Reconstructive outcomes of Mohs surgery compared with conventional excision: A 13-month prospective study

Area of Science:

• Dermatologic Surgery
• Plastic and Reconstructive Surgery
• Oncology

Background:

• The Mersey Regional Centre for Mohs Surgery, established in 2012, is the UK's first Mohs service led by a Mohs-trained Plastic & Reconstructive surgeon.
• Skin cancer resection and reconstruction present challenges in achieving optimal cosmetic and oncologic outcomes.

Purpose of the Study:

• To evaluate the reconstructive requirements and surgical outcomes of patients treated with Mohs surgery.
• To compare the outcomes of Mohs surgery with conventional excision (CE) and reconstruction for similar skin lesions.

Main Methods:

• Analysis of 157 patients treated over 13 months at the Mersey Regional Centre for Mohs Surgery.
• Comparative assessment of surgical outcomes, reconstructive techniques, and margin status between Mohs surgery and hypothetical conventional excision.

Main Results:

• Conventional excision would have resulted in more invasive or cosmetically inferior reconstructions in 56% of patients.
• Incomplete margins would have occurred in 24% of cases with conventional excision.
• Significant benefits were observed in 80% of patients, with 9% avoiding loss of fundamental structures or unnecessary complex reconstructions.

Conclusions:

• The Plastic & Reconstructive Mohs surgery service demonstrates a significant reconstructive benefit compared to non-Mohs resection.
• Careful patient selection and understanding the limitations of conventional excision are crucial for maximizing benefits.
• This specialized service contributes valuable improvements to skin cancer patient care within the Mersey and Cheshire Skin Cancer Network.