Related Experiment Video
Updated: Jan 28, 2026
Establishment of a Clinic-based Biorepository
Published on: May 29, 2017
Patient indications for Mohs micrographic surgery: a clinical practice guideline
C Murray1, D Sivajohanathan2, T P Hanna3
1Division of Dermatology, Women's College Hospital, and University of Toronto, Toronto, ON.
Objective:
The purpose of the present work was to develop evidence-based indications for Mohs micrographic surgery in patients with a diagnosis of skin cancer.
Methods:
The guideline was developed by Cancer Care Ontario's Program in Evidence-Based Care, together with the Melanoma Disease Site Group and the Surgical Oncology Program, through a systematic review of relevant literature, patient- and caregiver-specific consultation, and internal and external reviews.
Recommendation 1:
Given a lack of high-quality, comparative evidence, surgery (with postoperative or intraoperative margin assessment) or radiation (for those who are ineligible for surgery) should remain the standard of care for patients with skin cancer.
Recommendation 2:
Mohs micrographic surgery is recommended for patients with histologically confirmed recurrent basal cell carcinoma of the face and is appropriate for primary basal cell carcinomas of the face that are larger than 1 cm, have aggressive histology, or are located on the H zone of the face.
Recommendation 3:
Mohs micrographic surgery should be performed by physicians who have completed a degree in medicine or equivalent, including a Royal College of Physicians and Surgeons of Canada Specialist Certificate or equivalent, and have received advanced training in Mohs micrographic surgery.
Insights
This study outlines evidence-based guidelines for Mohs micrographic surgery in skin cancer patients. Mohs surgery is recommended for specific facial basal cell carcinomas and requires specialized training for optimal outcomes.
Area of Science:
- Dermatology
- Surgical Oncology
- Evidence-Based Medicine
Background:
- Skin cancer management requires clear indications for surgical interventions.
- Mohs micrographic surgery offers precise tumor removal but requires specific criteria for optimal use.
Purpose of the Study:
- To establish evidence-based indications for Mohs micrographic surgery in skin cancer patients.
- To provide guidance on the appropriate use of Mohs surgery for various skin cancer presentations.
Main Methods:
- Systematic literature review.
- Patient and caregiver consultations.
- Internal and external expert reviews.
Main Results:
- Surgery with margin assessment or radiation remains the standard of care for skin cancer.
- Mohs micrographic surgery is recommended for recurrent facial basal cell carcinoma (BCC) and select primary facial BCCs (larger than 1 cm, aggressive histology, or H-zone location).
- Advanced training is essential for physicians performing Mohs micrographic surgery.
Conclusions:
- Evidence-based guidelines are crucial for optimizing Mohs micrographic surgery utilization.
- Specific criteria guide the selection of patients for Mohs surgery, particularly for facial BCC.
- Ensuring qualified and trained personnel is paramount for successful Mohs surgical outcomes.
More Related Videos
Related Concept Videos
02:39Indicators
01:26Guidelines for Nursing Documentation II
Timely documentation is crucial to ensure continuity of care for patients. Any delays in recording or reporting medical information can result in medical errors and even adverse patient outcomes. From medication administration to diagnostic test results, every detail must be accurately and promptly documented to provide the best possible care for patients.
01:06Legal Guidelines for Documentation
01:23Guidelines for Sketching a Curve
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:30Guidelines for Nursing Documentation I
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.