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Contemporary Mohs Micrographic Surgery Histologic Preparation Methods, Laboratory-Assistive Personnel Training, and Practice Setting—A Survey Study

Ishii, Lisa, BS*; Arshanapalli, Ashish, MD; Surprenant, David, MD; Reserva, Jeave, MD; Moy, Lauren, MD; Martin, Brendan, PhD; Krol, Cindy, BS; Cesario, Linda, DPM, HT; Alam, Murad, MD§; Tung, Rebecca, MD

doi: 10.1097/DSS.0000000000001747
Original Article

BACKGROUND The Mohs histotechnologist (MH) performs tissue preparation, sectioning, and staining, which are critical tasks in ensuring a successful Mohs micrographic surgery (MMS).

OBJECTIVE To assess current norms in MH training, practice setting, and utilization of specific histologic techniques.

MATERIALS AND METHODS A 16-question survey was created and distributed using Survey Monkey to all members of the American Society for Mohs Histotechnology.

RESULTS Response rate was 30%. Most MHs received on-the-job training from other MHs or the Mohs surgeon. Mohs histotechnologists largely performed tasks related to tissue processing while Mohs surgeons generally illustrated the Mohs layer map. Automated routine staining was used in most laboratory tests, and laboratory tests used similar staining techniques. Most respondents worked in private offices verses academic centers. Total staining time was significantly longer at academic medical centers versus private offices (7 vs 5 minutes, p = .01).

CONCLUSION These findings provide an updated profile of current laboratory training and tissue preparation techniques at MMS practices across the country. Understanding the roles of the MH in laboratory functioning may help laboratories adopt best practices.

*Medical College of Georgia, Augusta University, Augusta, Georgia;

Division of Dermatology, Loyola University Medical Center, Maywood, Illinois;

American Society for Mohs Histotechnology, Milwaukee, Wisconsin;

§Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

Address correspondence and reprint requests to: Lisa Ishii, BS, Medical College of Georgia, Augusta University, 1810 Belcourt Avenue Unit 206, Nashville, TN 37212, 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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