What types of Mohs surgery are there?

Mohs surgery is a tissue-sparing surgical technique used to remove skin cancers, primarily basal cell and squamous cell carcinomas. There are two main types of Mohs surgery:

1. Standard Mohs Surgery:

This is the most common type of Mohs surgery and involves the following steps:

Removal of visible tumor: The surgeon uses a scalpel to remove the visible portion of the skin cancer.

Preparation of the surgical site: The area is numbed with local anesthesia, and a sterile drape is placed around the tumor site.

Mohs mapping: The surgeon creates a map of the surgical site by marking the tumor's borders with colored dyes.

Removal of cancerous tissue: The surgeon removes a thin layer of tissue around the tumor until no more cancerous cells are found. This process is repeated until clear margins are achieved, ensuring that all cancerous tissue has been removed.

Wound repair: Once the cancerous tissue has been removed, the surgical site is closed using sutures, skin grafts, or flaps.

Standard Mohs surgery typically takes several hours and can be performed in an outpatient setting.

2. Frozen Section Mohs Surgery:

Frozen section Mohs surgery is a variation of the standard Mohs technique and offers enhanced speed and convenience. Here's how it's performed:

Removal of visible tumor: Similar to standard Mohs surgery, the surgeon removes the visible portion of the skin cancer.

Preparation of tissue samples: Instead of mapping the surgical site, the surgeon immediately prepares multiple thin slices of the removed tissue samples.

Staining and examination: The tissue samples are quickly frozen, sectioned, stained, and examined under a microscope to identify any remaining cancerous cells.

Removal of additional tissue: If cancerous cells are found, the surgeon continues to remove thin layers of tissue from the affected area until clear margins are achieved.

Wound repair: Once the cancerous tissue has been removed, the surgical site is closed using sutures, skin grafts, or flaps.

Frozen section Mohs surgery significantly reduces the procedure time compared to standard Mohs surgery, as the tissue processing and examination occur simultaneously. This allows for the complete removal of the skin cancer during a single visit.

The choice of Mohs surgery technique depends on the location and size of the skin cancer, as well as the surgeon's preference. Both standard and frozen section Mohs surgery offer high cure rates and excellent preservation of healthy tissue, making them effective and minimally invasive options for treating skin cancers.