Microvascular free tissue reconstruction following Mohs' micrographic surgery for advanced head and neck skin cancer.

Seven consecutive patients from 1986 through 1989 for 8 extensive recurrent and/or irradiated skin cancers of the face and scalp are retrospectively evaluated. One patient was treated by conventional surgical margins, and the limitations of this method in sampling margins are compared to the Mohs' micrographic surgery (MMS) used for the other 6 patients. All were treated with free flaps without flap loss or major complications in spite of advanced age. The advantages of an interdisciplinary approach to achieve maximum cure rates, optimal reconstruction, and minimizing anesthesia time are discussed.