Mohs surgery - a new approach with a mould and glass discs: review of the literature and comparative study.
OBJECTIVE
Mohs surgery is a frozen section-guided surgical excision that is the treatment of choice for aggressive cutaneous malignancy. But it is labour intensive, particularly because numerous levels are needed on each specimen to obtain a complete histologic section. Three different techniques to Mohs surgery are compared. Our new approach with moulds and glass discs is explained and discussed.


METHODS
Review of the literature and comparative study using skin specimens of fresh cadavers.


METHODS
Regional care centre.


METHODS
First, we evaluate, for each of the three different techniques, the number of 10 micron-thick frozen sections required to obtain a macroscopically complete cross section of the specimen. Second, we examine microscopically the quality of these first complete sections. Finally, once we have obtained a macroscopically complete cross section, we evaluate the number of deeper levels required to obtain an adequate microscopic section.


RESULTS
In the first experiment, with the modern method, 90.1 sections were needed to obtain a full macroscopic section, 36.8 sections with the heat extractor method, and 10.6 sections with the new mould. The quality of the histologic glass slides was superior with the new mould. The number of deeper levels required to obtain an adequate microscopic section was 5.9 for the modern method, 4.4 for the heat extractor method, and 2.3 for the new approach (new mould).


CONCLUSIONS
Our new approach with moulds and glass discs is simple and allows us to flatten the specimen (to obtain a complete tissue section) more reliably and efficiently compared with both the modern and the heat extractor methods. The new approach allows us to obtain these results in less time and with fewer histologic glass slides. Some other aspects are discussed.
Gauthier
Pierre
P
Service d'Oto-rhino-laryngologie, Centre Hospitalier Régional de Lanaudière, St-Charles-Borromée, Québec, Canada. pierregauthier1@videotron.ca
Ngo
Hanh
H
Azar
Kamran
K
Allaire
André
A
Comeau
Lise
L
Maari
Catherine
C
Marinier
Pascale
P
Meunier
Nicole
N
D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D006801:Humans; D015580:Mohs Surgery / Q000295:instrumentation* / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery