Is a Plastic Surgeon Needed for Mohs Reconstruction?
- Posted on: Jan 15 2019
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When a patient has been diagnosed with skin cancer, the primary concern is treating the lesion or lesions properly so the chance of recurrence is very low. The Mohs microsurgical technique has demonstrated the high degree of precision patients deserve. Still, there may be a need for reconstruction after the initial surgery has removed all affected tissue. It is at this point that the dermatologist has a critical decision to make: perform the necessary reconstruction or collaborate with another specialist.
Ultimately, the best course of action is to determine what is in the best interest of the patient. Mohs micrographic surgery was initially developed and then further refined with the intent of significantly reducing scarring and the need for reconstructive techniques. However, statistics demonstrate that approximately 15 percent of patients who undergo Mohs require subsequent reconstruction. Therefore, it may not be enough to obtain training in the fundamentals of Mohs surgery. This is why the American Society for Mohs Surgery has developed a comprehensive closure course.
Mohs reconstruction is necessary when the initial procedure leaves a large wound. It is particularly important that patients feel comfortable with the measures that will be taken to restore the appearance of any part of the face. Reconstruction may require two or more stages, depending on the technique that will achieve the best results. Tissue grafting and flap techniques are commonly utilized. Flaps can be quite involved, requiring the creation and positioning of the flap prior to “sectioning” in which the flap is separated from its blood supply.
Mohs Reconstruction is All about Closure
Reconstructive techniques after Mohs surgery provides closure in more ways than one. Patients are anxious to put their skin cancer experience behind them, and reconstruction can be their final obstacle to overcome. It is at this point when many patients question who should perform reconstruction: their Mohs surgeon or a plastic surgeon. It is imperative that patients understand the extensive training their surgeon has undergone.
We first introduced our Mohs Closure Course in 2011. This comprehensive 2-day event is ideal for physicians who are competent in basic dermatologic surgery closure techniques and want to further their skills as they relate to skin cancer procedures. Dermatologists who take this course develop a high level of confidence in determining the best reconstruction approach based on anatomical structure and then executing that technique in the clinical setting.
Our next Closure Course takes place in just a few weeks. For information on this or future courses, call 1.800.616.2767.
Posted in: MOHS Surgery