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Skin cancer can appear literally anywhere on the body and Mohs surgery is considered the most precise and effective way to remove these tumors from the skin. Whether it’s a basal cell carcinoma, squamous cell carcinoma, or another type of skin cancer commonly treated with Mohs surgery, some type of reconstructive surgery is typically needed after the skin cancer is removed.
The Mohs process will leave a surgical defect or wound behind on the skin. Fellowship-trained Mohs micrographic surgeons, like Dr. Adam Mamelak at Sanova Dermatology, are trained not only in the Mohs technique, but also advanced skin reconstructive techniques.
There are a host or considerations when repairing the skin. But sometimes, no matter how skilled or creative the surgeon, it is difficult to pull the skin together, or mobilize skin from the surrounding area to cover and repair the wound. Doing so might impair the skin healing or significantly distort the area. Think about it: if a skin cancer was removed from the nostril, pulling the skin together could cause the nostril to be permanently upturned and appear flared. Fixing a wound on the eyelid could leave a patient with a permanently opened eye.
In these situations, a skin graft can be used. Skin grafts use a piece of skin from another area of your body (ex. behind or in front of the ear, the clavicle or arm, etc.) to cover the wound like a patch.
Skin from another part of the body (known as the ‘donor site’) is carefully selected for a skin graft procedure. The skin has to have a similar color and texture to the area that needs to be repaired and reconstructed (known as the ‘recipient site’). By using skin from another part of the body this can create minimal distortion when closing an area especially on the eyelids, nose and lips.
When a skin graft is placed, it has no blood supply connected to and being fed by the surrounding skin. It’s nutrients are therefore absorbed through the base of the graft until new blood vessels grow into the grafted skin from the surrounding area. Proper post-operative care is critical when this method of closure and repair is chosen to ensure the complete healing.
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