Mohs micrographic surgery is a technique for removing skin cancers. It involves taking horizontal sections of skin and examining them under a microscope. Using the technique, surgeons can achieve a high cure rate for basal cell and squamous cell carcinomas. Mohs surgery has been refined since it was developed in the 1930s by Dr. Frederic Mohs, but the basic process of examining horizontal sections, color-coding skin specimens and then formulating a map to indicate where malignant cells remain has continued.
Benefits
With the Mohs micrographic technique, dermatologists or dermatologic surgeons can cure more than 95 percent of patients who present with basal cell or squamous cell skin cancers. That's because using a microscopic to look at the removed tissue lets the doctor keep track of removed cells and get rid of the cancer at its roots. The visible portion of a tumor is often only the beginning, as roots can grow beyond what's visible even to a trained physician or surgeon's eye. Additionally, Mohs minimizes removal of normal tissue, allowing for the best cosmetic results.
When It's Used
Mohs is commonly used to cut away cancers in the skin of the head and neck. Patients and their doctors are most concerned about retaining as much of the normal tissue as possible in those areas. Not only are areas such as the eyelids, nose, lips and ears highly visible, they also have important functions.
Procedure
A doctor locates a visible tumor and, after the area is anesthetized, removes the visible portion. Another thin layer of tissue is then cut from around the cancer. The doctor makes a map that serves as a guide to any additional malignant cells and also examines the tissue slice for remaining cancer. If more cancerous cells are found, another slice is cut and the procedure repeated. This continues until there's no more evidence of malignancy.
Reconstruction
Following the Mohs micrographic technique, the remaining wound may be -- depending on its size -- be left to heal itself, sutured or reconstructed using skin grafting. In many cases the reconstruction is done at the same time the tumor is removed. Quite often, the doctor cannot at the beginning of surgery say exactly how much scarring or how much reconstruction will be necessary. If it's something beyond the scope of the doctor performing the surgery, you may be referred to another specialist, such as a plastic surgeon, an ophthalmologist or an otolaryngologist.
Complications
Any surgical procedure carries a risk of complications. With the Mohs micrographic technique, there is a chance of bleeding during surgery; nerve damage, which can cause numbness; infection; and post-surgical problems such as graft failure or bloods clots under the affected tissue.
Tags: Mohs micrographic technique, basal cell, basal cell squamous, cell squamous, cell squamous cell