MOHS MICROGRAPHIC SURGERY

Mohs micrographic surgery (MMS) is a specialized type of minimal margi nal surgery that offers cure rates superior to other options in the tr eatment of contiguous skin cancers in selected settings. Developed by Dr. Frederic E. Mohs, the technique originally required in situ tissue fixation before excision. Most Mohs micrographic surgeons now use the fresh tissue technique exclusively. Horizontal frozen histologic sect ions of the excised tumor permit more complete microscopic examination of the surgical margin than traditional methods. Residual tumor is gr aphically mapped and malignant extensions are pursued with staged exci sions until the tumor is removed. Maximum sparing of tumor-free adjace nt tissue is achieved with histologic mapping of the tumor boundaries, thus optimizing subsequent wound reconstruction. The history, techniq ues, indications, cure rates, and current controversies of MMS are rev iewed.