ABSTRACT
Mohs micrographic surgery (MMS) was first described in 1941, when Frederick Mohs described a technique involving in situ fixation of skin cancers followed by excision. The excised specimen was subjected to horizontal sections from the undersurface to yield a more comprehensive examination of the surgical margin when compared with conventional surgery. There are few absolute contraindications to MMS. The main reasons revolve around existing multiple medical comorbidities or patients who are non-compliant due to dementia. Patients undergoing Mohs surgery are almost invariably treated using local anaesthesia due to the potential for multiple cycles being required and lengthy treatment sessions, although rarely sedation may be used in some centres. Complications are similar to those encountered in any local anaesthetic dermatological surgery including (but not limited to): scarring; hypertrophic or keloid scarring; bleeding; bruising; flap or graft failure; alteration in sensation (including temporary or permanent numbness and/or neuropathic pain); and infection.
