- 10.17.24

Quick Review #246 - #surgery #surgeon #doctorgallagher #oralsurgery #oralsurgeon #omfs #dentist #dentistry #dental #mohssurgery #mohs #dermatology #plasticsurgery

Mohs surgery, also known as Mohs micrographic surgery, is a highly specialized and precise technique used primarily for the treatment of skin cancer, particularly in cosmetically and functionally sensitive areas such as the face, scalp, ears, neck, hands, and feet.

This method is most commonly used to treat basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), the two most prevalent types of skin cancer, but can also be used for other less common skin cancers like melanoma and certain rare skin tumors.

The Mohs procedure is unique in that it combines surgical excision with immediate microscopic examination of the removed tissue, allowing for the highest degree of accuracy in cancer removal. Unlike traditional excision methods, where a margin of healthy skin is also removed to ensure complete cancer eradication, Mohs surgery conserves as much healthy tissue as possible. This makes it especially valuable in areas where tissue preservation is critical for both aesthetic and functional reasons.

The Mohs procedure involves several distinct steps:

1. Initial Layer Removal: The surgeon starts by removing the visible tumor along with a thin layer of surrounding tissue. This initial tissue layer is mapped and carefully marked to correlate with its original position on the patient’s skin.

2. Microscopic Examination: The tissue is processed in a lab, typically adjacent to the operating room, and examined under a microscope by the surgeon. The tissue is frozen, cut into thin slices, and stained for examination. The surgeon inspects the entire margin of the excised tissue to check for the presence of cancer cells.

3. Stepwise Removal: If cancer cells are detected at any point along the tissue margin, the surgeon returns to the corresponding area on the patient’s skin and removes an additional layer of tissue, only from the specific region where cancer cells were found. This process is repeated layer by layer until no cancer cells are present, ensuring complete cancer removal with minimal damage to surrounding healthy tissue.

4. Repair and Reconstruction: Once the cancer is completely excised, the surgeon repairs the wound. Depending on the size and location of the defect, the wound may be closed with stitches, left to heal on its own, or reconstructed using a skin flap or graft for optimal cosmetic and functional outcomes. In some cases, a reconstructive surgeon may be involved if the defect is large or complex.

References:

1. STL Dermatology & Cosmetic Surgery. (n.d.). Mohs surgery & Mohs procedure.

2. Gross, K., & Steinman, H. K. (2009). Mohs micrographic surgery: Technique, indications, and applications. Dermatologic Clinics, 27(4), 515-524. https://lnkd.in/erWJQfn3

3. ChatGPT. 2024.

#podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast #doctor #dentistry #oralsurgery #dental #viral #dentalschool #dentalstudent #omfs #surgeon #doctorlife #dentistlife #residency #oralsurgeon #dentist #doctorgallagher