Characteristics of Mohs Practices in the United States: A Recall Survey of ACMS Surgeons

Abstract

The characteristics of current Mohs surgery practices in the United States provides useful data for training programs, potential trainees, workforce issues, statistical modeling systems, and Mohs surgeons in the evaluation of their own practices.

Mohs surgery in Australia: A survey of work practices

“…2 Australian Mohs surgeons probably treat more skin cancers with non-Mohs than with Mohs, however this was not specifically enquired about in our survey. Additionally, most Mohs surgeons continue to practice general dermatology, although many focus on procedural and cosmetic work.…”

“…The number of years since obtaining Mohs fellowship closely matches that of USA Mohs surgeons, where 26% had fewer than 5 years of experience, 22% had 6-10 years, 19% had 10-15 years, 11% had 16-20 years and 20% had greater than 20 years Mohs experience. 2 However, despite the rise in number of Australian Mohs surgeons in recent years there are a greater number of surgeons older than the average age group bracket (42%) than there are surgeons younger (21%) (Fig. 2).…”

“…Adjusting our data accordingly, it is apparent that USA Mohs surgeons treat a relatively higher proportion of SCC (23%) than BCC (73%), compared with Australian respondents, where the higher proportion of tumours treated with MMS is BCC (82%) compared with SCC and SCC in situ (16%). 1,2 The ratio of BCC to SCC is 3.2:1 amongst the USA group and 5.1:1 in the Australian group. Melanomas are rarely treated with traditional MMS in Australia, with only 21% of respondents reported having experience treating melanomas using the frozen fresh tissue technique.…”

The Rationale for Direct Linear Closure of Facial Mohsʼ Defects

“…Although primary closure is the most common method used for Mohs' reconstruction, 8 there is a tremendous amount of attention devoted to local geometric flaps including bilobed flaps, rhomboid flaps, and others. The reported advantage of these flaps is that they provide wound closure with minimal contour deformity, often with less tissue removal than a linear closure.…”

Mohs Versus Surgical Excision in Nonmelanoma Skin Cancers

“…The practice of Mohs micrographic surgery (MMS) has expanded significantly since Dr Frederick Mohs first described his technique for excising skin cancers 2. There are ample published data comparing the efficacy of MMS versus non-Mohs modalities including traditional surgical excision (TSE) for NMSCs.…”