Abstract

Introduction: Mohs’ micrographic surgery is a cancer resection technique that offers better histologyc control and healthy tissue saving, producing less surgical defects, less complex reconstructions and better aesthetic and functional results. The number histologyc and clinic complex cancer in the military hospital is high. The classic frozen Mohs’ micrographic surgery adaptation to paraffin technique is adjusted to the human and technical resources of our dermatology and pathology departments, decreasing costs, and getting reproducible and excellent results. 
Objetive: To show the efficacy of Mohs’ Micrographic Surgery paraffin variation in the high risk skin cancer treatment in the Dermatology Department Military Central Hospital of Bogota.
Materiales y Métodos: This is a descriptive study. One hundred four (104) patients with one hundred fourteen (114) skin cancers treated with Mohs’ Micrographic Surgery paraffin variation between June 2005 to July 2008 were included.
Results: One hundred fourteen (114) skin cancers in one hundred four (104) patients were included, one hundred seven (107) primary cancers and seven (7) recurrences. The skin cancers had an average time evolution of 20.5 months. One hundred two (102) (89,4%) were basal cell cancer, 7, (6%) squamous cell carcinoma, 1 (0.9%) malignant lentigo, and 3 (2.6%), other types of skin cancer. Nose (56%) followed by eye lid (15%) were the most frequent localizations. 83% of skin tumors had an equal o higher diameter to 6 millimeters. An average of 1.3 Mohs surgical times getting a histological cure of 96, 4% of cases was shown. The surgical correction was made by the dermatology surgeon in 78 cases. (68, 42%) The tissue saving in basal cell skin carcinoma was 35.1% and in squamous cell carcinoma 18.6% in comparison with the conventional resection borders. Follow up has been possible in 3 years (94%) of skin cancers belonging to 98 patients with out any recurrence in 3 years.
Conclusions: High risk skin cancer patients in the Military Hospital are beneficed from Mohs’ micrografic Surgery paraffin variation. This is a technique that is adjusted to the available resources, gets high curation rates, good health tissue saving, less aesthetic defects and allows surgical correction by the dermatology surgeon in most of the cases. This can be a reproducible technique for other institutions using the conventional histologic paraffin technique resources with only a short previous training.