Outpatient Setting Found Safe for Skin Cancer Surgery

A study has found that micrographic surgery to remove skin cancers is very safe when performed in an outpatient setting. The results were reported in the February 17, 2003, issue of the Archives of Dermatology.

Performed under local anesthesia, microscopically controlled surgery is known as Mohs surgery, because the technique was developed by Frederic Mohs, M.D., for the treatment of certain skin cancers. The technique combines surgical removal of the cancer with immediate microscopic examination of the removed tissue in order to identify any residual cancerous tissue. The Mohs technique has the highest cure rate of all skin cancer treatment methods.

Researchers tracked 1,343 outpatient Mohs procedures performed at Duke University Medical Center (Durham, NC, USA; www.mc.duke.edu) during the year 2000. They recorded information on the occurrence of five types of complications: postoperative bleeding, hematoma, wound dehiscence, wound infection, and skin flap or skin graft necrosis. The overall complication rate was 1.64%, or 22 complications out of the 1,343 surgeries. This rate was deemed low enough to conclude that performing Mohs surgery on an outpatient basis does not represent an undue risk. None of the patients required hospitalization or consultation with another doctor.

"We all see reports in the news of undesired patient outcomes following outpatient surgery,” noted Johnathan Cook, M.D., lead author and director of dermatologic surgery at Duke University Medical Center. "Although dermatologic surgery is largely not responsible for these cases, people tend to generalize and assume that all outpatient surgery is dangerous.”




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