Mohs Micrographic Surgery

Mohs micrographic surgery (MMS) is a specialized surgical and histologic processing technique for cutaneous neoplasms. It combines tumor extirpation and complete surgical margin evaluation. The conceptual basis for this technique is that tumors arising from a single focus have contiguous spread. The chapter reviews the indications, preoperative and postoperative management, commonly treated tumors, the technique itself, and the challenges encountered. The advantages of MMS include observed histological margin control, which leads to superior cure rates, maximum tissue sparing potential, convenience of an outpatient procedure, and cost effectiveness. Preservation of tissue permits more reconstructive options for preserving function and maintaining cosmesis. MMS is a very safe procedure and the complication rates are exceedingly low. However, MMS is one of several modalities for treating cutaneous malignancies and it is important to use MMS appropriately.