Mohs micrographic surgery was named after its founder, Dr. Frederic Mohs. He was able to remove skin cancers with a high degree of accuracy while preservng the non-cancerous areas around them. It has now become the procedure of choice for removing malignant skin lesions because the percentage of cure is in the ninetieth percentile and as mentioned, it preserves more of the noncancerous skin to facilitate the reconstructive effort.
As noted with my patient in this vignette, this type of procedure was not only successful in removing all of the disease but spared as much of the eyelid as possible so that the repair of the defect could proceed with an acceptable result. This technique of cancer removal on the skin's surface is extremely crucial in and around areas of the face and body where vital structures are located such as the eye, the ear, the mouth, etc. where as much normal tissue is left to prevent distortion of the anatomy from the reparative procedure.
Though most of the defects left behind following removal of skin cancers are small, at times they can be rather large. However, with good surgical design and technique, the goal of any Mohs procedure is first eradication of the disease followed with as normal a repair of the area as possible. In most cases, the repair is performed the day that the cancer is removed.
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