Assessment of Clinician- and Patient-Reported Outcomes After Mohs Micrographic Surgery

Evaluating postoperative outcomes after Mohs micrographic surgery (MMS) necessitates the use of patient-reported outcome measures (PROMs) and clinician (± patient) scar assessment tools.

To review patient- and clinician-reported outcome tools that have been developed to evaluate postoperative outcomes that are relevant to MMS.

A literature search was conducted to identify patients and clinician-reported outcome tools developed for surgery on the head and neck and for skin cancer surgery (including MMS).

Sixteen articles were included. Five PROMs (dermatology life quality index, Skindex 16/29, skin cancer index [SCI], Skin Cancer Quality of Life Impact Tool/SF, Facial Apperance Related Questionnaire [FACE-Q]) and 5 clinician (± patient) scar assessment tools (Vancouver Scar Scale, Patient and Observer Scar Assessment Scale [POSAS], Manchester Scar Scale [MSS], Stony Brook Scar Evaluation Scale, Global Cosmetic Rating/Visual Analog Scale) are evaluated in detail. Among PROMs, the SCI and FACE-Q Skin Cancer module have demonstrated the strongest validation for facial skin cancers. Emerging tools, for example, Mohs micrographic surgery reconstruction questionnaire-12, reflect efforts to refine patient-centered outcome assessment specific to MMS. Clinician scar assessment tools remain valuable with POSAS widely regarded for combining objective scar characteristics with patient-reported symptoms. Vancouver Scar Scale and MSS offer structured observer-based evaluations, whereas other tools provide simple early postoperative assessments.

Integrating PROMs with clinician-reported scar assessment tools enables a comprehensive, multidimensional understanding of surgical outcomes-capturing both the subjective patient experience and objective clinical metrics.