Tiefenbrunn - American Society for Mohs Surgery
Tiefenbrunn - American Society for Mohs Surgery
Tiefenbrunn - American Society for Mohs Surgery
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I<br />
Missing skin edge in<br />
stage I must be<br />
examined in stage II<br />
II<br />
<br />
<br />
Note map not marked<br />
<br />
• Traditionally <strong>Mohs</strong> surgeons have<br />
asssumed that the location of the tumor<br />
on the slide is exactly the same as it is in<br />
the patient.<br />
t<br />
• The ideas about to be presented<br />
contradict this theory and have<br />
implications <strong>for</strong> the planning of stage II.<br />
• It is in the planning and execution of stage<br />
II that many errors in <strong>Mohs</strong> <strong>Surgery</strong> occur.<br />
<br />
<br />
• A finite amount of tissue is sectioned<br />
away from the specimen be<strong>for</strong>e the first<br />
section is placed on a slide.<br />
• Assuming 20 turns of the cryostat be<strong>for</strong>e<br />
a section is obtained, at 6 microns with<br />
“sawdust effect” to equal 10 microns,<br />
200 microns are lost.<br />
• 200 microns = .2 mm, a space in which<br />
tumor can travel undetected.
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