Optimising Mohs clinic flow and patient treatment: the vital role of cryotomy

Pioneered in the USA by Dr Frederic Mohs in the 1930s, Mohs micrographic surgery is a highly effective means of treating certain types of skin cancer such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Basal cells are present in the lower part of the epidermis, while squamous cells are found in the outer part. These cancer types are often ill-defined, with deep ‘roots’ and difficult to treat effectively using standard methods. Basal cell carcinoma accounts for the majority of skin cancers; however, as the population is ageing, the relative proportion of SCCs is growing.¹

Originally, the Mohs technique involved using zinc chloride paste to devitalise the tumour overnight, before a disc of the fixed tissue was taken. Today, the procedure uses frozen tissue to give virtually instant results, while removing the minimum quantity of healthy tissue. In recent years the method has been welcomed by an increasing number of clinics and surgeons, and there are now over 60 clinics worldwide.

Mohs surgery is a highly successful and cost-effective technique and has a cure rate of up to 99% for BCC.² Widely used throughout the USA and Australasia for many years, Mohs is steadily gaining in reputation in the UK, where there are now over 20 clinics.