Mohs math--where the error hides.
BACKGROUND
Mohs surgical technique allows a full view of surgical margins and has a reported cure rate approaching 100%.


METHODS
A survey amongst Mohs surgeons was performed to assess operator technique. In addition, an animated clay model was constructed to identify and quantify tissue movement seen during the processing of Mohs surgical specimens.


RESULTS
There is variability in technique used in Mohs surgery in regards to the thickness of layers, and the number of blocks layers are cut into. A mathematical model is described which assesses the clinical impact of this variability.


CONCLUSIONS
Our mathematical model identifies key aspects of technique that may contribute to error. To keep the inherent error rate at a minimum, we advocate minimal division and minimal physical thickness of Mohs specimens.
Ellis
Jeffrey I
JI
Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, New York, 11203, USA. jellis@journalreview.org
Khrom
Tatiana
T
Wong
Anthony
A
Gentile
Mario O
MO
Siegel
Daniel M
DM
D002983:Clinical Competence; D019538:Health Care Surveys; D006801:Humans; D008954:Models, Biological; D015580:Mohs Surgery / Q000379:methods*; D012878:Skin Neoplasms / Q000601:surgery; D013048:Specimen Handling