Recovering from Mohs surgery on the feet or lower legs? Expert podiatric care can make all the difference in preventing complications and ensuring optimal healing. Let’s work together for better outcomes! 💙 #WoundCare #MohsSurgery #Podiatry #FFLC

Ravnik Singh
Kevin Lam, DPM, FACFAS

Podiatrists frequently encounter patients who have undergone Moh’s surgery for skin cancer, particularly on the lower extremities. Moh’s surgery is a highly precise technique designed to remove cancerous tissue layer by layer while preserving as much healthy tissue as possible. This method is particularly effective for treating basal cell carcinoma, squamous cell carcinoma, and certain types of melanoma, boasting success rates as high as 99%. However, while Moh’s surgery is highly effective in removing cancerous cells, the post-surgical healing process – especially when the wound is left to heal by secondary intention – requires management to prevent complications and ensure optimal recovery.

Wounds on the feet and lower legs pose unique challenges due to reduced blood flow, pressure for infection. Proper wound care following Mohs surgery is crucial in preventing delayed healing, wound breakdown, and infection, all of which can lead to long-term complications. By understanding the healing process and the role of podiatric intervention, patients and healthcare professionals can work together to optimize recovery outcomes.

Key Consideration for Healing After Mohs Surgery

Healing by secondary intention – where the wound heals naturally without surgical closure – can take anywhere from 6 to 12 weeks or longer, depending on factors such as the wound’s size, location, and the patient’s overall health. Typically, the wound should be reduced by at least 50% within the first month; otherwise, it may be classified as chronic and require advanced intervention. Since open wounds are more susceptible to infection, keeping the area clean and following prescribed wound care routines significantly reduces risks and promotes proper healing.

Proper wound care following Mohs surgery includes:

• Keeping the wound clean and dry.
• Applying appropriate dressings to maintain moisture balance and prevent infection.
• Offloading pressure from the wound site, particularly for wounds on the sole of the foot.
• Monitoring for signs of infection, such as increased redness, warmth, or drainage.
• Regular follow-ups with a podiatrist or wound care specialist to assess progress and make necessary adjustments to treatment.

The Podiatrist’s Role in Post-Mohs Wound Care

Podiatrists play a crucial role in managing wounds, particularly for those on the feet and lower legs, where circulation issues and mechanical stress can significantly impact healing. Your podiatrist will assess wound severity, taking into account blood flow, pressure distribution, and overall patient health, to develop an individualized treatment plan.

A comprehensive wound management approach often involves:

• Regular wound debridement to remove nonviable tissue and biofilm that can hinder healing.
• Advanced dressing techniques to maintain a balanced wound environment and encourage tissue regeneration.
• Infection prevention strategies, including the use of topical and systemic antibiotics if necessary.
• Patient education on at-home wound care, proper footwear, and activity modifications to reduce strain on the healing wound.
• Collaboration with other specialists, such as dermatologists, vascular specialists, and plastic surgeons, to ensure comprehensive and coordinated care.

If a wound is slow to heal, your podiatrist may incorporate advanced techniques such as bioengineered skin substitutes, negative pressure wound therapy, or hyperbaric oxygen therapy to accelerate recovery and reduce the risk of complications.

Advanced Healing Approaches for Post-Mohs Wounds

For patients at higher risk of delayed healing – such as those with diabetes, peripheral arterial disease (PAD), or a history of poor wound healing – podiatrists may use advanced wound care techniques to promote faster recovery are biologic dressings applied immediately post-surgery to provide growth factors that accelerate tissue regeneration and reduce complications. They are particularly beneficial for high-risk patients who may struggle with slow healing.

Surgical closure solutions may be necessary in cases where healing by secondary intention is not ideal. Podiatrists may coordinate with surgeons who perform split-thickness skin grafts (STSG) or muscle flaps to promote faster closure and minimize scarring. Preoperative planning, including ensuring graft availability before surgery, allows for same-day or next-day application, expediting the healing process and reducing wound duration.

Regular wound debridement is another key component, as removing nonviable tissue and biofilm enhances recovery, promotes new tissue formation, and minimizes the risk of infection.

Preventing Complications in Post-Mohs Wound Healing

While Mohs surgery effectively removes cancerous cells, the healing journey requires vigilance to prevent complications. Patients should watch for signs of delayed healing, infection, or wound deterioration. Persistent redness, warmth, or swelling can indicate an inflammatory response or infection. Increased pain or tenderness that worsens over time may signal an underlying issue requiring medical attention. Pus or foul-smelling drainage from the wound suggests infection, while wound enlargement instead of reduction over time may indicate poor healing progress. Darkened or necrotic tissue forming at the wound site can be a sign of tissue death and should be addressed immediately by a healthcare professional.

If any of these signs appear, seeking prompt medical attention is crucial. Early intervention can prevent serious complications, such as deep infections or non-healing ulcers, which could require additional surgical intervention.

Mohs surgery is an exceptional technique for eliminating skin cancer while preserving as much healthy tissue as possible. However, post-surgical wound care – especially on the feet and lower extremities – requires careful attention and expert management. Podiatrists play a vital role in ensuring successful healing, using advanced techniques and collaborative care to optimize outcomes. Whether you’re a patient in need of specialized wound care or a dermatologist seeking a trusted partner for post-Mohs recovery, expert podiatric support is available to guide you through the healing journey.

Collaboration Opportunities for Optimal Care

At Family Foot & Leg Center, we remain at the forefront of wound care advancements, integrating research-driven techniques to enhance healing outcomes. Patients who have recently undergone Mohs surgery and have concerns about their wound healing can receive specialized support through personalized treatment plans tailored to their specific needs.

For Patients: If you or a loved one has undergone Mohs surgery on the foot or lower leg and need expert wound care, scheduling a consultation with a podiatrist can help ensure optimal healing. Proper wound management can significantly reduce the risk of complications and promote faster recovery, allowing you to return to your normal activities with confidence.

For Dermatologists: We invite dermatologists to collaborate with us in optimizing post-Mohs wound management. By working together, we can ensure that patients receive comprehensive care, reducing complications and expediting healing. A multidisciplinary approach strengthens patient outcomes and enhances the effectiveness of skin cancer treatment.

If you have recently had Mohs surgery on a lower extremity, don’t hesitate contacting Dr. Singh’s office at (239) 430-3668 (FOOT) or visit www.NaplesPodiatrist.com to schedule an appointment.

Serving Southwest Florida Since 2005, Family Foot & Leg Center has 9 convenient locations throughout Collier, Lee, Charlotte, and Sarasota Counties. Offering pediatric to geriatric family care: Ingrown Toenails, Heel Pain, Bunions, Foot / Ankle Arthritis Pain, Plantar Fasciitis, Foot / Ankle Surgery, Custom Orthotics, and Diabetic Wound Care. In office X-rays, ultrasounds, and minor surgical suite exam rooms. Practice powered by EMR and advanced technologies. Home of the Lam Minimally Invasive No-Scar Bunion Surgery! Come Discover Why Patients Love Our 5-Star Foot & Ankle Care! Same Day Appointments! Easy Online Appointment Scheduling.