Mohs micrographic surgery: How ACMS fellowship directors practice.

BACKGROUND

Mohs micrographic surgery (MMS) is widely employed in the removal of skin cancer. As this technique becomes more widely employed, it is useful to establish the patterns of care provided by American College of Mohs Surgery (ACMS)-approved fellowship directors.

OBJECTIVE

To compile and analyze data collected annually by the ACMS to determine practice patterns and trends in MMS as performed by ACMS-approved fellowship directors.

MATERIALS AND METHODS

A retrospective study of case logs from 50 fellowship directors obtained from the ACMS detailing case volume, type of cancer treated, location, lesion size, wound size, number of stages, referral percentage, and type of repairs performed.

RESULTS

Annual case volume per surgeon has increased linearly. The incidence of squamous cell carcinoma treated using MMS is rising steadily. The size of lesions treated using MMS has decreased slightly over several decades, as has the number of stages of MMS taken per lesion. The majority of MMS performed by fellowship directors is for skin cancer on the face. Dermatologic surgeons perform most of their own reconstructions. Academic and private fellowship practice patterns are nearly identical.

CONCLUSIONS

ACMS-approved fellowship directors use MMS mainly for facial skin cancers, and they perform most of their own reconstructions. Practice patterns for most fellowship directors are similar. Private fellowships and academic fellowships are similar in scope and practice.