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Triage in Mohs micrographic surgery.

Anis Miladi1, Jonathan Bingham

  • 1Department of Dermatology, National Naval Medical Center, Bethesda, Maryland, USA. anis.miladi@med.navy.mil

Journal of Drugs in Dermatology : JDD
|March 4, 2011
PubMed
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Predicting Mohs surgery complexity is challenging. A new system identifies factors like tumor recurrence, aggressive histology, large size, and location to better manage surgical scheduling and predict case difficulty.

Area of Science:

  • Dermatology
  • Surgical Oncology

Background:

  • Mohs micrographic surgery case difficulty can be unpredictable.
  • Limited pre-operative information often contributes to this unpredictability.

Purpose of the Study:

  • To develop and validate a simplified system for triaging Mohs surgery cases.
  • To predict surgical complexity based on pre-operative factors.

Main Methods:

  • Retrospective study analyzing Mohs surgery cases.
  • Development of a system to "triage" cases based on predicted complexity.
  • Validation of the system using 12 months of case data.

Main Results:

  • Complex Mohs surgery cases (≥4 stages) were associated with recurrent tumors, basal cell carcinoma (BCC) with aggressive histology, tumors >1 cm, and nasal location.

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  • The developed triaging system demonstrated ability to predict case complexity regarding clearance stages and reconstruction needs.

    • Conclusions:

    • A simplified case-triaging system can effectively predict Mohs surgery complexity.
    • This system aids in better management of surgical scheduling for complex cases.