Mohs Micrographic Surgery – History
Mohs micrographic surgery was developed by Frederic E. Mohs, M.D. in 1936 at the University of Wisconsin. In its original form, described as “chemosurgery”, the technique utilized a 20% zinc chloride fixative paste that was applied directly to the skin of the patient for fixation of the tissue. Subsequently, the involved skin was surgically removed by serial excision with microscopic control of the tissue margins.
Removal of tissue was performed in layers and color coded with dyes in order to orient specimens to the patient. Dr. Mohs created a unique technique of color-coding excised specimens and developed a mapping process to accurately identify the location of remaining cancerous cells. This original “chemosurgery” technique, which is no longer performed, was very painful and sometimes took days to complete.
The surgical procedure has been extensively refined over the last seven decades, but it still relies on the fundamental principles of color-coded mapping of excised specimens and their thorough microscopic examination. Surgeons now excise the tumor in layers and examine the fresh tissue immediately. This reduces the normal treatment time to one visit and allows for immediate reconstruction of the wound.
In 1967, the American College of Mohs Micrographic Surgery and Cutaneous Oncology was formed to recognize surgeons who have completed specific, certified training in the Mohs technique. The College also functions as a regulatory and certification body for over 60 Mohs fellowship training programs and provides a source of continuing education for more than 700 practitioners of Mohs Micrographic Surgery.