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March 1992

Surgical Overutilization and the Mohs Surgeon-Reply

Author Affiliations

Mohs Surgery Clinic University of Wisconsin 2800 University Ave Madison, WI53705

Arch Dermatol. 1992;128(3):410. doi:10.1001/archderm.1992.01680130132023

In Reply.—  Thank you for your letter commenting on our article.1 As you know, the use of freehand autographs dates back to antiquity to the Hindus. In recent times Reverdin (1869)2 is credited with transplanting 1-mm2 skin. Ollier (1872)2 reported the transplantation of larger areas (4- to 8-cm2). Carl Thiersch (1886)3 reported his technique 14 years later, which was essentially the same technique as that of Oilier. The technique for harvesting freehand skin grafts thus has many fathers.As you know, there is no absolute method of determining the peripheral margins of skin cancer. Even though, in some instances, the clinical margins of the tumor are visible, micrographic surgery has demonstrated that sometimes there are unpredictable projections of the tumor that may extend beyond the visible palpable borders.4 The 5- and 10-year local recurrence rate for previously untreated (primary) basal cell carcinoma has been reported

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