ABD Mohs Surgery key terms

A tissue-sparing skin cancer removal technique in which the surgeon excises the tumor, maps it, and examines 100% of the peripheral and deep margins on frozen sections before closing the defect.

The outer edge of an excised tissue specimen, corresponding to the lateral border of the surgical defect; it is inked and flattened for complete microscopic evaluation in Mohs surgery.

The undersurface of an excised tissue specimen, representing the base of the surgical defect; it must be examined along with peripheral margins for true complete margin control.

A tissue specimen rapidly frozen, cut on a cryostat, and stained so it can be examined microscopically during the same operative session, enabling immediate margin assessment.

A refrigerated microtome that freezes and slices tissue at controlled subzero temperatures, producing thin sections for intraoperative microscopic examination.

A basic dye used to stain frozen-section slides in Mohs surgery; it highlights nuclear detail and is often alternated with H&E to aid interpretation.

Hematoxylin and eosin staining, the standard method that colors nuclei blue-purple and cytoplasm pink, used to assess tissue architecture and tumor presence on frozen sections.

A common locally destructive skin cancer arising from basal keratinocytes, often with pearly papules and telangiectasias; it rarely metastasizes but can invade deeply if untreated.

A malignant tumor of keratinocytes that can invade locally and metastasize; risk features include depth, poor differentiation, perineural invasion, and immunosuppression.

Tumor cells tracking along or within nerve sheaths, a high-risk feature associated with local recurrence and deeper spread, often requiring more extensive margin assessment.

Clinical and histologic characteristics such as large size, deep invasion, aggressive subtype, recurrent status, immunosuppression, or perineural invasion that predict greater recurrence or metastasis risk and influence treatment choice.

A cancer that has returned after prior treatment; it often has irregular, subclinical extensions and distorted anatomy, making it a common indication for Mohs surgery.

The process of verifying that surgical margins are free of tumor by examining the entire cut surface microscopically, reducing the chance of leaving residual disease.

A cut made in tissue adjacent to a specimen to allow it to lie flat for complete margin visualization; it must be mapped so the orientation of the tissue is preserved.

A diagrammatic record that divides the surgical defect and specimen into labeled segments so that any tumor found on microscopy can be traced back to a precise anatomic location.

The initial removal of the bulk of a tumor before the staged Mohs layers are taken, reducing tumor burden and allowing clearer margin assessment.

A layered wound repair involving undermining or extensive mobilization of tissue beyond simple edge-to-edge approximation, used to close defects after tumor removal.

Dissecting beneath wound edges to mobilize tissue and reduce tension during closure, improving cosmetic outcome and decreasing the risk of wound dehiscence.

A local flap using two adjacent lobes to redistribute tissue and close a defect, often used on the nasal tip where tissue is limited and mobility is constrained.

A piece of skin transferred without its own blood supply to cover a defect; it survives by imbibition and revascularization from the recipient bed.

A skin graft containing both epidermis and the full dermis, often harvested from the preauricular or supraclavicular area, providing better color and texture match than split-thickness grafts.

A skin graft containing epidermis and part of the dermis, typically harvested with a dermatome; it is useful for large defects but tends to contract and may have poorer color match.

The force pulling wound edges apart; excessive tension impairs blood flow, worsens scarring, and increases dehiscence risk, so it guides closure design.

The lateral wing of the nostril, a cosmetically and functionally sensitive site where defects often require careful flap or graft reconstruction to preserve airway and contour.

The seventh cranial nerve, which supplies the muscles of facial expression; its branches are at risk during surgery in the parotid, cheek, and temple regions.

A branch of the facial nerve crossing the zygomatic arch and temple, supplying the frontalis and orbicularis oculi; injury can cause brow ptosis and difficulty closing the eye.

A facial nerve branch running near the mandibular border and supplying depressor muscles of the lower lip; injury can cause asymmetric lower lip movement.

Injection of an anesthetic agent such as lidocaine with epinephrine to numb a specific area; epinephrine reduces bleeding and prolongs anesthesia but must be used cautiously in certain patients.

Adverse effects from excessive local anesthetic absorption, ranging from perioral numbness and tinnitus to seizures and cardiac arrhythmia; dose limits and patient weight guide safe use.

An agent such as epinephrine added to local anesthetic to constrict blood vessels, reduce surgical bleeding, and prolong the anesthetic effect.

Use of medications that reduce blood clotting; decisions about continuing these drugs around skin surgery balance bleeding risk against thromboembolic risk.

Excessive intraoperative or postoperative hemorrhage, often related to anticoagulants, large defects, or inadequate hemostasis, requiring pressure, cautery, or revision.

Airborne byproducts generated by electrocautery or laser, which can contain chemicals and particles; evacuation and smoke precautions protect operating room staff.

Use of heat from an electric current to coagulate tissue and control bleeding during surgery; it also generates surgical smoke requiring evacuation.

Practices and policies that protect healthcare workers from hazards such as bloodborne pathogens, surgical smoke, and ergonomic injury in the procedure room.

Infection-control measures applied to all patients, including hand hygiene, gloves, eye protection, and safe handling of sharps and body fluids.

The process of explaining a procedure's purpose, risks, benefits, and alternatives so a patient can voluntarily agree to treatment; it must be documented.

A collaborative process in which clinician and patient discuss options, evidence, and patient values to choose a treatment plan together.

Accurate written or electronic recording of clinical findings, procedures, consent, and outcomes, which supports continuity of care, billing, and legal defensibility.

Systematic activities that monitor and improve care processes and outcomes, such as tracking margin clearance, complication rates, and patient satisfaction.