The role of Mohs' micrographic surgery in the management of skin cancer and a perspective on the management of the surgical defect.
In the past 30 years, MMS has become recognized as the treatment of choice for certain uncommon cutaneous neoplasms and for certain variants of BCC, squamous cell carcinoma, and melanoma. It offers an extremely high cure rate and maximally preserves healthy tissue, which often allows for preservation of function as well as an optimal cosmetic outcome. Because it is performed in an office setting under local anesthesia, MMS is a very cost-effective procedure and often extends operability to patients who are poor candidates for general anesthesia. In the past 30 years, MMS has evolved in a number of ways. The fixed tissue technique is uncommonly employed today. This makes the procedure less painful and faster and allows for immediate reconstruction. In addition, because statistics have demonstrated the reliability of MMS, it has become less necessary to delay definitive reconstruction or use temporizing measures. With experience and training, more Mohs' surgeons have become adept at repairing the surgical defects they create; nevertheless, at times, it is necessary for the Mohs' surgeon to call on his or her colleagues to reconstruct the Mohs' defect or to assist in ridding patients of their cancer. At times, a multidisciplinary approach may provide the best care for patients. It also encourages collegiality and this has led to increasing respect for MMS by other surgical disciplines in the past 30 years.
Lang
Pearon G
PG
Department of Dermatology, Medical University of South Carolina, 96 Jonathan Lucas Street, #623, Charleston, SC 29425, USA. langpg@musc.edu
D005153:Facial Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D015580:Mohs Surgery / Q000379:methods / Q000592:standards; D010348:Patient Care Team; D019651:Plastic Surgery Procedures / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*