In the treatment of cancer of the lip a chemosurgical procedure offers certain important advantages. As previously described,1 the chemosurgical method was devised to provide a microscopically controlled means for the excision of various accessible forms of cancer. The method entails, first, chemical fixation of the suspected tissues in situ and, second, systematic excision and microscopic examination of the fixed tissues. This process of fixation, excision and microscopic examination is repeated until a microscopically cancer-free surface is reached. The main advantages conferred by the microscopic control are (1) unprecedented reliability and (2) conservatism.
Preparatory to the first application of the fixative the skin surrounding the cancer of the lip is freshly shaved, all crusts and scales are removed from the surface of the tumor and a keratolytic, such as dichloroacetic acid or a saturated solution of trichloroacetic acid, is applied until the surface becomes white. Keratolysis is necessary
MOHS FE. CHEMOSURGICAL TREATMENT OF CANCER OF THE LIPA MICROSCOPICALLY CONTROLLED METHOD OF EXCISION. Arch Surg. 1944;48(6):478-488. doi:10.1001/archsurg.1944.01230010491009