Understanding Mohs Micrographic Surgery

The doctor marks the location of the tumor, including a 1 to 1.5mm margin of uninvolved skin.  The patient is locally anesthetized with lidocaine and epinephrine.  The epinephrine vasoconstricts arteries, which reduces bleeding and also slows the absorption of the lidocaine, thereby prolonging the effect of the anesthesia.

The tissue is then excised at a 45° beveled edge and brought to the mohs tech for processing.  

The drawing should be in the exact shape of the specimen, and the same size or larger. The map should also show the level, piece number, nicks, orientation, and inking of the piece.  

If the doctor sees any cancer on the slide, it's location is marked on the map and another layer of tissue is removed from that area.  This procedure is repeated until no further cancer is found.  This ensures that only cancerous tissue is removed during the procedure, minimizing the loss of healthy tissue. 

Model of standard mohs levels. Will be available at the office.