his rooms.

The wound takes 25 days to become strong. You may need to modify your work and/or excersize schedule to prevent your wound from opening. For the first few days after the surgery there will be swelling and possibly some bruising, which will subside within a few days.

Most patients will receive a prescription for pain medication and/or an antibiotic upon discharge. If you do not receive one, please check with the ward sister/doctor.

Scar Information:

  • All human beings heal by permanent scar formation.
  • Scar tissue is red for 3-6 months or longer, then usually fades to white. Sunlight exposure may cause a scar to darken. Blood vessels (telangiectasia) can form around a surgical site.
  • The appearance of a surgery scar usually continues to improve for 6-12 months as the scar “matures”. The tissues around the surgical site often remains swollen for about one month.
  • Scars overlying the active muscle areas tend to widen (stretch) with time. This cannot
    always be prevented.
  • Scars can heal thick (keloid or hypertropic scar) or can heal thin (atrophic scar). How they heal depends in part upon the location on the body and the healing process of the patient.
  • The final appearance of a scar depends upon many factors including the SIZE, DEPTH, and LOCATION of your cancer. Chances for a good result can be estimated for a given procedure, but can NEVER BE GUARANTEED.
  • If a surgical site is injured before healing is complete, the scar may gape open, the wound may bleed, and the scar may become more obvious. A change of feeling (sensation) often occurs around a scar. In some areas of the body there is a risk of motor nerve damage.

Should there be any uncertainty, kindly ask myself or my receptionist for assistance, phone the practice at 012 346 4202, email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or This e-mail address is being protected from spambots. You need JavaScript enabled to view it or in case of an emergency after hours please phone 083 630 4241.