Triage in Mohs micrographic surgery

Mohs micrographic surgery can be unpredictable with respect to the level of difficulty of individual cases, especially when pre-operative information is limited. In a retrospective study, Sahai and Walling found complex tumors as defined by requiring four or more stages to clearance to be associated with: recurrent tumors, basal cell carcinoma (BCC) with aggressive histology, tumors with a pre-operative size greater than 1 cm and tumors on the nose.1 The authors created a simplified system for "triaging" Mohs surgery cases in order to predict case complexity and, thus, be better able to manage the scheduling of those cases. Data gathered from 12 months of utilizing this system was used to validate the system's ability to predict case complexity with respect to number of stages for tumor clearance and complexity of reconstruction.