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Dermatologic Clinics Jan 2023Mohs micrographic surgery (MMS) is widely accepted as the gold standard for skin cancer cure, and properly trained surgeons who carry out this procedure are experts in... (Review)
Review
Mohs micrographic surgery (MMS) is widely accepted as the gold standard for skin cancer cure, and properly trained surgeons who carry out this procedure are experts in the science and management of skin cancer. There are many potential pitfalls and challenges that a surgeon may encounter while carrying out MMS, and these can increase the likelihood of tumor recurrence and increased patient morbidity. With precise surgical technique, careful tissue handling, and laboratory processes that safeguard against errors, this procedure can provide excellent cure rates for most skin cancers, including melanoma, while maximizing tissue conservation in a low-cost outpatient clinical setting.
Topics: Humans; Mohs Surgery; Neoplasm Recurrence, Local; Skin Neoplasms; Melanoma
PubMed: 36410982
DOI: 10.1016/j.det.2022.07.006 -
Facial Plastic Surgery Clinics of North... Aug 2017Mohs micrographic surgery is a specialized form of skin cancer surgery in which the Mohs surgeon acts as both surgeon and pathologist. The procedure is characterized by... (Review)
Review
Mohs micrographic surgery is a specialized form of skin cancer surgery in which the Mohs surgeon acts as both surgeon and pathologist. The procedure is characterized by its histopathologic margin control and ability to spare tissue, particularly in cosmetically sensitive locations. Mohs surgery is known for both limiting the size of the final defect and its high cure rate. In this review, the authors highlight indications for the procedure, detail the technique itself, discuss cutaneous tumors for which Mohs micrographic surgery is indicated, and present the economic benefit of Mohs surgery.
Topics: Humans; Mohs Surgery; Preoperative Care; Skin Neoplasms
PubMed: 28676157
DOI: 10.1016/j.fsc.2017.03.002 -
American Family Physician Sep 2005Mohs micrographic surgery is an approach to skin cancer removal that aims to achieve the highest possible rates of cure and to minimize the size of the wound and... (Review)
Review
Mohs micrographic surgery is an approach to skin cancer removal that aims to achieve the highest possible rates of cure and to minimize the size of the wound and consequent distortions at critical sites such as the eyes, ears, nose, and lips. Mohs micrographic surgery is a two-step, same-day procedure performed with local anesthetic. It involves removing the tumor in stages by histologically confirming clear margins on frozen sections and by addressing the resultant defect. Options for healing include second intent, primary closure, local flaps, interpolation flaps, and grafts. Larger tumors may require referral for reconstructive surgery. Mohs micrographic surgery is the treatment of choice for skin tumors in critical sites, large or recurrent tumors, tumors in sites of radiation therapy, and tumors with aggressive histologic features.
Topics: Humans; Mohs Surgery; Skin Neoplasms
PubMed: 16156344
DOI: No ID Found -
Journal of the American Academy of... Jul 1998Mohs micrographic surgery (MMS) is a specialized type of minimal marginal surgery that offers cure rates superior to other options in the treatment of contiguous skin... (Review)
Review
Mohs micrographic surgery (MMS) is a specialized type of minimal marginal surgery that offers cure rates superior to other options in the treatment of contiguous skin cancers in selected settings. Developed by Dr. Frederic E. Mohs, the technique originally required in situ tissue fixation before excision. Most Mohs micrographic surgeons now use the fresh tissue technique exclusively. Horizontal frozen histologic sections of the excised tumor permit more complete microscopic examination of the surgical margin than traditional methods. Residual tumor is graphically mapped and malignant extensions are pursued with staged excisions until the tumor is removed. Maximum sparing of tumor-free adjacent tissue is achieved with histologic mapping of the tumor boundaries, thus optimizing subsequent wound reconstruction. The history, techniques, indications, cure rates, and current controversies of MMS are reviewed.
Topics: Carcinoma; Dermatologic Surgical Procedures; Freezing; History, 20th Century; Humans; Keratoacanthoma; Melanoma; Mohs Surgery; Neoplasm Recurrence, Local; Neoplasm, Residual; Plastic Surgery Procedures; Skin; Skin Neoplasms; Tissue Fixation
PubMed: 9674401
DOI: 10.1016/s0190-9622(98)70405-0 -
Ugeskrift For Laeger Feb 2017Micrographic surgery is currently the only technique which ensures complete removal of basal cell carcinomas. The major limitation is the high set-up cost, which is... (Review)
Review
Micrographic surgery is currently the only technique which ensures complete removal of basal cell carcinomas. The major limitation is the high set-up cost, which is particularly connected with specialized training of surgeons, technicians and the set-up of a histology facility for frozen tissue sectioning and staining. In the long run, however, the cost of Mohs surgery per patient does not exceed that of conventional surgery. The technique is very safe and has multiple advantages over any other treatment modality. It achieves the highest cure rates, it is minimally invasive, it is tissue-sparing and it enables the optimal closure of the surgical defect. Mohs surgery is cost-effective, especially when dealing with poorly demarcated, high-risk, facial tumours, where it should be considered as the first choice of treatment.
Topics: Carcinoma, Basal Cell; Facial Neoplasms; Humans; Mohs Surgery; Skin Neoplasms
PubMed: 28397683
DOI: No ID Found -
Dermatologic Clinics Apr 2011
Topics: Dermatology; Humans; Mohs Surgery; Skin Neoplasms
PubMed: 21421138
DOI: 10.1016/j.det.2011.02.009 -
Cutis Apr 2023The lips are commonly affected by skin cancer because of increased sun exposure over time. Even with early detection, many of these skin cancers require surgical removal... (Review)
Review
The lips are commonly affected by skin cancer because of increased sun exposure over time. Even with early detection, many of these skin cancers require surgical removal with subsequent reconstruction. Mohs micrographic surgery is the preferred method of treatment for nonmelanoma skin cancers of the lip, as it has the lowest recurrence rates and allows for the maximum preservation of healthy tissue. After surgery, the remaining lip defect often requires reconstruction with skin grafts or a local cutaneous or myocutaneous flap. There are several local flap reconstruction options available, and some may be used in combination for more complex defects. We provide a succinct review of commonly utilized flaps and outline their indications, risks, and benefits.
Topics: Humans; Mohs Surgery; Lip; Plastic Surgery Procedures; Surgical Flaps; Skin Neoplasms
PubMed: 37289682
DOI: 10.12788/cutis.0743 -
The Journal of Dermatologic Surgery and... Mar 1993
Topics: Clinical Competence; Mohs Surgery
PubMed: 8141858
DOI: 10.1111/j.1524-4725.1993.tb00348.x -
Journal of Cosmetic Dermatology Jun 2022
Topics: Carcinoma, Basal Cell; Humans; Mohs Surgery; Rosacea; Skin Neoplasms
PubMed: 34510704
DOI: 10.1111/jocd.14454 -
Mayo Clinic Proceedings Aug 2017The incidence and diagnosis of cutaneous malignancies are steadily rising. In addition, with the aging population and increasing use of organ transplant and... (Review)
Review
The incidence and diagnosis of cutaneous malignancies are steadily rising. In addition, with the aging population and increasing use of organ transplant and immunosuppressive medications, subsets of patients are now more susceptible to skin cancer. Mohs micrographic surgery (MMS) has become the standard of care for the treatment of high-risk nonmelanoma skin cancers and is increasingly used to treat melanoma. Mohs micrographic surgery has the highest cure rates, spares the maximal amount of normal tissue, and is cost-effective for the treatment of cutaneous malignancies. As in other medical fields, appropriate use criteria were developed for MMS and have become an evolving guideline for determining which patients and tumors are appropriate for referral to MMS. Patients with cutaneous malignancies often require multidisciplinary care. With the changing landscape of medicine and the rapidly increasing incidence of skin cancer, primary care providers and specialists who do not commonly manage cutaneous malignancies will need to have an understanding of MMS and its role in patient care. This review better familiarizes the medical community with the practice of MMS, its utilization and capabilities, differences from wide excision and vertical section pathology, and cost-effectiveness, and it guides practitioners in the process of appropriately evaluating and determining when patients with skin cancer might be appropriate candidates for MMS.
Topics: Carcinoma, Squamous Cell; Cost-Benefit Analysis; Humans; Incidence; Melanoma; Mohs Surgery; Neoplasm Recurrence, Local; Skin Neoplasms
PubMed: 28778259
DOI: 10.1016/j.mayocp.2017.04.009