Intraoperative use of Mohs' surgery for the resection of major cutaneous head and neck cancer under general anaesthetic: Initial experiences, efficiency and outcomes

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
Hyder RidhaM D Moncrieff

Abstract

Complete excision of high-risk extensive non-melanoma skin cancers in the head and neck is paramount to achieving loco-regional control. However, achieving clear margins still remains a significant challenge. Mohs' micrographic surgery (MMS) provides the most accurate method of intraoperative mapping and histological assessment of tumour margins. We have developed a technique combining MMS with reconstruction as a single-stage procedure performed under general anaesthetic. We present our experience and results. Following regional skin cancer multidisciplinary team (MDT) discussion, patients considered appropriate for management as a single-stage combined procedure were referred for assessment. At surgery, a two-team approach was employed consisting of an MMS resection team and a reconstructive team, allowing simultaneous resection and elevation of any free tissue required for reconstruction. Outcome data were retrieved from a prospectively collated MMS database. Twenty-six cases were performed between January 2010 and January 2013. Fifty-eight percent of cases were basal cell carcinomas. Clear margins were achieved in 50% of cases following the first Mohs' layer. Free tissue reconstruction was required in 13 cases. Mean anaesth...Continue Reading

References

Feb 14, 2002·The British Journal of Dermatology·R MotleyUNKNOWN Royal College of Radiologists, Faculty of Clinical Oncology
Jul 3, 2008·The British Journal of Dermatology·N R TelferUNKNOWN British Association of Dermatologists
Nov 16, 2010·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Amit Kantilal ShahRichard Matthew Haywood
Nov 5, 2013·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·P ProwseJ Morton

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Citations

Jul 18, 2021·Journal of the American Academy of Dermatology·Emma RussellThomas Knackstedt

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