ABSTRACT
Mohs micrographic surgery: histologically controlled removal of skin tumors
Mohs micrographic surgery (MMS) is a method of surgical treatment of skin cancer through excision with full histological imaging of the margins in frozen sections. To ensure a complete removal of a tumor, several stages of re-excisions of tissues invaded by cancer may be required. Reconstruction of the defect is performed only after it has been confirmed that there is no tumor infiltration in the margins of the excised tissues and, as a result, in the margins of the postoperative defect. For decades MMS has been recommended for treating numerous skin neoplasms which spread through continuity, including in particular high-risk basal cell cancers. MMS offers a good insight into the microstructure of tissues and allows adjusting the extent of excision to the exact location of tumor infiltration, thus providing a highly effective treatment option that helps spare the healthy tissue. MMS is commonly used in the USA and Australia, and less frequently in Europe. In Poland, MMS has been used since the late 1990s mostly in its basic ‘fresh tissue’ version. It was introduced by the author of this article, together with coworkers from the Department of Dermatology at the Teaching Hospital of the Wrocław Medical University. The article describes the origin, development, properties and procedure of MMS, technical and organizational difficulties associated with the use of MMS, as well as prospects for future applications.
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