An alternate approach for harvesting Mohs specimens with a flexible scalpel.
BACKGROUND: Mohs micrographic surgery is a highly successful technique for removing skin cancers while conserving normal tissue. However, conservation of the deep margins can often be difficult to achieve when using a standard scalpel. An inability to conserve normal tissue at the deep margins can greatly impact the complexity of repair, duration of surgery, aesthetic result, and patient morbidity. OBJECTIVE: To find an alternative method of obtaining Mohs specimens that offers greater control of the depth of incision when compared to the standard scalpel. METHODS: We utilized a flexible scalpel to obtain Mohs levels on patients with superficial cutaneous malignancies in anatomic locations where careful conservation of the deep margins would allow for less extensive repair. RESULTS: For those patients who had tumor-free margins after one level of Mohs surgery, the shallower defects achieved with the flexible scalpel allowed for excellent cosmetic outcomes and decreased patient operative time and morbidity. CONCLUSION: The flexible scalpel is both effective and efficient in obtaining thin Mohs specimens when conservation of the deep margin is of utmost importance.