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A Survey of Mohs Tissue Tracking Practices

Dietert, Jessica B., MD*; MacFarlane, Deborah F., MD, MPH

doi: 10.1097/DSS.0000000000001723
Original Article

BACKGROUND There are little data regarding error within the multistep process of Mohs micrographic surgery (MMS).

OBJECTIVE A survey of Mohs surgeons was performed to evaluate variation in tissue handling and processing within the MMS process.

METHODS AND MATERIALS A 9-question electronic survey was distributed to members of the American College of Mohs Micrographic Surgery. A total of 97 responses were analyzed.

RESULTS Most surgeons personally transport the tissue (71.1%), most frequently in a specimen container (54.6%). Method of tissue identification during transportation varied significantly. Most surgeons personally hand-draw the map (77.1%). A diagram was most commonly used to convey tissue orientation to the histotechnician (65.4%). Only 31.3% of histotechnicians used labeling of blocks to identify tissue within the cryostat. Most respondents (72.2%) are the only surgeon processing tissue in the laboratory at one time; however, 28.9% reported performing 10 or more cases per day.

CONCLUSION Most respondents are responsible for tissue transport and mapping, which likely reduces potential error. However, the method of transport and labeling, as well as identification by the histotechnician, was more variable. Ultimately, having a consistent process and clear communication with personnel will help reduce potential error during Mohs surgery.

*Division of Dermatology, Washington University in Saint Louis School of Medicine, St. Louis, Missouri;

Department of Dermatology, MD Anderson Cancer Center, Houston, Texas

Address correspondence and reprint requests to: Jessica B. Dietert, MD, 505 W Louis Henna Blvd, Suite 200, Austin, TX 78728, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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