The safety of Mohs surgery: A prospective multicenter cohort study

Background: Complications associated with Mohs surgery have been evaluated by single-surgeon studies. While these studies provide evidence for the safety of the procedure, prospective, multicenter studies afford a higher level of clinical evidence and establish further the safety profile of Mohs surgery in the ambulatory setting. Objective: This study was designed to prospectively evaluate major and minor complications as well as postoperative pain associated with Mohs surgery. Methods: A multicenter prospective cohort study was conducted evaluating the rate of major and minor complications as well as postoperative pain associated with the treatment of skin cancer using Mohs surgery in 1550 patients with 1792 tumors. Follow-up was obtained in 1709 of the 1792 tumors treated (95.3%). Results: No major complications occurred during Mohs surgery or reconstruction. A total of 44 (2.6%) minor primary postoperative complications occurred during the study. On a scale from 0 to 10, the average peak postoperative pain level was 1.99. Limitations: Limitations of the study include the variability of practice patterns across practice sites as well as the 4.7% of patients lost to follow-up. Conclusion: Mohs surgery is performed with a high degree of safety and is well tolerated by patients. (J Am Acad Dermatol 2012; 67:1302-9.)