The role of Mohs' micrographic surgery in the management of skin cancer and a perspective on the management of the surgical defect

For patients with skin cancer, Mohs' micrographic surgery (MMS) offers a high cure rate and, at the same time, preserves healthy tissue. It is cost effective and, because it is performed under local anesthesia, extends operability to patients who are poor candidates for general anesthesia. With the evolution of the fresh tissue technique, immediate reconstruction has become commonplace. Although many Mohs' surgeons are quite skilled in ridding patients of their tumor and adept at reconstruction, there are still times when a multidisciplinary approach is required. Although offering a high cure rate for many tumors, MMS may fail, especially in cases in which there are tumors that are capable of metastasizing.