Mohs Surgery

Mohs Surgery is a specialized technique for the removal of skin cancers, developed over 70 years ago by Dr. Frederic Mohs at the University of Wisconsin.

Each year, over 1,000,000 new cases of skin cancer are diagnosed in the United States. Many of these are adequately treated by simple surgical excision or electrodesiccation and curettage (burning and scraping). However, certain tumors in particularly high risk locations, large tumors that have recurred after previous surgery, or tumors in cosmetically important areas are best treated by Mohs Surgery.  This method requires both sequential excision of tissue and preparation of special frozen sections for microscopic examination under local anesthesia in the following steps:

    1. The area is anesthetized using a long acting local anesthetic.

    2. A thin layer of tissue surrounding and including the tumor is excised.

    3. At this point, a dressing is applied to the area and you will be able to rest in the reception room while the next step of the process takes place. This will take about 1-2 hours.

    4. A map is drawn that corresponds exactly to the tumor’s location, size and orientation.

    5. The excised tissue is sectioned, and each section is given a number, which is indicated on the map.

    6. Frozen sections are then performed on the total under surface and skin edges of each section. In this fashion, the entire surgical margin can be examined.

    7. Each section is examined under the microscope by Dr. Schulze. If the tumor is still present on any section, it is marked on its corresponding section on the map.

    8. Because the map corresponds exactly to the tumor, Dr. Schulze can go back to the area being excised and locate the exact area where the remaining skin cancer was found on the section microscopically.  If necessary, another thin layer is removed from the appropriate location.

    9. The entire procedure is repeated until all areas are free of cancer.

    10. The advantages of Mohs surgery are the ability to give you the highest cure rate possible while providing maximal conservation of normal skin for the best cosmetic result.

    11. The defect that remains will usually be repaired the same morning.

 

        Why Choose a Fellowship Trained Mohs Surgeon?

        Mohs micrographic surgery has set a new standard in skin cancer treatment. An increasing number of physicians are performing Mohs surgery, which is now widely accepted as the most effective treatment for most types of skin cancer. However, not all Mohs surgeons receive the same level of training as Keith E. Schulze, M.D., a fellowship trained Mohs surgeon.

        When it comes to your skin cancer treatment, you deserve no less than the best. Dr. Schulze has achieved the highest degree of Mohs surgery qualification by completing an American College of Mohs Surgery approved fellowship. For you, this means peace of mind, knowing that you will receive superior quality and competency, as well as an optimal outcome.

        Dr. Keith Schulze and ACMS - Committed to Superior Care

        The ACMS (http://www.skincancermohssurgery.org/) was established by Dr. Frederic Mohs himself, and its fellowship training program is generally acknowledged as the benchmark in Mohs surgery training. Through an extensive application and interview process, only the most qualified physicians are selected by ACMS to participate in a fellowship program. Participants must undergo a rigorous 1 to 2 year training program subsequent to completing a residency in dermatology.

        During fellowship training, Dr. Schulze studied and trained under the guidance of veteran Mohs College surgeons who have demonstrated expertise in Mohs surgery. A cornerstone of the ACMS fellowship training program is cultivating experience and judgment in each graduate. Since skin cancer occurs in a diversity of forms, degrees and locations, the program is set up to be thorough and stringent.

        Dr. Schulze met the following requirements in completing his ACMS Fellowship:

        • Participated in a minimum of 500 Mohs surgery cases
        • Learned to accurately interpret slides of tissue samples removed during Mohs surgery
        • Performed a vast array of reconstructions, ranging from the simplest to the most complex, multi-step repairs


        As an ACMS graduate, Dr. Schulze gained an uncommon level of exposure, including everything from challenging tumor locations to rare tumor pathology and complex wound reconstruction. You can rest assured that he has the training and experience to achieve the best outcome from your skin cancer treatment.

        For more information view the Mohs College Patient Education Video.
        http://www.mohscollege.org/about/video_patient_education.php