Adapting with the Pandemic: Modified Mohs Micrographic Surgery Using Rim and Deep Margin Technique

Area of Science:

• Dermatology
• Surgical Oncology

Background:

• The COVID-19 pandemic led to significant delays in medical treatments, including dermatological procedures.
• Delayed treatment for skin cancers such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) increases tumor size and metastatic risk.
• Postponing Mohs micrographic surgery (MMS) for over a year elevates complication risks, particularly bleeding and impaired wound healing in elderly patients.

Observation:

• A modified MMS technique, termed the "rim and deep margin" technique, was developed to mitigate bleeding risks.
• This technique has been previously successful in managing large tumors.
• The study presents additional cases demonstrating the efficacy of this modified MMS approach.

Findings:

• The "rim and deep margin" technique effectively minimizes bleeding during MMS procedures.
• This modified approach also reduces operative time, benefiting patient recovery.
• Successful application of the technique during the COVID-19 pandemic highlights its utility for patients facing delayed care.

Implications:

• The modified MMS technique offers a safer and more efficient surgical option for patients with delayed skin cancer treatment.
• This approach is particularly valuable for elderly patients or those with increased comorbidity risks.
• The technique's success during the pandemic underscores its adaptability and importance in managing dermatological surgical backlogs.