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An alternate approach for harvesting Mohs specimens with a flexible scalpel
1Naples Center for Dermatology and Cosmetic Surgery, Naples, Florida 34108, USA.
Background:
Mohs micrographic surgery is a highly successful technique for removing skin cancers while conserving normal tissue. However, conservation of the deep margins can often be difficult to achieve when using a standard scalpel. An inability to conserve normal tissue at the deep margins can greatly impact the complexity of repair, duration of surgery, aesthetic result, and patient morbidity.
Objective:
To find an alternative method of obtaining Mohs specimens that offers greater control of the depth of incision when compared to the standard scalpel.
Methods:
We utilized a flexible scalpel to obtain Mohs levels on patients with superficial cutaneous malignancies in anatomic locations where careful conservation of the deep margins would allow for less extensive repair.
Results:
For those patients who had tumor-free margins after one level of Mohs surgery, the shallower defects achieved with the flexible scalpel allowed for excellent cosmetic outcomes and decreased patient operative time and morbidity.
Conclusion:
The flexible scalpel is both effective and efficient in obtaining thin Mohs specimens when conservation of the deep margin is of utmost importance.