Single instructional sessions may not be sufficient to maintain simple suture proficiency over the course of a 30-day elective. We propose the use of preparatory instructional videos, followed by instructor demonstration to introduce the technique. Independent practice with intermittent evaluation and critique allows for skill acquisition and time efficiency at the initial training. Students should view instructional videos and practice at least 10 repetitions every 10 days to maintain their skill.

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BACKGROUND Wide local excision (WLE) with 2 to 5 cm margins has been conventionally used for the treatment of superficial leiomyosarcoma (LMS). Because margin control is the strongest predictor of clinical recurrence, many dermatologic surgeons have recently recommended Mohs micrographic surgery (MMS) over wide local excision (WLE) as the primary treatment modality. OBJECTIVE To determine the aggregate rate of local recurrence after treatment of superficial LMS with MMS among the few reports in the literature. METHODS A systematic literature search using the PubMed/MEDLINE database and the Cochrane Library was performed from inception to June 2017. One case report from our institution was included. RESULTS A meta‐analysis of 14 reports of 48 cases of superficial LMS treated with MMS showed a mean recurrence rate of 2.08% to 6.25% with a mean follow‐up period of 1570.9 days, compared to reported recurrence rates of 30% to 50% for WLE. Among these cases there were no reports of distant metastases. CONCLUSION Treatment of superficial leiomyosarcoma with MMS shows markedly lower rates of recurrence compared to reported rates of recurrence after WLE. Further prospective trials with larger sample sizes are needed to compare both modalities.

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