Bleeding after Mohs surgery

Every medical procedure, no matter how big or small, has a potential for complications. Although Mohs surgery is considered a minimally invasive, extremely accurate and precise method for removing malignant tumors from the skin, unwanted outcomes can from time to time occur.

“The complication rate for Mohs surgery is actually extremely low,” says Dr. Adam Mamelak, board-certified dermatologist and fellowship-trained Mohs micrographic surgeon in Austin, Texas. “For the majority of patients we see, this procedure is very straightforward, with a smooth and relatively painless recovery.”

Dressing the woundStill, it can be quite frightening to think that you may have a complication after Mohs surgery. Bleeding, in particular, seems to be one of the bigger concerns that patients have.

“Bleeding is actually quite rare after surgery,” says Dr. Mamelak. “Patients can often get some bruising after Mohs, especially when the surgery is performed on the lower forehead or around the eyes. Blood thinners such as Asprin, Ibprofen, Coumadin, Warfarin and Plavix, can all thin the blood and also predispose to bruising after surgery.

It should be noted that Dr. Mamelak recommends all patients check with their surgeon prior to their procedure to determine if they need to stop their blood thinners. Sometimes, the risk of bruising is considered better than what can happen when patients are not on their medications.

If bleeding does occurs, if you notice an ooze or a drip, or your bandage starts becoming red, Dr. Mamelak recommends following these simple steps:

  1. Lie down and apply firm pressure to the surgical area.

After your surgery, a bulky pressure dressing/bandage is typically placed over the wound. It is not recommended to remove this dressing.  Instead, apply pressure with a clean gauze pad directly over top of the dressing that is covering your wound.

  1. Apply direct and constant pressure to the area for 10-15 minutes. Do not stop holding pressure until the full time has elapsed.
  2. If the bleeding continues after 10 minutes, apply pressure to the area for an additional 20 minutes. Make sure the pressure is constant and the gauze is not removed and checked during this time. No PEEKING!
  3. When the bleeding stops, the original pressure dressing may require additional tape to better secure it to the wound.

If the original bandage is soaked from the bleeding, remove it and replace with a fresh bandage.

If a new bandage is applied, it is recommended to apply pressure over the fresh bandage to ensure the bleeding does not start again.

  1. If the bleeding still has not stopped, contact your surgeon for further assistance or instructions.

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If you have questions about Mohs surgery or concerns about your skin surgery procedure, please contact us today!  The physicians at Sanova Dermatology and the Austin Mohs Surgery Center are available to assist you.

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