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March 1992

Surgical Overutilization and the Mohs Surgeon

Author Affiliations

Department of Dermatology Emory University School of Medicine Atlanta, GA 30322

Arch Dermatol. 1992;128(3):410. doi:10.1001/archderm.1992.01680130132022

To the Editor.—  For the uninitiated, the article by Snow and Zweibel1 entitled "Freehand Skin Grafts Using the Shave Technique" that appeared in the May 1991 issue of the Archives is an interesting reexposition of an original technique described over 100 years ago by Thiersch.2 The authors describe their use of the Thiersch method well.In the case report presented, it is quite distressing to note that Mohs excision was employed on a tiny (5 × 7 mm), primary and superficial basal cancer, unless the patient was not charged for the Mohs excision, which was clearly not indicated for this tumor. Utilization of Mohs saucerization technique also destroyed the underlying perichondrium, which would not have happened with primary excision and skilled blunt dissection under the tumor. Thus, destruction of the perichondrial support bed for grafting and overutilization of Mohs surgery were simultaneously presented in the case report.In

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