A Survey of Mohs Tissue Tracking Practices

There are little data regarding error within the multistep process of Mohs micrographic surgery (MMS).

A survey of Mohs surgeons was performed to evaluate variation in tissue handling and processing within the MMS process.

A 9-question electronic survey was distributed to members of the American College of Mohs Micrographic Surgery. A total of 97 responses were analyzed.

Most surgeons personally transport the tissue (71.1%), most frequently in a specimen container (54.6%). Method of tissue identification during transportation varied significantly. Most surgeons personally hand-draw the map (77.1%). A diagram was most commonly used to convey tissue orientation to the histotechnician (65.4%). Only 31.3% of histotechnicians used labeling of blocks to identify tissue within the cryostat. Most respondents (72.2%) are the only surgeon processing tissue in the laboratory at one time; however, 28.9% reported performing 10 or more cases per day.

Most respondents are responsible for tissue transport and mapping, which likely reduces potential error. However, the method of transport and labeling, as well as identification by the histotechnician, was more variable. Ultimately, having a consistent process and clear communication with personnel will help reduce potential error during Mohs surgery.