Mohs' micrographic surgery and prompt reconstruction for basal cell carcinoma: report of 62 cases using the combined method.

Aggressive, recurrent, and difficult to manage skin cancers may require complex solutions. In this review of 62 skin cancers, we demonstrate a novel approach to the management of these tumors. Mohs' micrographic surgery was used to remove the tumor, and was followed by immediate or delayed plastic surgical repair. Using this combined method, the highest attainable cure rate is linked with a coordinated prompt cosmetic repair. In this series of 54 patients with 62 skin cancers, there was one recurrence with a follow-up of one to four years. Most cases (65%) involved reconstruction within ten days of tumor removal. Eighty-one percent had a single-stage reconstruction. In seventeen patients, new tumors developed at other sites during the four-year follow-up period. On the basis of our experience with this combined method, we feel that Mohs' surgery, coordinated with prompt plastic repair, offers distinct advantages in the management of difficult skin cancers.