Timothy L. Parker, MD
Thomas L.H. Hocker, MD

ADS Ambulatory Surgery Center

Connected to Advanced Dermatologic Surgery is the Medicare-approved and state licensed ADS Ambulatory Surgery Center. This is an outpatient ambulatory surgery center used exclusively by our physicians for reconstruction procedures following Mohs surgery. By having this separate facility for reconstruction, we can provide a safer and more specialized environment for surgical repair. The surgery center’s two operating rooms are fully equipped with all components required by the state to safely perform the most complex outpatient reconstruction procedures if needed. They also provide a setting that greatly reduces your chances of infection and complications, and therefore increases your likelihood of a good outcome.

Once our physicians have determined microscopically that all of the skin cancer has been removed, you will be brought back into the procedure room where we will discuss with you the best way to treat the wound resulting from your surgery. At this point, the questions on most patients’ minds are...

Will my surgery leave a scar?
Yes. Any form of treatment for skin cancer will leave a scar; however, because Mohs surgery removes as little healthy tissue as possible, scarring is minimized. Immediately after the cancer is removed, our physicians will choose the safest method of repair to provide the best cosmetic result.

What if I require reconstruction?
In most cases, reconstruction will provide you with the best outcome. When this is the case, you will be prepared for the surgery center. You will be required to wear a surgical gown (usually over your clothes, depending on the location and type of reconstruction), surgical cap and booties over your shoes. It is best if you wear a button-up shirt that is easily removed so that this can be done before you get into the gown. You will then be taken into the surgery center by one of our clinical staff. When in the surgery center, a blood pressure cuff will be placed on your forearm and a sensor clipped onto your index finger to monitor your pulse, oxygen level and blood pressure. Just like with the Mohs portion, we will use local anesthetic and you will be awake. A small surgical drape will be placed over the area just before the surgery begins. This drape can be adjusted as needed.

In a few cases, allowing the area to heal by itself without surgical reconstruction is the best option, because in some anatomic locations natural wound healing results in a better cosmetic outcome than by surgical intervention. In other cases, the tissue-sparing benefits of Mohs surgery allow removal of the skin cancer with a resultant wound so superficial that there is no need for further repair. If the area is allowed to heal by itself, it will usually heal within 3 to 8 weeks, depending upon the size, depth and location of the wound.

If you do require reconstruction, our physicians have undergone extensive training in the area of reconstruction after Mohs surgery, and have gained expertise in repairs, particularly those in the facial areas. Depending upon the size, depth and location of the removed skin cancer, we may choose to repair the wound with stitches, staples, a skin graft or skin flap in order to provide the best cosmetic result.

Will I experience pain?
Most patients do not complain of uncontrolled pain after surgery. If there is discomfort, Tylenol® or Tylenol 3® provides excellent relief. Avoid taking aspirin-containing medications the first few days after surgery (these include aspirin, Aleve®, Ibuprofen, Advil®, etc.) as they may cause bleeding. If you take the medication for blood-thinning purposes per your doctor’s order and you have been instructed to discontinue it for your surgery, you may begin taking the medication the day after your surgery. Do not stop your blood-thinner unless specifically instructed by our office to do so. If necessary, a prescription for pain medication and/or antibiotic will be given to you when you are given your instructions following the surgery.

Will I have any limitations on activities?
Each repair has its own unique restrictions, but generally we ask that you do not:

What about follow-up care?
Usually at least one return visit with one of our clinical staff members will be needed to examine the healed area or to remove stitches. Some patients are also scheduled for post-operative visits with one of our physicians.

Whether your wound is allowed to heal or it requires reconstruction, you and your companion at the appointment will be given oral and written instructions on daily wound care in order to prevent infection and to promote healing for the best cosmetic result. A follow-up appointment will be scheduled to remove the stitches or staples (if necessary), and to monitor the healing process before you leave on the day of your surgery. Your insurance may require us to collect your copay (if you have one) for follow-up appointments. But, generally a follow-up is covered by your insurance in the cost of surgery.

Once you have been released from our care, you should return to your referring physician for routine check-ups. A follow-up period of five years for the treated cancer is essential. After having skin cancer, statistics show that you have a much higher chance of developing additional skin cancers. You should have your skin checked by your physician at least once a year, not only to examine the treated area, but also to check for new cancers.